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Coly M, Adams D, Attarian S, Bouhour F, Camdessanché JP, Carey G, Cauquil C, Chanson JB, Chrétien P, Créange A, Delmont E, Fargeot G, Frachet S, Gendre T, Kuntzer T, Labeyrie C, Maisonobe T, Michaud M, Moulin M, Nicolas G, Noury JB, Péréon Y, Puma A, Sole G, Taithe F, Tard C, Théaudin M, Timsit S, Venditti L, Echaniz-Laguna A. Clinical, paraclinical and outcome features of 166 patients with acute anti-GQ1b antibody syndrome. J Neurol 2024:10.1007/s00415-024-12410-4. [PMID: 38767661 DOI: 10.1007/s00415-024-12410-4] [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: 01/31/2024] [Revised: 04/24/2024] [Accepted: 04/26/2024] [Indexed: 05/22/2024]
Abstract
BACKGROUND & PURPOSE In this retrospective study, we aimed at defining the clinical, paraclinical and outcome features of acute neurological syndromes associated with anti-GQ1b antibodies. RESULTS We identified 166 patients with neurological symptoms appearing in less than 1 month and anti-GQ1b antibodies in serum between 2012 and 2022. Half were female (51%), mean age was 50 years (4-90), and the most frequent clinical features were areflexia (80% of patients), distal upper and lower limbs sensory symptoms (78%), ophthalmoplegia (68%), sensory ataxia (67%), limb muscle weakness (45%) and bulbar weakness (45%). Fifty-three patients (32%) presented with complete (21%) and incomplete (11%) Miller Fisher syndrome (MFS), thirty-six (22%) with Guillain-Barre syndrome (GBS), one (0.6%) with Bickerstaff encephalitis (BE), and seventy-three (44%) with mixed MFS, GBS & BE clinical features. Nerve conduction studies were normal in 46% of cases, showed demyelination in 28%, and axonal loss in 23%. Anti-GT1a antibodies were found in 56% of cases, increased cerebrospinal fluid protein content in 24%, and Campylobacter jejuni infection in 7%. Most patients (83%) were treated with intravenous immunoglobulins, and neurological recovery was complete in 69% of cases at 1 year follow-up. One patient died, and 15% of patients relapsed. Age > 70 years, initial Intensive Care Unit (ICU) admission, and absent anti-GQ1b IgG antibodies were predictors of incomplete recovery at 12 months. No predictors of relapse were identified. CONCLUSION This study from Western Europe shows acute anti-GQ1b antibody syndrome presents with a large clinical phenotype, a good outcome in 2/3 of cases, and frequent relapses.
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Affiliation(s)
- Martin Coly
- Neurology Department, Bicêtre University Hospital, 94276, Le Kremlin-Bicêtre, France
- French National Reference Center for Rare Neuropathies (CERAMIC), 94276, Le Kremlin-Bicêtre, France
- Sorbonne University, 75013, Paris, France
| | - David Adams
- Neurology Department, Bicêtre University Hospital, 94276, Le Kremlin-Bicêtre, France
- French National Reference Center for Rare Neuropathies (CERAMIC), 94276, Le Kremlin-Bicêtre, France
- INSERM U1195, Paris-Saclay University, 94276, Le Kremlin-Bicêtre, France
| | - Shahram Attarian
- Reference Centre for Neuromuscular Diseases PACA RARE, Filnemus, EURO-NMD, CHU Timone, 13005, Marseille, France
| | - Françoise Bouhour
- Reference Centre for Neuromuscular Diseases PACA RARE, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, 69677, Bron Cedex, France
| | | | - Guillaume Carey
- Centre de Référence Des Maladies Neuromusculaires Nord/Est/Ile-de-France, Neurology Department, U1172, CHU Lille, 59000, Lille, France
| | - Cécile Cauquil
- Neurology Department, Bicêtre University Hospital, 94276, Le Kremlin-Bicêtre, France
- French National Reference Center for Rare Neuropathies (CERAMIC), 94276, Le Kremlin-Bicêtre, France
- INSERM U1195, Paris-Saclay University, 94276, Le Kremlin-Bicêtre, France
| | - Jean-Baptiste Chanson
- Department of Neurology, Reference Center for Neuromuscular Disorders NEIDF, European Reference Network for Neuromuscular Diseases EURO-NMD, University Hospital of Strasbourg, 67098, Strasbourg, France
| | - Pascale Chrétien
- Clinical Immunology Laboratory, Bicêtre University Hospital, 94276, Le Kremlin-Bicêtre, France
- Paris University, CNRS, INSERM, UTCBS, Paris, France
- Pathology Department, Bicêtre University Hospital, 94276, Le Kremlin-Bicêtre, France
| | - Alain Créange
- Neurology Department, Créteil University Hospital, UPEC, 94010, Créteil, France
| | - Emilien Delmont
- Reference Centre for Neuromuscular Diseases PACA RARE, Filnemus, EURO-NMD, CHU Timone, 13005, Marseille, France
| | - Guillaume Fargeot
- Neurology Department, Bicêtre University Hospital, 94276, Le Kremlin-Bicêtre, France
- French National Reference Center for Rare Neuropathies (CERAMIC), 94276, Le Kremlin-Bicêtre, France
| | - Simon Frachet
- Neurology Department, Limoges University Hospital, 87042, Limoges, France
| | - Thierry Gendre
- Neurology Department, Créteil University Hospital, UPEC, 94010, Créteil, France
| | - Thierry Kuntzer
- Department of Clinical Neurosciences, Lausanne University Hospital (CHUV) and University of Lausanne, 1011, Lausanne, Switzerland
| | - Céline Labeyrie
- Neurology Department, Bicêtre University Hospital, 94276, Le Kremlin-Bicêtre, France
- French National Reference Center for Rare Neuropathies (CERAMIC), 94276, Le Kremlin-Bicêtre, France
- INSERM U1195, Paris-Saclay University, 94276, Le Kremlin-Bicêtre, France
| | - Thierry Maisonobe
- Department of Clinical Neurophysiology, Pitié-Salpêtrière University Hospital, 75013, Paris, France
| | - Maud Michaud
- Neurology Department, NEIDF Reference Center, Nancy University Hospital, 54000, Nancy, France
| | - Maximilien Moulin
- Neurology Department, Reims University Hospital, 51092, Reims, France
| | - Guillaume Nicolas
- Nord-Est/Ile-de-France Neuromuscular Reference Center, Neurology Department, Raymond Poincaré Hospital, UVSQ Paris-Saclay University, Garches, France
| | - Jean-Baptiste Noury
- Centre de Référence Des Maladies Neuromusculaires AOC, INSERM, LBAI, UMR1227, CHRU de Brest, Brest, France
| | - Yann Péréon
- Reference Centre for Neuromuscular Disorders AOC Filnemus, Euro-NMD, Hôtel-Dieu, CHU Nantes, 44000, Nantes, France
| | - Angela Puma
- Peripheral Nervous System and Muscle Department, Université Côte d'Azur, Pasteur 2 Hospital, Centre Hospitalier Universitaire de Nice, Nice, France
| | - Guilhem Sole
- Reference Centre for Neuromuscular Diseases AOC, Filnemus, Euro-NMD, Neurology and Neuromuscular Diseases Department, Hôpital Pellegrin, CHU de Bordeaux, 33076, Bordeaux, France
| | - Frédéric Taithe
- Neurology Department, Clermont-Ferrand University Hospital, 63058, Clermont-Ferrand, France
| | - Céline Tard
- Centre de Référence Des Maladies Neuromusculaires Nord/Est/Ile-de-France, Neurology Department, U1172, CHU Lille, 59000, Lille, France
| | - Marie Théaudin
- Department of Clinical Neurosciences, Lausanne University Hospital (CHUV) and University of Lausanne, 1011, Lausanne, Switzerland
| | - Serge Timsit
- Centre de Référence Des Maladies Neuromusculaires AOC, INSERM, LBAI, UMR1227, CHRU de Brest, Brest, France
| | - Laura Venditti
- Neurology Department, Bicêtre University Hospital, 94276, Le Kremlin-Bicêtre, France
- French National Reference Center for Rare Neuropathies (CERAMIC), 94276, Le Kremlin-Bicêtre, France
| | - Andoni Echaniz-Laguna
- Neurology Department, Bicêtre University Hospital, 94276, Le Kremlin-Bicêtre, France.
- French National Reference Center for Rare Neuropathies (CERAMIC), 94276, Le Kremlin-Bicêtre, France.
- INSERM U1195, Paris-Saclay University, 94276, Le Kremlin-Bicêtre, France.
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Eigler C, McDougall L, Bauman A, Bernhardt P, Hentschel M, Blackham KA, Nicolas G, Fani M, Wild D, Cordier D. Radiolabeled Somatostatin Receptor Antagonist Versus Agonist for Peptide Receptor Radionuclide Therapy in Patients with Therapy-Resistant Meningioma: PROMENADE Phase 0 Study. J Nucl Med 2024; 65:573-579. [PMID: 38423782 DOI: 10.2967/jnumed.123.266817] [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: 10/05/2023] [Revised: 01/05/2024] [Indexed: 03/02/2024] Open
Abstract
Our primary aim was to compare the therapeutic index (tumor-to-bone marrow and tumor-to-kidney absorbed-dose ratios) of the new radiolabeled somatostatin receptor antagonist [177Lu]Lu-DOTA-JR11 with the established radiolabeled somatostatin receptor agonist [177Lu]Lu-DOTATOC in the same patients with progressive, standard therapy-refractory meningioma. Methods: In this prospective, single-center, open-label phase 0 study (NCT04997317), 6 consecutive patients were included: 3 men and 3 women (mean age, 63.5 y). Patients received 6.9-7.3 GBq (standard injected radioactivity) of [177Lu]Lu-DOTATOC followed by 3.3-4.9 GBq (2 GBq/m2 × body surface area) of [177Lu]Lu-DOTA-JR11 at an interval of 10 ± 1 wk. In total, 1 [177Lu]Lu-DOTATOC and 2-3 [177Lu]Lu-DOTA-JR11 treatment cycles were performed. Quantitative SPECT/CT was done at approximately 24, 48, and 168 h after injection of both radiopharmaceuticals to calculate meningioma and organ absorbed doses as well as tumor-to-organ absorbed-dose ratios (3-dimensional segmentation approach for meningioma, kidneys, liver, bone marrow, and spleen). Results: The median of the meningioma absorbed dose of 1 treatment cycle was 3.4 Gy (range, 0.8-10.2 Gy) for [177Lu]Lu-DOTATOC and 11.5 Gy (range, 4.7-22.7 Gy) for [177Lu]Lu-DOTA-JR11. The median bone marrow and kidney absorbed doses after 1 treatment cycle were 0.11 Gy (range, 0.05-0.17 Gy) and 2.7 Gy (range, 1.3-5.3 Gy) for [177Lu]Lu-DOTATOC and 0.29 Gy (range, 0.16-0.39 Gy) and 3.3 Gy (range, 1.6-5.9 Gy) for [177Lu]Lu-DOTA-JR11, resulting in a 1.4 (range, 0.9-1.9) times higher median tumor-to-bone marrow absorbed-dose ratio and a 2.9 (range, 2.0-4.8) times higher median tumor-to-kidney absorbed-dose ratio with [177Lu]Lu-DOTA-JR11. According to the Common Terminology Criteria for Adverse Events version 5.0, 2 patients developed reversible grade 2 lymphopenia after 1 cycle of [177Lu]Lu-DOTATOC. Afterward, 2 patients developed reversible grade 3 lymphopenia and 1 patient developed reversible grade 3 lymphopenia and neutropenia after 2-3 cycles of [177Lu]Lu-DOTA-JR11. No grade 4 or 5 adverse events were observed at 15 mo or more after the start of therapy. The disease control rate was 83% (95% CI, 53%-100%) at 12 mo or more after inclusion. Conclusion: Treatment with 1 cycle of [177Lu]Lu-DOTA-JR11 showed 2.2-5.7 times higher meningioma absorbed doses and a favorable therapeutic index compared with [177Lu]Lu-DOTATOC after injection of 1.4-2.1 times lower activities. The first efficacy results demonstrated a high disease control rate with an acceptable safety profile in the standard therapy for refractory meningioma patients. Therefore, larger studies with [177Lu]Lu-DOTA-JR11 are warranted in meningioma patients.
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Affiliation(s)
- Christopher Eigler
- Clinic for Radiology and Nuclear Medicine, University Hospital Basel, Basel, Switzerland
| | - Lisa McDougall
- Clinic for Radiology and Nuclear Medicine, University Hospital Basel, Basel, Switzerland
| | - Andreas Bauman
- Clinic for Radiology and Nuclear Medicine, University Hospital Basel, Basel, Switzerland
| | - Peter Bernhardt
- Department of Medical Radiation Sciences, Institution of Clinical Science, University of Gothenburg, Gothenburg, Sweden; and
| | - Michael Hentschel
- Clinic for Radiology and Nuclear Medicine, University Hospital Basel, Basel, Switzerland
| | - Kristine A Blackham
- Clinic for Radiology and Nuclear Medicine, University Hospital Basel, Basel, Switzerland
| | - Guillaume Nicolas
- Clinic for Radiology and Nuclear Medicine, University Hospital Basel, Basel, Switzerland
| | - Melpomeni Fani
- Clinic for Radiology and Nuclear Medicine, University Hospital Basel, Basel, Switzerland
| | - Damian Wild
- Clinic for Radiology and Nuclear Medicine, University Hospital Basel, Basel, Switzerland;
| | - Dominik Cordier
- Department of Neurosurgery, University Hospital Basel, Basel, Switzerland
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Fortanier E, Berling E, Zanin A, Le Guillou A, Micaleff J, Nicolas G, Lozeron P, Attarian S. Reply to letter on What biological markers could be used for diagnosis and monitoring of nitrous oxide abuse. Eur J Neurol 2024; 31:e16187. [PMID: 38124455 DOI: 10.1111/ene.16187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 12/08/2023] [Indexed: 12/23/2023]
Affiliation(s)
- Etienne Fortanier
- Reference Center for Neuromuscular Diseases and amyotrophic lateral sclerosis, La Timone University Hospital, Aix-Marseille University, Marseille, France
| | - Edouard Berling
- APHP, Service de Neurologie, Hôpital Raymond Poincaré, Centre de Référence Nord-Est-Ile-de-France, FHU PHENIX, Garches, France
- Université de Versailles Saint-Quentin-en-Yvelines, U1179 INSERM, Paris-Saclay, France
| | - Adrien Zanin
- Service de Physiologie Clinique-Explorations Fonctionnelles, DMU DREAM, APHP, Hôpital Lariboisière, Paris, France
- Laboratory for Vascular Translational Science, INSERM, U1148, Université de Paris, Paris, France
| | | | - Joelle Micaleff
- Marseille University Hospital, Clinical Pharmacology and Pharmacosurveillance, Regional Addictovigilance Center of Marseille, Marseille, France
- INSERM UMR1106, Aix-Marseille University, Marseille, France
| | - Guillaume Nicolas
- APHP, Service de Neurologie, Hôpital Raymond Poincaré, Centre de Référence Nord-Est-Ile-de-France, FHU PHENIX, Garches, France
- Université de Versailles Saint-Quentin-en-Yvelines, U1179 INSERM, Paris-Saclay, France
| | - Pierre Lozeron
- Service de Physiologie Clinique-Explorations Fonctionnelles, DMU DREAM, APHP, Hôpital Lariboisière, Paris, France
- Laboratory for Vascular Translational Science, INSERM, U1148, Université de Paris, Paris, France
| | - Shahram Attarian
- Reference Center for Neuromuscular Diseases and amyotrophic lateral sclerosis, La Timone University Hospital, Aix-Marseille University, Marseille, France
- INSERM, GMGF, Aix-Marseille University, Marseille, France
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Nicolas G. Lessons from genetic studies in Alzheimer disease. Rev Neurol (Paris) 2024:S0035-3787(24)00290-X. [PMID: 38429159 DOI: 10.1016/j.neurol.2023.12.006] [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: 11/22/2023] [Accepted: 12/27/2023] [Indexed: 03/03/2024]
Abstract
Research on Alzheimer disease (AD) genetics has provided critical advances to the knowledge of AD pathophysiological mechanisms. The etiology of AD can be divided into monogenic (autosomal dominant inheritance) and complex (multifactorial determinism). In monogenic AD, recent advances mainly concern mutation-associated mechanisms, presymptomatic clinical studies, and the search for modifiers of ages of onset that are still ongoing. In complex AD, genetic factors can be further categorized into three classes: (i) the APOE-ɛ4 and ɛ2 common alleles that represent a category by themselves as they are both common and with a strong impact on AD risk; (ii) common variants with a modest effect, identified in genome-wide association studies (GWAS); and (iii) rare variants with a moderate-to-strong effect, identified in case-control sequencing studies. Regarding APOE, odds ratios, available in multiple ethnicities, can now be converted into penetrance curves, although such curves remain to be performed in diverse ethnicities. In addition, advances in the understanding of mechanisms have been recently reported and rare APOE variants add to the complexity. In the GWAS category, novel loci have been discovered thanks to larger studies, doubling the number of hits as compared to the previous reference meta-analysis. However, such modest risk factors cannot be used in the clinic, neither individually, nor in genetic risk scores. In the category of rare variants, two novel genes, ABCA1 and ATP8B4 now add to the three main ones, TREM2, SORL1, and ABCA7. The study of such rare variants suggests oligogenic inheritance in some families, as also suggested by digenic penetrance curves for SORL1 loss-of-function variants with APOE-ɛ4. Cumulate frequencies of definite (so-called) rare risk factors are 2.3% to 3.6% (depending on thresholds on odds ratios) in control databases and many more remain to be classified and identified, showing how important these risk factors may be as part of the complex determinism of AD. A better understanding of these rare risk factors and their combined effects on each other, with common variants, and with environmental factors, should allow for a prediction of AD risk and, eventually, preventive medicine. Taken together, most genetic determinants of AD, in monogenic and in complex forms, point toward the aggregation of Aβ as a pivotal triggering factor, such that targeting it may be efficient as prevention in at-risk individuals. The role of neuroinflammation, microglia, and Tau pathology modulation are important sources of research for disease modification.
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Affiliation(s)
- G Nicolas
- Univ Rouen Normandie, Normandie Univ, Inserm U1245 and CHU Rouen, Department of Genetics and CNRMAJ, 76000 Rouen, France.
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Rouyer A, Tard C, Dessein AF, Spinazzi M, Bédat-Millet AL, Dimitri-Boulos D, Nadaj-Pakleza A, Chanson JB, Nicolas G, Douillard C, Laforêt P. Long-term prognosis of fatty-acid oxidation disorders in adults: Optimism despite the limited effective therapies available. Eur J Neurol 2024; 31:e16138. [PMID: 38015438 DOI: 10.1111/ene.16138] [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: 06/09/2023] [Revised: 09/25/2023] [Accepted: 10/21/2023] [Indexed: 11/29/2023]
Abstract
INTRODUCTION Fatty-acid oxidation disorders (FAODs) are recessive genetic diseases. MATERIALS AND METHODS We report here clinical and paraclinical data from a retrospective study of 44 adults with muscular FAODs from six French reference centers for neuromuscular or metabolic diseases. RESULTS The study cohort consisted of 44 adult patients: 14 with carnitine palmitoyl transferase 2 deficiency (32%), nine with multiple acyl-CoA deficiency (20%), 13 with very long-chain acyl-CoA dehydrogenase deficiency (30%), three with long-chain 3-hydroxyacyl-CoA dehydrogenase deficiency (7%), and five with short-chain acyl-CoA dehydrogenase deficiency (11%). Disease onset occurred during childhood in the majority of patients (59%), with a mean age at onset of 15 years (range = 0.5-35) and a mean of 12.6 years (range = 0-58) from disease onset to diagnosis. The principal symptoms were acute muscle manifestations (rhabdomyolysis, exercise intolerance, myalgia), sometimes associated with permanent muscle weakness. Episodes of rhabdomyolysis were frequent (84%), with a mean creatinine kinase level of 68,958 U/L (range = 660-300,000). General metabolic complications were observed in 58% of patients, respiratory manifestations in 18% of cases, and cardiological manifestations in 9% of cases. Fasting acylcarnitine profile was used to orient genetic explorations in 65% of cases. After a mean follow-up of 10 years, 33% of patients were asymptomatic and 56% continued to display symptoms after exercise. The frequency of rhabdomyolysis decreased after diagnosis in 64% of cases. CONCLUSION A standardized register would complete this cohort description of muscular forms of FAODs with exhaustive data, making it possible to assess the efficacy of therapeutic protocols in real-life conditions and during the long-term follow-up of patients.
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Affiliation(s)
- Alice Rouyer
- Neurology Department, Raymond Poincaré University Hospital, Assitance Publique des Hopitaux de Paris, Garches, France
| | - Céline Tard
- Neurology Department, University of Lille, Inserm, Centre Hospialo-Niversitaire Lille, U1172-LilNCog (JPARC)-Lille Neuroscience and Cognition, Nord-Est-Ile-de-France Neuromuscular Reference Center, Cognitive-Motor Unit of Expertise, Centre Hospitalo-Régional Universitaire Lille, Lille, France
| | - Anne-Frédérique Dessein
- Institute of Biochemistry, Biology, and Pathology Center, Metabolism Department and Medical Reference Center for Inherited Metabolic Diseases, Lille University Hospital, Lille, France
| | - Marco Spinazzi
- Department of Neurology, Neuromuscular Reference Center Atlantique Occitanie Caraïbe, University Hospital, Angers, France
| | | | - Dalia Dimitri-Boulos
- Internal Medicine Department, Quinze-Vingts National Ophthalmology Hospital, Paris, France
| | - Aleksandra Nadaj-Pakleza
- Department of Neurology, Reference Center for Neuromuscular Disorders Nord-Est-Ile-de-France, European Reference Network for Rare Neuromuscular Diseases, University Hospital of Strasbourg, Strasbourg, France
| | - Jean-Baptiste Chanson
- Department of Neurology, Reference Center for Neuromuscular Disorders Nord-Est-Ile-de-France, European Reference Network for Rare Neuromuscular Diseases, University Hospital of Strasbourg, Strasbourg, France
| | - Guillaume Nicolas
- Neurology Department, Raymond Poincaré University Hospital, Assitance Publique des Hopitaux de Paris, Garches, France
- Nord-Est-Ile-de-France Neuromuscular Reference Center, Fédération Hospitalo-Universitaire PHENIX, Garches, France
- U 1179 INSERM, Paris-Saclay University, Montigny-le-Bretonneux, France
| | - Claire Douillard
- Endocrinology-Diabetology-Metabolism Department and Medical Reference Center for Inherited Metabolic Diseases Jeanne de Flandre Hospital, Centre Hospitalo-Régional Universitaire Lille, Lille, France
| | - Pascal Laforêt
- Neurology Department, Raymond Poincaré University Hospital, Assitance Publique des Hopitaux de Paris, Garches, France
- Nord-Est-Ile-de-France Neuromuscular Reference Center, Fédération Hospitalo-Universitaire PHENIX, Garches, France
- U 1179 INSERM, Paris-Saclay University, Montigny-le-Bretonneux, France
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Friebe L, Freitag MT, Braun M, Nicolas G, Bauman A, Bushnell D, Christ E, Wild D. Peptide Receptor Radionuclide Therapy Is Effective for Clinical Control of Symptomatic Metastatic Insulinoma: A Long-Term Retrospective Analysis. J Nucl Med 2024; 65:228-235. [PMID: 38164592 DOI: 10.2967/jnumed.123.265894] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 07/25/2023] [Indexed: 01/03/2024] Open
Abstract
Metastatic insulinoma is a rare malignant neuroendocrine tumor characterized by inappropriate insulin secretion, resulting in life-threatening hypoglycemia, which is often difficult to treat. There is currently very limited information about the efficacy of peptide receptor radionuclide therapy (PRRT) for clinical control of hypoglycemia. The aim of this long-term retrospective study was to evaluate the therapeutic efficacy of PRRT for improving hypoglycemia, to evaluate the change of medication after PRRT, and to calculate progression-free survival (PFS) and overall survival (OS). Methods: Inclusion criteria were histologically proven somatostatin receptor-positive metastatic malignant insulinoma and at least 2 cycles of [90Y]Y-DOTATOC or [177Lu]Lu-DOTATOC therapy from early 2000 to early 2022. A semiquantitative scoring system was used to quantify the severity and frequency of hypoglycemic episodes under background antihypoglycemic therapy (somatostatin analog, diazoxide, everolimus, corticosteroids): score 0, no hypoglycemic episodes; score 1, hypoglycemic events requiring additional conservative treatment with optimization of nutrition; score 2, severe hypoglycemia necessitating hospitalization and combined medication or history of hypoglycemic coma. Hypoglycemic score before and after PRRT was analyzed. Time of benefit was defined as a time range of fewer hypoglycemic episodes in the observation period than at baseline. Information on antihypoglycemic medication before and after therapy, PFS, and OS was recorded. Results: Twenty-six of 32 patients with a total of 106 [90Y]Y-DOTATOC/[177Lu]Lu-DOTATOC cycles were included. The average observation period was 21.5 mo (range, 2.3-107.4 mo). Before therapy, 81% (n = 21) of the patients had a hypoglycemia score of 2 and 19% (n = 5) had a score of 1. After PRRT, 81% of patients (n = 21) had a decreased score, and the remaining 5 patients showed a stable situation. There was temporary worsening of hypoglycemia just after injection of [90Y]Y-DOTATOC/[177Lu]Lu-DOTATOC in 19% of patients. The average time of benefit in the observation period was 17.2 mo (range, 0-70.2 mo). Antihypoglycemic medication reduction was achieved in 58% (n = 15) of patients. The median OS and PFS after the start of PRRT were 19.7 mo (95% CI, 6.5-32.9 mo) and 11.7 mo (95% CI, 4.9-18.5 mo), respectively. Conclusion: To our knowledge, our study included the largest cohort of patients with malignant insulinoma to be evaluated. Long-lasting symptom control and reduction of antihypoglycemic medications were shown in most patients after late-line PRRT.
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Affiliation(s)
- Liene Friebe
- Clinic of Radiology and Nuclear Medicine, University Hospital Basel, Basel, Switzerland
| | - Martin T Freitag
- Clinic of Radiology and Nuclear Medicine, University Hospital Basel, Basel, Switzerland
- ENETS Center of Excellence for Neuroendocrine and Endocrine Tumors, University Hospital Basel, Basel, Switzerland
- Clinic of Nuclear Medicine, University Hospital Freiburg, Freiburg, Germany
| | - Martin Braun
- Clinic of Radiology and Nuclear Medicine, University Hospital Basel, Basel, Switzerland
| | - Guillaume Nicolas
- Clinic of Radiology and Nuclear Medicine, University Hospital Basel, Basel, Switzerland
- ENETS Center of Excellence for Neuroendocrine and Endocrine Tumors, University Hospital Basel, Basel, Switzerland
| | - Andreas Bauman
- Clinic of Radiology and Nuclear Medicine, University Hospital Basel, Basel, Switzerland
| | - David Bushnell
- Division of Nuclear Medicine, Department of Radiology, University of Iowa Hospitals and Clinics, Iowa City, Iowa; and
| | - Emanuel Christ
- ENETS Center of Excellence for Neuroendocrine and Endocrine Tumors, University Hospital Basel, Basel, Switzerland
- Department of Endocrinology, Diabetology, and Metabolism, University Hospital Basel, Basel, Switzerland
| | - Damian Wild
- Clinic of Radiology and Nuclear Medicine, University Hospital Basel, Basel, Switzerland;
- ENETS Center of Excellence for Neuroendocrine and Endocrine Tumors, University Hospital Basel, Basel, Switzerland
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Raineteau Y, Pla R, Bideau B, Bideau N, Nicolas G. From dry-land to the water: training and testing practices of strength and conditioning coaches in high level French sprint swimmers. Front Sports Act Living 2024; 5:1338856. [PMID: 38283120 PMCID: PMC10811196 DOI: 10.3389/fspor.2023.1338856] [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: 11/15/2023] [Accepted: 12/29/2023] [Indexed: 01/30/2024] Open
Abstract
Introduction The aim of this study was to explore training and testing practices from Strength & Conditioning (S&C) coaches who manage groups of high-level French swimmers in elite training centers. The transfer of abilities from dry-land to in situ condition was also investigated. Methods 24 French S&C coaches completed a survey via an online platform. Frequency analyses were made for quantitative and qualitative responses, the level of significance set for this study was p ≤ 0.05. Results Core stability, Strength & Power were the three most targeted qualities. Core strengthening in all its forms, Bench Press & Squat were the three most prescribed exercises. 79% of S&C coaches adapted exercises according to different parameters. Most of the coaches indicated that dry-land S&C sessions were preferentially placed before in-water sessions. Very varied exercises were used in-water to make the transfer from dry-land more effective. 87% of participants monitored the training load and 38% assessed the force and velocity parameters for some S&C exercises. Discussion Dry-land training practices of S&C coaches were mostly in line with scientific recommendations. In the light of results of the questionnaire, it would appear that testing procedures might be a key issue for transferring qualities from dry-land to in situ.
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Affiliation(s)
- Yannis Raineteau
- M2S Laboratory—Laboratoire Mouvement Sport Santé, Université Rennes 2, Rennes, France
- Optimization Service, Fédération Française de Natation, Clichy, France
| | - Robin Pla
- Optimization Service, Fédération Française de Natation, Clichy, France
| | - Benoit Bideau
- M2S Laboratory—Laboratoire Mouvement Sport Santé, Université Rennes 2, Rennes, France
- MIMETIC-Team, INRIA Rennes Bretagne Atlantique, Rennes, France
| | - Nicolas Bideau
- M2S Laboratory—Laboratoire Mouvement Sport Santé, Université Rennes 2, Rennes, France
- MIMETIC-Team, INRIA Rennes Bretagne Atlantique, Rennes, France
| | - Guillaume Nicolas
- M2S Laboratory—Laboratoire Mouvement Sport Santé, Université Rennes 2, Rennes, France
- MIMETIC-Team, INRIA Rennes Bretagne Atlantique, Rennes, France
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von Niederhäusern PA, Seppi C, Sandkühler R, Nicolas G, Haerle SK, Cattin PC. Augmented reality for sentinel lymph node biopsy. Int J Comput Assist Radiol Surg 2024; 19:171-180. [PMID: 37747574 PMCID: PMC10770201 DOI: 10.1007/s11548-023-03014-w] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 08/29/2023] [Indexed: 09/26/2023]
Abstract
INTRODUCTION Sentinel lymph node biopsy for oral and oropharyngeal squamous cell carcinoma is a well-established staging method. One variation is to inject a radioactive tracer near the primary tumor of the patient. After a few minutes, audio feedback from an external hand-held [Formula: see text]-detection probe can monitor the uptake into the lymphatic system. Such probes place a high cognitive load on the surgeon during the biopsy, as they require the simultaneous use of both hands and the skills necessary to correlate the audio signal with the location of tracer accumulation in the lymph nodes. Therefore, an augmented reality (AR) approach to directly visualize and thus discriminate nearby lymph nodes would greatly reduce the surgeons' cognitive load. MATERIALS AND METHODS We present a proof of concept of an AR approach for sentinel lymph node biopsy by ex vivo experiments. The 3D position of the radioactive [Formula: see text]-sources is reconstructed from a single [Formula: see text]-image, acquired by a stationary table-attached multi-pinhole [Formula: see text]-detector. The position of the sources is then visualized using Microsoft's HoloLens. We further investigate the performance of our SLNF algorithm for a single source, two sources, and two sources with a hot background. RESULTS In our ex vivo experiments, a single [Formula: see text]-source and its AR representation show good correlation with known locations, with a maximum error of 4.47 mm. The SLNF algorithm performs well when only one source is reconstructed, with a maximum error of 7.77 mm. For the more challenging case to reconstruct two sources, the errors vary between 2.23 mm and 75.92 mm. CONCLUSION This proof of concept shows promising results in reconstructing and displaying one [Formula: see text]-source. Two simultaneously recorded sources are more challenging and require further algorithmic optimization.
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Affiliation(s)
| | - Carlo Seppi
- Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland
| | - Robin Sandkühler
- Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland
| | - Guillaume Nicolas
- Nuclear Medicine Clinic, University Hospital Basel, Basel, Switzerland
| | | | - Philippe C Cattin
- Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland
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Raineteau Y, Nicolas G, Bideau B, Bideau N, Pla R. Associations between load-velocity profiling and race parameters of elite swimmers in the 100 and 200m freestyle events. Front Sports Act Living 2023; 5:1326106. [PMID: 38162699 PMCID: PMC10757606 DOI: 10.3389/fspor.2023.1326106] [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: 10/22/2023] [Accepted: 11/30/2023] [Indexed: 01/03/2024] Open
Abstract
Introduction Improving swimming performance involves assessments of biomechanical variables of the stroke, and it can be achieved using semi-tethered swimming tests. The aim of this study was thus to investigate the associations between load-velocity (L-V) profiles, from a semi-tethered swimming protocol and race variables in the 100 m and 200 m freestyle events. Methods Eight swimmers completed a L-V profiling protocol consisting of four sprints (25 m, 25 m, 20 m, 15 m) against increasing loads (0.1, 2.0, 4.0, 6.0 kg respectively) with complete recovery between repetitions (>5 min). The L-V linear regression was used to estimate maximal velocity (V0) and body mass normalized load (rL0). Race variables such as clean swimming speed (V), stroke rate (SR), distance per cycle (SL) and stroke index (SI) were assessed from video analysis of 100 m and 200 m freestyle events taking place 3-4 days after the L-V protocol. Results L-V results showed high levels of speed (mean ± SD: 1.87 ± 0.04 m/s) and heavy maximal relative loads (mean ± SD: 38.5 ± 6.51 as % of body mass). Swimmers also achieved high-level performances in the 100 m (mean ± SD time: 51.95 ± 0.75 s) and the 200 m (mean ± SD time: 113.85 ± 2.67 s). For the 100 m events, the maximal relative load showed strong correlation with performance (r = 0.63) whereas trivial correlation was observed for the 200 m events (r = 0.12). SR on the 100 m and the 200 m also showed very strong association with rL0 (r = 0.83) and a strong association with V0 (r = 0.68) respectively. Conclusion The relationships between L-V variables and race variables depend on the distance of the event. However, L-V variables seem to be less related to SR and SL evolutions for the 100 m than in the 200 m event. Moreover, L-V profiles tend to be more related to the 100 m than 200 m freestyle performance. L-V profile should be interpreted taking into consideration the specific physiological and biomechanical constraints of the main events of the swimmer.
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Affiliation(s)
- Yannis Raineteau
- M2S Laboratory—Laboratoire Mouvement Sport Santé, Université Rennes 2, Rennes, France
- Optimization service, Fédération Française de Natation, Clichy, France
| | - Guillaume Nicolas
- M2S Laboratory—Laboratoire Mouvement Sport Santé, Université Rennes 2, Rennes, France
- MIMETIC-Team, INRIA Rennes Bretagne Atlantique, Rennes, France
| | - Benoit Bideau
- M2S Laboratory—Laboratoire Mouvement Sport Santé, Université Rennes 2, Rennes, France
- MIMETIC-Team, INRIA Rennes Bretagne Atlantique, Rennes, France
| | - Nicolas Bideau
- M2S Laboratory—Laboratoire Mouvement Sport Santé, Université Rennes 2, Rennes, France
- MIMETIC-Team, INRIA Rennes Bretagne Atlantique, Rennes, France
| | - Robin Pla
- Optimization service, Fédération Française de Natation, Clichy, France
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Fortanier E, Berling E, Zanin A, Guillou AL, Micaleff J, Nicolas G, Lozeron P, Attarian S. How to distinguish Guillain-Barré syndrome from nitrous oxide-induced neuropathy: A 2-year, multicentric, retrospective study. Eur J Neurol 2023; 30:3296-3306. [PMID: 37494104 DOI: 10.1111/ene.15998] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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: 03/27/2023] [Revised: 07/10/2023] [Accepted: 07/20/2023] [Indexed: 07/27/2023]
Abstract
BACKGROUND Recreational use of nitrous oxide (N2 O) has dramatically increased in recent years, resulting in numerous cases of acute sensorimotor tetraparesis secondary to nitrous oxide-induced neuropathy (N2 On). Challenging clinical features can mimic Guillain-Barré syndrome (GBS), the main differential diagnosis upon admission. The most sensitive biomarkers for distinguishing between these two conditions remain to be determined. METHODS Fifty-eight N2 On patients from three referral centers were retrospectively included over a 2-year period and compared to GBS patients hospitalized during the same timeframe (47 patients). Collected demographic, clinical, biological, and electrophysiological data were compared between the two groups. RESULTS The typical N2 On clinical pattern included distal sensorimotor deficit in lower limbs with absent reflexes, proprioceptive ataxia, and no cranial involvement (56.7% of our cohort). Misleading GBS-like presentations were found in 14 N2 On patients (24.1%), and 13 patients (22.4%) did not report N2 O use during initial interview. Only half the N2 On patients presented with reduced vitamin B12 serum levels upon admission. A slightly increased cut-off (<200 pmol/L) demonstrated 85.1% sensitivity and 84.5% specificity in distinguishing N2 On from GBS. Only 6.9% of N2 On patients met the criteria for primary demyelination (p < 0.01), with only one presenting conduction blocks. A diagnostic algorithm combining these two biomarkers successfully classified all GBS-like N2 On patients. CONCLUSIONS Vitamin B12 serum level < 200 pmol/L cut-off and conduction blocks in initial electrophysiological study are the two most sensitive biomarkers for rapidly distinguishing N2 On from GBS patients. These two parameters are particularly useful in clinically atypical N2 On with GBS-like presentation.
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Affiliation(s)
- Etienne Fortanier
- Reference Center for Neuromuscular Diseases and ALS, La Timone University Hospital, Aix-Marseille University, Marseille, France
| | - Edouard Berling
- APHP, Service de Neurologie, Hôpital Raymond Poincaré, Centre de référence Nord-Est-Ile-de-France, FHU PHENIX, Garches, France
- Université de Versailles Saint-Quentin-en-Yvelines, U 1179 INSERM, Paris-Saclay, France
| | - Adrien Zanin
- Service de Physiologie Clinique-Explorations Fonctionnelles, DMU DREAM, APHP, Hôpital Lariboisière, Paris, France
- Laboratory for Vascular Translational Science, U1148, Université de Paris, INSERM, Paris, France
| | | | - Joelle Micaleff
- Marseille University Hospital, Clinical Pharmacology and Pharmacosurveillance, Regional Addictovigilance Center of Marseille, Marseille, France
- Aix-Marseille University, INSERM UMR 1106, Marseille, France
| | - Guillaume Nicolas
- APHP, Service de Neurologie, Hôpital Raymond Poincaré, Centre de référence Nord-Est-Ile-de-France, FHU PHENIX, Garches, France
- Université de Versailles Saint-Quentin-en-Yvelines, U 1179 INSERM, Paris-Saclay, France
| | - Pierre Lozeron
- Service de Physiologie Clinique-Explorations Fonctionnelles, DMU DREAM, APHP, Hôpital Lariboisière, Paris, France
- Laboratory for Vascular Translational Science, U1148, Université de Paris, INSERM, Paris, France
| | - Shahram Attarian
- Reference Center for Neuromuscular Diseases and ALS, La Timone University Hospital, Aix-Marseille University, Marseille, France
- Aix-Marseille University, INSERM, GMGF, Marseille, France
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Cintas P, Bouhour F, Cauquil C, Masingue M, Tard C, Sacconi S, Delmont E, Choumert A, Chanson JB, Michaud M, Solé G, Cassereau J, Noury JB, Nicolas G, Bellance R, Péréon Y, Camdessanché JP, Magy L, Attarian S. Current clinical management of CIDP with immunoglobulins in France: An expert opinion. Rev Neurol (Paris) 2023; 179:914-922. [PMID: 37019741 DOI: 10.1016/j.neurol.2023.03.010] [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: 09/13/2022] [Revised: 01/05/2023] [Accepted: 03/13/2023] [Indexed: 04/05/2023]
Abstract
Treatment strategies in chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) must be adapted on a case-to-case basis. Validated and reproducible tools for monitoring treatment response are required at diagnosis, when initiating treatment and throughout follow-up. A task force of French neurologists, experts in neuromuscular disease reference centers, was assembled to provide expert advice on the management of typical CIDP with intravenous immunoglobulins (Ig), and to harmonize treatment practices in public and private hospitals. The task force also referred to the practical experience of treating CIDP with Ig at the diagnostic, induction and follow-up stages, including the assessment and management of Ig dependence, and following the recommendations of the French health agency.
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Affiliation(s)
- P Cintas
- Service de neurologie, CHU de Toulouse Purpan, centre de référence de pathologies neuromusculaires, Toulouse, France
| | - F Bouhour
- Service d'ENMG et de pathologies neuromusculaires, hospices civils de Lyon, hôpital neurologique, Lyon, France
| | - C Cauquil
- Service de neurologie, AP-HP Kremlin-Bicêtre, Paris, France
| | - M Masingue
- Service de neuromyologie, centre de référence des maladies neuromusculaires Nord/Est/Île-de-France, AP-HP Pitié-Salpêtrière, Paris, France
| | - C Tard
- Unité d'expertise cognitivo-motrice, U1172, service de neurologie, CHU de Lille, centre de référence des maladies neuromusculaires Nord/Est/Île-de-France, Lille, France
| | - S Sacconi
- Système nerveux périphérique et muscle, CHU de Nice, université Côte d'Azur, Nice, France
| | - E Delmont
- Service de neurologie, centre de référence des maladies neuromusculaires et SLA, hôpital de la Timone, Marseille, France
| | - A Choumert
- Service des maladies neurologiques rares, CHU de la Réunion, groupe hospitalier Sud Réunion, Saint-Pierre, France
| | - J-B Chanson
- Service de neurologie, CHRU Strasbourg, centre de référence neuromusculaire Nord/Est/Île-de-France, Strasbourg, France
| | - M Michaud
- Service de neurologie, CHU de Nancy, hôpital Central, Nancy, France
| | - G Solé
- Service de neurologie et maladies neuromusculaires, CHU de Bordeaux, centre de référence des maladies neuromusculaires AOC, hôpital Pellegrin, Bordeaux, France
| | - J Cassereau
- CHU d'Angers, centre de référence des maladies neuromusculaires AOC, Angers, France
| | - J-B Noury
- Inserm, LBAI, UMR1227, centre de référence des maladies neuromusculaires AOC, CHRU de Brest, Brest, France
| | - G Nicolas
- Service de neurologie, centre de référence neuromusculaire Nord-Est/Île-de-France , Université UVSQ Paris-Saclay, hôpital Raymond-Poincaré, Garches, France
| | - R Bellance
- CeRCa, site constitutif de centre de référence caribéen des maladies neuromusculaires rares, CHU de Martinique, hôpital P. Zobda-Quitman, Fort-de-France, France
| | - Y Péréon
- Explorations fonctionnelles, Filnemus, Euro-NMD, Nantes université, CHU de Nantes, centre de référence AOC, Nantes, France
| | - J-P Camdessanché
- Service de neurologie, CHU de Saint-Étienne, hôpital Nord, Saint-Étienne, France
| | - L Magy
- Service et laboratoire de neurologie, centre de référence neuropathies périphériques rares, NNerf, UR 20218 NeurIT, CHU de Limoges, hôpital Dupuytren, Limoges, France
| | - S Attarian
- Service de neurologie, centre de référence des maladies neuromusculaires et SLA, hôpital de la Timone, Marseille, France.
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Bouvet A, Pla R, Delhaye E, Nicolas G, Bideau N. Profiles of stroke regulations discriminate between finishing positions during international open water races. J Sports Sci 2023; 41:1309-1316. [PMID: 37824415 DOI: 10.1080/02640414.2023.2268902] [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: 03/16/2023] [Accepted: 10/03/2023] [Indexed: 10/14/2023]
Abstract
This study aims to identify stroke regulation profiles and tipping-points in stroke regulation timing during international open water races according to performance level. Twelve elite or world-class swimmers were analysed during 18 international races. Stroke rate and jerk cost were computed cycle-to-cycle using an Inertial Measurement Unit and regulations profiles fitted using polynomials. We performed two-ways mixed-ANOVA to compare stroke kinematics among race segments and performance groups (G1 -fastest- to G3 -slowest-). Swimmers displayed specific regulation profiles (i.e., J-shape with end-spurt, J-shape without end-spurt and reverse L-shape for stroke rate and U-shape, reverse J-shape and reverse L-shape for jerk cost, for respectively G1, G2 and G3) with significant effect of race segment on stroke kinematics for G1 and G2. We highlighted tipping-points in stroke regulations profiles (TP1 and TP2) at respectively 30% and 75% of the race with greater magnitude in G1 than G2. TP1 reflects the end of a stroke economy period (0-30%) and TP2 the end of a progressive increase in stroke kinematics (30-75%) towards end-spurt (75-100%). Open water races follow a high-grading dynamics requiring biomechanical regulations along the race. Targeting stroke rate reserve and management of stroke smoothness should be considered during training of open water swimmers.
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Affiliation(s)
- Antoine Bouvet
- M2S laboratory (Movement, Sport & Health), University Rennes 2, ENS Rennes, Bruz, France
- MIMETIC-Analysis-Synthesis Approach for Virtual Human Simulation, INRIA Rennes Bretagne Atlantique, Rennes, France
- CREST (Center for Research in Economics and Statistics), ENSAI, Bruz, France
| | - Robin Pla
- French Swimming Federation, Clichy, France
- IRMES-URP 7329, Institut de Recherche Médicale et d'Epidémiologie du Sport, Université Paris Cité, Paris, France
| | - Erwan Delhaye
- M2S laboratory (Movement, Sport & Health), University Rennes 2, ENS Rennes, Bruz, France
- MIMETIC-Analysis-Synthesis Approach for Virtual Human Simulation, INRIA Rennes Bretagne Atlantique, Rennes, France
| | - Guillaume Nicolas
- M2S laboratory (Movement, Sport & Health), University Rennes 2, ENS Rennes, Bruz, France
- MIMETIC-Analysis-Synthesis Approach for Virtual Human Simulation, INRIA Rennes Bretagne Atlantique, Rennes, France
| | - Nicolas Bideau
- M2S laboratory (Movement, Sport & Health), University Rennes 2, ENS Rennes, Bruz, France
- MIMETIC-Analysis-Synthesis Approach for Virtual Human Simulation, INRIA Rennes Bretagne Atlantique, Rennes, France
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Krief N, Gabriel R, Cauquil C, Adams D, Fargeot G, Maisonobe T, Osman D, Schmidt M, Chanson JB, Bigaut K, Sole G, Tard C, Nicolas G, Pereon Y, Aure K, Lagrange E, Lefilliatre M, Labeyrie MA, Echaniz-Laguna A. Clinical features and maternal and fetal outcomes in women with Guillain-Barré syndrome in pregnancy. J Neurol 2023; 270:4498-4506. [PMID: 37294323 PMCID: PMC10252168 DOI: 10.1007/s00415-023-11808-w] [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: 05/14/2023] [Revised: 06/02/2023] [Accepted: 06/03/2023] [Indexed: 06/10/2023]
Abstract
BACKGROUND Guillain-Barre syndrome (GBS) is an acute inflammatory polyradiculoneuropathy rarely observed during pregnancy. METHODS In this retrospective study, we analyzed the characteristics of pregnant women with GBS (pGBS) diagnosed in French University Hospitals in the 2002-2022 period and compared them with a reference group of same-age non-pregnant women with GBS (npGBS) identified in the same institutions & timeframe. RESULTS We identified 16 pGBS cases. Median age was 31 years (28-36), and GBS developed in the 1st, 2nd, and 3rd trimester in 31%, 31% and 38% of cases respectively. A previous infection was identified in six cases (37%), GBS was demyelinating in nine cases (56%), and four patients (25%) needed respiratory assistance. Fifteen patients (94%) were treated with intravenous immunoglobulins, and neurological recovery was complete in all cases (100%). Unscheduled caesarean section was needed in five cases (31%), and two fetuses (12.5%) died because of cytomegalovirus (CMV) infection (1 case) and HELLP (Hemolysis, Elevated Liver enzymes and Low Platelets) syndrome (1 case). In comparison with a reference group of 18 npGBS women with a median age of 30 years (27-33), pGBS patients more frequently had CMV infection (31% vs 11%), had a prolonged delay between GBS onset and hospital admission (delay > 7 days: 57% vs 12%), more often needed ICU admission (56% vs 33%) and respiratory assistance (25% vs 11%), and more often presented with treatment-related fluctuations (37% vs 0%). CONCLUSIONS This study shows GBS during pregnancy is a severe maternal condition with significant fetal mortality.
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Affiliation(s)
- Nolwenn Krief
- Neurology Department, APHP, CHU de Bicêtre, 94276, Le Kremlin-Bicêtre, France
- French National Reference Center for Rare Neuropathies (NNERF), 94276, Le Kremlin-Bicêtre, France
- INSERM U1195, Paris-Saclay University, Le Kremlin-Bicêtre, France
| | - René Gabriel
- Obstetrics and Gynecology Department, CHU de Reims, Reims, France
| | - Cécile Cauquil
- Neurology Department, APHP, CHU de Bicêtre, 94276, Le Kremlin-Bicêtre, France
- French National Reference Center for Rare Neuropathies (NNERF), 94276, Le Kremlin-Bicêtre, France
- INSERM U1195, Paris-Saclay University, Le Kremlin-Bicêtre, France
| | - David Adams
- Neurology Department, APHP, CHU de Bicêtre, 94276, Le Kremlin-Bicêtre, France
- French National Reference Center for Rare Neuropathies (NNERF), 94276, Le Kremlin-Bicêtre, France
- INSERM U1195, Paris-Saclay University, Le Kremlin-Bicêtre, France
| | - Guillaume Fargeot
- Neurology Department, APHP, CHU Pitié-Salpêtrière, 75013, Paris, France
- Reference Center for Neuromuscular Disorders, APHP, Sorbonne Université, CHU Pitié-Salpêtrière, Paris, France
| | - Thierry Maisonobe
- Neurology Department, APHP, CHU Pitié-Salpêtrière, 75013, Paris, France
- Reference Center for Neuromuscular Disorders, APHP, Sorbonne Université, CHU Pitié-Salpêtrière, Paris, France
| | - David Osman
- Intensive Care Department, APHP, CHU de Bicêtre, 94276, Le Kremlin-Bicêtre, France
| | - Matthieu Schmidt
- Service de Médecine Intensive Réanimation, Institut de Cardiologie, APHP, Sorbonne Université Hôpital Pitié-Salpêtrière, Paris, France
| | - Jean-Baptiste Chanson
- Department of Neurology, Strasbourg University Hospital, Strasbourg, France
- Neuromuscular Reference Center Nord/Est/Ile de France, Department of Neurology, Strasbourg University Hospital, Strasbourg, France
| | - Kevin Bigaut
- Department of Neurology, Strasbourg University Hospital, Strasbourg, France
- Neuromuscular Reference Center Nord/Est/Ile de France, Department of Neurology, Strasbourg University Hospital, Strasbourg, France
| | - Guilhem Sole
- Department of Neurology and Neuromuscular Diseases, CHU Bordeaux, University of Bordeaux, Bordeaux, France
- AOC National Reference Center for Neuromuscular Disorders, Bordeaux, France
| | - Céline Tard
- Department of Neurology, Centre Hospitalo-Universitaire (CHU) de Lille, Centre de Référence des Maladies Neuromusculaires Nord/Est/Ile-de-France, U1172, Lille, France
| | - Guillaume Nicolas
- Department of Neurology, Hôpital Raymond Poincaré, Université Versailles-Saint-Quentin-en-Yvelines, Garches, France
| | - Yann Pereon
- Department of Clinical Neurophysiology, CHU Nantes, Nantes, France
- Centre de Référence Maladies Neuromusculaires Atlantique-Occitanie-Caraïbes, Filnemus, Euro-NMD, Hôtel-Dieu, Nantes, France
| | - Karine Aure
- Service de Neurophysiologie, Hôpital Foch, Suresnes, France
| | - Emmeline Lagrange
- Department of Neurology, Grenoble University Hospital, Grenoble, France
| | | | | | - Andoni Echaniz-Laguna
- Neurology Department, APHP, CHU de Bicêtre, 94276, Le Kremlin-Bicêtre, France.
- French National Reference Center for Rare Neuropathies (NNERF), 94276, Le Kremlin-Bicêtre, France.
- INSERM U1195, Paris-Saclay University, Le Kremlin-Bicêtre, France.
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Templeton AJ, Omlin A, Berthold D, Beyer J, Burger IA, Eberli D, Engeler D, Fankhauser C, Fischer S, Gillessen S, Nicolas G, Kroeze S, Lorch A, Müntener M, Papachristofilou A, Schaefer N, Seiler D, Stenner F, Tsantoulis P, Vlajnic T, Zilli T, Zwahlen D, Cathomas R. Interdisciplinary Swiss consensus recommendations on staging and treatment of advanced prostate cancer. Swiss Med Wkly 2023; 153:40108. [PMID: 37598311 DOI: 10.57187/smw.2023.40108] [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] [Indexed: 08/21/2023] Open
Abstract
The management of prostate cancer is undergoing rapid changes in all disease settings. Novel imaging tools for diagnosis have been introduced, and the treatment of high-risk localized, locally advanced and metastatic disease has changed considerably in recent years. From clinical and health-economic perspectives, a rational and optimal use of the available options is of the utmost importance. While international guidelines list relevant pivotal trials and give recommendations for a variety of clinical scenarios, there is much room for interpretation, and several important questions remain highly debated. The goal of developing a national consensus on the use of these novel diagnostic and therapeutic strategies in order to improve disease management and eventually patient outcomes has prompted a Swiss consensus meeting. Experts from several specialties, including urology, medical oncology, radiation oncology, pathology and nuclear medicine, discussed and voted on questions of the current most important areas of uncertainty, including the staging and treatment of high-risk localized disease, treatment of metastatic hormone-sensitive prostate cancer (mHSPC) and use of new options to treat metastatic castration-resistant prostate cancer (mCRPC).
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Affiliation(s)
- Arnoud J Templeton
- Medical Oncology, St. Claraspital, Basel, Switzerland / St. Clara Research Ltd., Basel, Switzerland
- Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Aurelius Omlin
- Onkozentrum Zurich, University of Zurich
- Tumorzentrum Hirslanden Zurich, Switzerland
| | | | - Jörg Beyer
- Medical Oncology, Inselspital, Universitätsspital, Bern, Switzerland
| | - Irene A Burger
- Department of Nuclear Medicine, Kantonsspital Baden, Baden, Switzerland
| | - Daniel Eberli
- Department of Urology, Universitätsspital Zürich, Zurich, Switzerland
| | - Daniel Engeler
- Department of Urology, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | | | - Stefanie Fischer
- Department of Medical Oncology and Hematology, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - Silke Gillessen
- Medical Oncology, Ente Ospedaliero Cantonale (EOC), Bellinzona, Switzerland
| | - Guillaume Nicolas
- Department of Nuclear Medicine, Universitätsspital Basel, Basel, Switzerland
| | - Stephanie Kroeze
- Department of Radio-Oncology, Kantonsspital Aarau, Aarau, Switzerland
| | - Anja Lorch
- Medical Oncology and Hematology, Universitätsspital Zürich, Zurich, Switzerland
| | - Michael Müntener
- Department of Urology, Stadtspital Zürich Triemli, Zurich, Switzerland
| | | | - Niklaus Schaefer
- Department of Visceral Surgery, CHUV, Lausanne, Vaud, Switzerland
| | - Daniel Seiler
- Department of Urology, Rotes Schloss Zürich, Zurich, Switzerland
| | - Frank Stenner
- Medical Oncology and Hematology, Universitätsspital Basel, Basel, Switzerland
| | - Petros Tsantoulis
- Medical Oncology and Hematology, Université de Genève (HUG), Geneva, Switzerland
| | - Tatjana Vlajnic
- Institute of Pathology, Kantonsspital Graubünden, Chur, Switzerland
- Institute of Medical Genetics and Pathology, Universitätsspital Basel, Basel, Switzerland
| | - Thomas Zilli
- Department of Radio-Oncology, Ente Ospedaliero Cantonale (EOC), Bellinzona, Switzerland
| | - Daniel Zwahlen
- Department of Radio-Oncology, Kantonsspital Winterthur, Winterthur, Switzerland
| | - Richard Cathomas
- Division of Oncology/Hematology, Kantonsspital Graubünden, Chur, Switzerland
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15
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Chitimus DM, Berling E, Garderet L, Venturelli N, Malfatti E, Authier FJ, Nicolas G, Laforêt P, Lefeuvre C. Systemic light chain amyloidosis myopathy responsive to daratumumab monotherapy. Eur J Neurol 2023; 30:745-748. [PMID: 36403110 PMCID: PMC10098764 DOI: 10.1111/ene.15640] [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: 09/21/2022] [Revised: 11/09/2022] [Accepted: 11/17/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND AND PURPOSE Amyloid myopathy is a rare and severe manifestation of systemic light chain (AL) amyloidosis. Early diagnosis and staging are mandatory for optimal therapy, given the rapid progression of muscle weakness. Despite the efficacy of bortezomib-based treatment regimens, there is a lack of therapeutic alternatives in non-responsive patients. METHOD The case report of a patient with systemic AL amyloidosis myopathy treated with daratumumab is presented. RESULTS A 70-year-old man displayed severe proximal muscle weakness which had developed over a 10-month period. Blood tests revealed an immunoglobulin A lambda monoclonal gammopathy, whilst muscle biopsy showed amyloid deposits within the arteriolar walls, confirming the diagnosis of amyloid myopathy associated with AL amyloidosis. Initial treatment with a bortezomib-based regimen showed no clinical or hematological improvement. After switching to daratumumab monotherapy, our patient achieved a favorable evolution with respect to functional muscle scoring and a complete hematological response. CONCLUSION To our knowledge, this is the first case report of an amyloid myopathy showing a remarkable clinical improvement in response to daratumumab monotherapy. It thereby highlights the potential of daratumumab as a monotherapeutical approach to the treatment of amyloid myopathy complicating AL amyloidosis.
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Affiliation(s)
- Diana Maria Chitimus
- Neurology Department, Raymond Poincaré University Hospital, APHP, Garches, France
| | - Edouard Berling
- Neurology Department, Raymond Poincaré University Hospital, APHP, Garches, France
- Nord-Est-Ile-de-France Neuromuscular Reference Center, FHU PHENIX, Garches, France
- U 1179 INSERM, Université Paris-Saclay, Montigny-le-Bretonneux, France
| | - Laurent Garderet
- Haematology Department, Hôpital Pitié-Salpêtrière, APHP, Paris, France
| | - Nadia Venturelli
- Diagnostic and Interventional Medical Imaging Department, Raymond Poincaré Hospital, Garches, France
- DMU Smart Imaging, GH Université Paris-Saclay, APHP, Garches, France
| | - Edoardo Malfatti
- Nord-Est-Ile-de-France Neuromuscular Reference Center, FHU PHENIX, Garches, France
- U955 INSERM, EnvA, EFS, IMRB, Université Paris Est, Créteil, France
- Centre de Référence de Pathologie Neuromusculaire Nord-Est-Ile-de-France, APHP, Henri Mondor Hospital, Créteil, France
| | - François Jérôme Authier
- Nord-Est-Ile-de-France Neuromuscular Reference Center, FHU PHENIX, Garches, France
- U955 INSERM, EnvA, EFS, IMRB, Université Paris Est, Créteil, France
- Centre de Référence de Pathologie Neuromusculaire Nord-Est-Ile-de-France, APHP, Henri Mondor Hospital, Créteil, France
| | - Guillaume Nicolas
- Neurology Department, Raymond Poincaré University Hospital, APHP, Garches, France
- Nord-Est-Ile-de-France Neuromuscular Reference Center, FHU PHENIX, Garches, France
- U 1179 INSERM, Université Paris-Saclay, Montigny-le-Bretonneux, France
| | - Pascal Laforêt
- Neurology Department, Raymond Poincaré University Hospital, APHP, Garches, France
- Nord-Est-Ile-de-France Neuromuscular Reference Center, FHU PHENIX, Garches, France
- U 1179 INSERM, Université Paris-Saclay, Montigny-le-Bretonneux, France
| | - Claire Lefeuvre
- Neurology Department, Raymond Poincaré University Hospital, APHP, Garches, France
- Nord-Est-Ile-de-France Neuromuscular Reference Center, FHU PHENIX, Garches, France
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16
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Guémy C, Durand MC, Brisset M, Nicolas G. Changes in electrophysiological findings suggestive of demyelination following Guillain-Barré syndrome: A retrospective study. Muscle Nerve 2023; 67:394-400. [PMID: 36814082 DOI: 10.1002/mus.27803] [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: 07/08/2022] [Revised: 02/10/2023] [Accepted: 02/14/2023] [Indexed: 02/24/2023]
Abstract
INTRODUCTION/AIMS Acute inflammatory demyelinating polyradiculoneuropathy (AIDP) is the most common form of Guillain-Barré syndrome (GBS) in Western countries. However, electrophysiological descriptions of changes in abnormalities suggestive of demyelination after an AIDP episode are rare. We aimed to describe the clinical and electrophysiological features of AIDP patients after the acute episode, to investigate changes in abnormalities suggestive of demyelination and to compare with electrophysiological features of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). METHODS We reviewed the clinical and electrophysiological characteristics of 61 patients followed at regular intervals after the AIDP episode. RESULTS We detected early electrophysiological abnormalities from the first nerve conduction studies (NCS) performed before 3 wk. Abnormalities suggestive of demyelination worsened on subsequent examinations. This worsening continued after more than 3 mo of follow-up for some parameters. We also found the persistence of abnormalities suggestive of demyelination for long periods after the acute episode, beyond 18 mo of follow-up, despite clinical improvement in most patients. DISCUSSION In AIDP, NCS findings continue to worsen several weeks or even months after the onset of symptoms, and "CIDP-like" abnormalities suggestive of demyelination may persist for a long period of time, in contrast to the existing literature and the usually favorable clinical course. Thus, the discovery of conduction abnormalities on NCS performed long after an AIDP should always be interpreted according to the clinical context and not systematically lead to a diagnosis of CIDP.
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Affiliation(s)
- Clément Guémy
- Neurology Department, Raymond-Poincaré Hospital, Garches, France
| | | | - Marion Brisset
- Neurology Department, Raymond-Poincaré Hospital, Garches, France.,Physiology Department, Raymond-Poincaré Hospital, Garches, France
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17
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Chirindel A, Kidd M, Rentsch CA, Stenner F, Templeton AJ, Nitzsche E, Wild D, Nicolas G, Modlin IM. Evaluation of a novel transcriptomic tumor signature (PROSTest) as response biomarker for 177Lu-PSMA therapy in advanced prostate cancer. J Clin Oncol 2023. [DOI: 10.1200/jco.2023.41.6_suppl.183] [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: 03/16/2023] Open
Abstract
183 Background: Radionuclide therapy targeting the prostate specific membrane antigen (177Lu-PSMA therapy) has proven to be an effective treatment in men with metastatic castration resistant prostate cancer (mCRPCs). Despite representing a significant therapeutic breakthrough, a critical unmet need in 177Lu-PSMA therapy, is a prognostic biomarker for treatment optimization. Imaging and standard biomarkers have limited value. The PROSTest is a new 27-gene algorithmic signature originally developed for prostate adenocarcinoma diagnosis (0 to 100, positive score ≥20). We hypothesized that PROSTest would be elevated in mCRPCs and could have utility as a biomarker for mCRPC management. Methods: Prospective enrollment of 113 mCRPC for 177Lu-PSMA therapy (KlbB-5338-0302021 study). Pathology, clinical and biomarker data were available as was PSMA-PET/CT. Blood samples were collected for PROSTest prior to therapy. Target genes were isolated and amplified using qPCR. PROSTest scores (0-100) were obtained following algorithmic analysis. Scores were correlated with mCRPC diagnosis and baseline information. Scores and standard clinical measures were evaluated as prognostic factors with survival as endpoint. Mann-Whitney U-test, Kaplan-Meier survival and Cox proportional hazards regression analysis were utilized. All data: median (IQ range). Results: 89 (79%) patients were evaluable. Age was 75 (68-80). Disease characteristics at time of diagnosis included Gleason scores 8-10 (70%) and TMM: T3-T4 tumors (67%), N1 (53%), M1 (45%). At the time of therapy all patients were metastatic and all exhibited PSMA-positive disease. The highest tumor SUVmax was 51 (28-78). PSA levels were 69ng/mL (18-305). The PROSTest score was 89 (81-92). PROSTest scores were weakly correlated with age (r=0.33, p=0.0015) but not with baseline histopathological parameters (e.g., Gleason score, TNM) or pretreatment imaging results (e.g., SUVmax). Twenty-four (27%) patients have perished. Treatment and follow-up (5 months, 3-18) are ongoing. The mOS was 15 months. No factors were associated with death as an outcome except for the PROSTest score. PROSTest scores ≥79 (based on ROC analysis) were associated with significantly increased risk for mortality (HR: 2.9, 95% CI: 1.5-7.4). The mOS was 14 months in patients with pre-therapy PROSTest scores >79 compared to mOS not reached for PROSTest scores <79 ( p=0.02). In the COX model, baseline PROSTest was confirmed to be significantly predictive of death despite therapy (β = 1.51, p=0.01). Conclusions: The PROSTest blood gene expression score is elevated in mCRPCs. Levels are not associated with baseline clinical, histopathological, pretreatment PSA or imaging parameters. Elevated expression (≥79) of this biomarker prior to treatment was associated with a lower survival and could be used to predict survival in patients undergoing 177Lu-PSMA.
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Affiliation(s)
| | | | | | | | | | | | - Damian Wild
- University Hospital Basel, Basel, Switzerland
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18
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Demestre L, Grange S, Dubois C, Bideau N, Nicolas G, Pontonnier C, Dumont G. Characterization of the dynamic behavior of a diving board using motion capture data. Sports Eng 2022. [DOI: 10.1007/s12283-022-00388-z] [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: 12/01/2022]
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19
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Wallon D, Nicolas G. Genetica della malattia di Alzheimer. Neurologia 2022. [DOI: 10.1016/s1634-7072(22)47093-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
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20
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Mateo M, Nicolas G. Mapping capability of linear correlation statistics for characterization of complex materials using laser-induced breakdown spectroscopy. Anal Chim Acta 2022; 1227:340260. [DOI: 10.1016/j.aca.2022.340260] [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] [Received: 05/16/2022] [Revised: 07/22/2022] [Accepted: 08/11/2022] [Indexed: 11/01/2022]
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21
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Delhaye E, Bouvet A, Nicolas G, Vilas-Boas JP, Bideau B, Bideau N. Automatic Swimming Activity Recognition and Lap Time Assessment Based on a Single IMU: A Deep Learning Approach. Sensors 2022; 22:s22155786. [PMID: 35957347 PMCID: PMC9371205 DOI: 10.3390/s22155786] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 07/27/2022] [Accepted: 07/29/2022] [Indexed: 12/10/2022]
Abstract
This study presents a deep learning model devoted to the analysis of swimming using a single Inertial Measurement Unit (IMU) attached to the sacrum. Gyroscope and accelerometer data were collected from 35 swimmers with various expertise levels during a protocol including the four swimming techniques. The proposed methodology took high inter- and intra-swimmer variability into account and was set up for the purpose of predicting eight swimming classes (the four swimming techniques, rest, wallpush, underwater, and turns) at four swimming velocities ranging from low to maximal. The overall F1-score of classification reached 0.96 with a temporal precision of 0.02 s. Lap times were directly computed from the classifier thanks to a high temporal precision and validated against a video gold standard. The mean absolute percentage error (MAPE) for this model against the video was 1.15%, 1%, and 4.07%, respectively, for starting lap times, middle lap times, and ending lap times. This model is a first step toward a powerful training assistant able to analyze swimmers with various levels of expertise in the context of in situ training monitoring.
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Affiliation(s)
- Erwan Delhaye
- M2S Laboratory (Movement, Sports & Health), University Rennes 2, ENS Rennes, 35170 Bruz, France; (A.B.); (G.N.); (B.B.); (N.B.)
- MIMETIC-Analysis-Synthesis Approach for Virtual Human Simulation, INRIA Rennes Bretagne Atlantique, Campus de Beaulieu, 263 Av. Général Leclerc, 35042 Rennes, France
- Correspondence:
| | - Antoine Bouvet
- M2S Laboratory (Movement, Sports & Health), University Rennes 2, ENS Rennes, 35170 Bruz, France; (A.B.); (G.N.); (B.B.); (N.B.)
- MIMETIC-Analysis-Synthesis Approach for Virtual Human Simulation, INRIA Rennes Bretagne Atlantique, Campus de Beaulieu, 263 Av. Général Leclerc, 35042 Rennes, France
| | - Guillaume Nicolas
- M2S Laboratory (Movement, Sports & Health), University Rennes 2, ENS Rennes, 35170 Bruz, France; (A.B.); (G.N.); (B.B.); (N.B.)
- MIMETIC-Analysis-Synthesis Approach for Virtual Human Simulation, INRIA Rennes Bretagne Atlantique, Campus de Beaulieu, 263 Av. Général Leclerc, 35042 Rennes, France
| | - João Paulo Vilas-Boas
- LABIOMEP Laboratory (Porto Biomechanics Laboratory), Faculty of Sport, CIFI2D, University of Porto, 4200-450 Porto, Portugal;
| | - Benoît Bideau
- M2S Laboratory (Movement, Sports & Health), University Rennes 2, ENS Rennes, 35170 Bruz, France; (A.B.); (G.N.); (B.B.); (N.B.)
- MIMETIC-Analysis-Synthesis Approach for Virtual Human Simulation, INRIA Rennes Bretagne Atlantique, Campus de Beaulieu, 263 Av. Général Leclerc, 35042 Rennes, France
| | - Nicolas Bideau
- M2S Laboratory (Movement, Sports & Health), University Rennes 2, ENS Rennes, 35170 Bruz, France; (A.B.); (G.N.); (B.B.); (N.B.)
- MIMETIC-Analysis-Synthesis Approach for Virtual Human Simulation, INRIA Rennes Bretagne Atlantique, Campus de Beaulieu, 263 Av. Général Leclerc, 35042 Rennes, France
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22
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Grangeon L, Quesney G, Verdalle-Cazes M, Coulette S, Renard D, Wacongne A, Allou T, Olivier N, Boukriche Y, Blanchet-Fourcade G, Labauge P, Arquizan C, Canaple S, Godefroy O, Martinaud O, Verdure P, Quillard-Muraine M, Pariente J, Magnin E, Nicolas G, Charbonnier C, Maltête D, Formaglio M, Raposo N, Ayrignac X, Wallon D. Different clinical outcomes between cerebral amyloid angiopathy-related inflammation and non-inflammatory form. J Neurol 2022; 269:4972-4984. [PMID: 35752990 DOI: 10.1007/s00415-022-11145-4] [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: 12/10/2021] [Revised: 04/12/2022] [Accepted: 04/13/2022] [Indexed: 10/17/2022]
Abstract
OBJECTIVE Cerebral amyloid angiopathy-related inflammation (CAA-ri) is a rare manifestation related to CAA, thought to be more severe. We aimed to compare the clinical and radiological outcomes of CAA-ri and non-inflammatory CAA. MATERIALS AND METHODS We retrospectively included all patients with CAA-ri from 13 French centers. We constituted a sex- and age-matched control cohort with non-inflammatory CAA and similar disease duration. Survival, autonomy and cognitive evolution were compared after logistic regression. Cerebral microbleeds (CMB), intracerebral hemorrhage, cortical superficial siderosis and hippocampal atrophy were analyzed as well as CSF biomarker profile and APOE genotype when available. Outcomes were compared using Kaplan-Meier curves and log-rank tests. RESULTS Data from 48 CAA-ri patients including 28 already reported and 20 new patients were analyzed. Over a mean of 3.1 years, 11 patients died (22.9%) and 18 (37.5%) relapsed. CAA-ri patients were more frequently institutionalized than non-inflammatory CAA patients (30% vs 8.3%, p < 0.001); mortality rates remained similar. MMSE and modified Rankin scale scores showed greater severity in CAA-ri at last follow-up. MRI showed a higher number of CMB at baseline and last follow-up in CAA-ri (p < 0.001 and p = 0.004, respectively). CSF showed lower baseline levels of Aß42 in CAA-ri than non-inflammatory CAA (373.3 pg/ml vs 490.8 pg/ml, p = 0.05). CAA-ri patients more likely carried at least one APOE ε4 allele (76% vs 37.5%, adjusted p = 0.05) particularly as homozygous status (56% vs 6.2%, p < 0.001). INTERPRETATION CAA-ri appears to be more severe than non-inflammatory CAA with a significant loss of autonomy and global higher amyloid burden, shown by more CMB and a distinct CSF profile. This burden may be partially promoted by ε4 allele.
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Affiliation(s)
- L Grangeon
- Department of Neurology, Rouen University Hospital, 76031, Rouen, France.
| | - G Quesney
- Department of Neurology, Rouen University Hospital, 76031, Rouen, France
| | - M Verdalle-Cazes
- Department of Radiology, Rouen University Hospital, Rouen, France
| | - S Coulette
- Department of Neurology, INM, Univ Montpellier, INSERM, Montpellier University Hospital, Montpellier, France
| | - D Renard
- Department of Neurology, Nimes University Hospital, Nimes, France
| | - A Wacongne
- Department of Neurology, Nimes University Hospital, Nimes, France
| | - T Allou
- Department of Neurology, Perpignan Hospital, Perpignan, France
| | - N Olivier
- Department of Neurology, Perpignan Hospital, Perpignan, France
| | - Y Boukriche
- Department of Neurology, Beziers Hospital, Beziers, France
| | | | - P Labauge
- Department of Neurology, INM, Univ Montpellier, INSERM, Montpellier University Hospital, Montpellier, France
| | - C Arquizan
- Department of Neurology, INM, Univ Montpellier, INSERM, Montpellier University Hospital, Montpellier, France
| | - S Canaple
- Department of Neurology and Functional Neuroscience, Lab (UR UPJV 4559), Amiens University Hospital and University of Picardy Jules Verne, Amiens, France
| | - O Godefroy
- Department of Neurology and Functional Neuroscience, Lab (UR UPJV 4559), Amiens University Hospital and University of Picardy Jules Verne, Amiens, France
| | - O Martinaud
- Department of Neurology, Caen University Hospital, Caen, France.,EPHE, INSERM, U1077, CHU de Caen, Neuropsychologie Et Imagerie de La Mémoire Humaine, Normandie Univ, UNICAEN, PSL Research University, Caen, France
| | - P Verdure
- Department of Neurology, Les Feugrais Hospital, Elbeuf, France
| | - M Quillard-Muraine
- Laboratoire de Biochimie, Rouen University Hospital and University of Rouen, Rouen, France
| | - J Pariente
- Neurology Department, Hôpital Pierre-Paul Riquet, Centre Hospitalier, Universitaire de Toulouse, Toulouse, France
| | - E Magnin
- Department of Neurology, Besancon Hospital, Besancon, France
| | - G Nicolas
- INSERM U1245, IRIB, Normandy University, CNR-MAJ, Rouen University Hospital, Rouen, France
| | - C Charbonnier
- INSERM U1245, IRIB, Normandy University, CNR-MAJ, Rouen University Hospital, Rouen, France
| | - D Maltête
- Department of Neurology, Rouen University Hospital, 76031, Rouen, France
| | - M Formaglio
- Department of Neurology, Lyon University Hospital, Lyon, France
| | - N Raposo
- Neurology Department, Hôpital Pierre-Paul Riquet, Centre Hospitalier, Universitaire de Toulouse, Toulouse, France
| | - X Ayrignac
- Department of Neurology, INM, Univ Montpellier, INSERM, Montpellier University Hospital, Montpellier, France
| | - D Wallon
- Department of Neurology, Rouen University Hospital, 76031, Rouen, France.,Department of Neurology, Besancon Hospital, Besancon, France
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23
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Demestre L, Morin P, May F, Bideau N, Nicolas G, Pontonnier C, Dumont G. Motion-Based Ground Reaction Forces and Moments Prediction Method for Interaction with a Moving And/Or Non-Horizontal Structure. J Biomech Eng 2022; 144:1141730. [PMID: 35722981 DOI: 10.1115/1.4054835] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Indexed: 11/08/2022]
Abstract
Inverse dynamics methods are commonly used for the biomechanical analysis of human motion. External forces applied on the subject are required as an input data to solve the dynamic equilibrium of the subject. Force platforms measure ground reactions forces and moments (GRF&Ms) but they limit the ecological aspect of experimental conditions. Motion-based GRF&Ms prediction may circumvent this limitation. The current study aims at evaluating the accuracy of an optimization-based GRF&Ms prediction method modified to be applied to the interaction with a moving and/or non horizontal structure. The main improvement of the method deals with the contact detection in such a moving and/or non horizontal frame. To evaluate the accuracy of the method, 20 subjects performed squats and steps on an instrumented moving structure, measuring both motion and GRF&Ms. The comparison of the root mean square error between the predicted and measured GFR&Ms divided by the subjects mass showed a similar order of magnitude than those from the method without the studied modification (0.14 N/kg for antero-posterior forces, 0.29 N/kg for medio lateral forces, 0.61 N/kg for longitudinal forces, 0.06 Nm/kg for frontal moments, 0.13 Nm/kg for sagittal moments, and 0.03 Nm/kg for transverse moments). The results showed the suitability of the method to study human motions for tasks performed on a moving and/or non-horizontal structure.
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Affiliation(s)
| | | | - François May
- IRISA - UMR 6074, Univ Rennes, 35000 Rennes, France
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24
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Mallaev M, Chirindel AF, Nicolas G, Tamm M, Hojski A, Wiese M, Stolz D, Lardinois D. 3D-quantitated lung perfusion SPECT/CT: Impact on intended management compared to lung perfusion scan in marginal candidates for lung resection surgery. Br J Surg 2022. [DOI: 10.1093/bjs/znac185.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Objective
Based on previous studies, single-photon emission computed tomography/computed tomography (SPECT/CT) has been proven to be more accurate and reproducible than planar lung perfusion scintigraphy. We conducted a study to evaluate the impact of 3D-quantitated lung perfusion SPECT/CT on intended management in candidates for lung resection surgery.
Methods
Retrospective study including candidates for lung resection surgery with lung perfusion imaging. Patients underwent preoperative evaluation according to ERS/ESTS algorithm. The lobar contribution to the total lung perfusion was estimated using planar antero-posterior, posterior oblique and three-dimensional anatomical SPECT/CT method (CT Pulmo 3D and xSPECT- Quant, Siemens). The difference in lobar perfusion with resulting changes in the extent of lung resection were analyzed to reveal possible changes in operability.
Results
120 patients (46 females) with known lung cancer or pulmonary lesion considered for resection with available lung perfusion scintigraphy and SPECT/CT were enrolled. The mean age (±SD) of patients was 68 ±9 years, the target lesions were located in upper lobe in 57.7% and in lower lobe in 33.5%. The median [IQR] FEV1 was 70.5% [52–84] and median DLCO 56.6% [47.1–67.4]. The planar posterior oblique method, compared to 3D-quantitated SPECT/CT, underestimated the perfusion of upper lobes by a median difference of 5% (right [2–9; IQR]; left [2.5–8], p= < 0.0001), while it overestimated the both lower lobes (left by 4% [2–7]; right by 6% [2–9], p= < 0.0001). In contrast to the planar scintigraphy based evaluation, 4(3.3%) patients with upper lobe lesions were classified as inoperable when 3D-quantitated SPECT/CT was used for calculation of predicted postoperative lung function.
Conclusion
In selected patients with upper lobe lesions, 3D-quantitated SPECT/CT would have changed the treatment strategy from operable to inoperable. Importantly, post-operative mortality in this particular subgroup was disproportionally high. 3D-quantitated SPECT/CT shall be further evaluated as it might improve preoperative risk stratification in marginal lung resection candidates.
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Affiliation(s)
- M Mallaev
- University Hospital Basel Clinic of Thoracic Surgery, , Basel, Switzerland
| | - A-F Chirindel
- University Hospital Basel Clinic of Radiology and Nuclear Medicine, , Basel, Switzerland
| | - G Nicolas
- University Hospital Basel Clinic of Radiology and Nuclear Medicine, , Basel, Switzerland
| | - M Tamm
- University Hospital Basel Clinic of Pulmonology, , Basel, Switzerland
| | - A Hojski
- University Hospital Basel Clinic of Thoracic Surgery, , Basel, Switzerland
| | - M Wiese
- University Hospital Basel Clinic of Thoracic Surgery, , Basel, Switzerland
| | - D Stolz
- University Hospital Basel Clinic of Pulmonology, , Basel, Switzerland
| | - D Lardinois
- University Hospital Basel Clinic of Thoracic Surgery, , Basel, Switzerland
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Dupé C, Lefeuvre C, Solé G, Behin A, Pottier C, Duval F, Carlier RY, Prigent H, Lacau-Saint-Guily J, Azzeddine A, Taouagh N, Hamroun D, Nicolas G, Laforêt P. Macroglossia: A potentially severe complication of late-onset POMPE disease. Eur J Neurol 2022; 29:2121-2128. [PMID: 35302691 DOI: 10.1111/ene.15330] [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: 11/11/2021] [Revised: 02/10/2022] [Accepted: 03/03/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Pompe disease is a rare neuromuscular disorder caused by a deficiency of a lysosomal enzyme, acid α-glucosidase. Macroglossia is a classic clinical sign of several inherited myopathies and has also been reported to occur progressively in late-onset Pompe disease (LOPD). METHODS We describe patients with LOPD and macroglossia included in the French national Pompe disease registry. Clinical, functional, and radiological data have been collected during periodic follow-up and analyzed retrospectively. These cases have been compared with 15 previously reported cases. RESULTS 5 patients, 3 female and 2 males, from 71 to 88 years old, have been included in this study. All but one of the patients suffered from symptoms related to macroglossia before the diagnosis of Pompe disease. Three had localized tongue atrophy and one had significant localized tongue hypertrophy which led to glossectomy 10 years before diagnosis. Two patients had severe dysphagia, one of whom underwent gastrostomised for enteral nutritional support. One patient experienced the persistence of numerous sleep apneas despite nocturnal BiPAP ventilation. All our patients had dysarthria, and two required speech therapy. Four patients had a tongue hypersignal on MRI T1 sequences. CONCLUSIONS Detection of macroglossia should be part of the clinical diagnosis and follow-up of patients with LOPD, with a careful evaluation of its main consequences. Macroglossia can have severe functional impacts on speech, swallowing and sleep. Whole-body MRI with facial sections may facilitate the early diagnosis of Pompe disease with the "bright tongue sign".
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Affiliation(s)
- Charlotte Dupé
- Neurology Department, Raymond Poincaré University Hospital, Garches, APHP, France
| | - Claire Lefeuvre
- Neurology Department, Raymond Poincaré University Hospital, Garches, APHP, France.,U 1179 INSERM, Université Versailles Saint Quentin en Yvelines, Paris-Saclay, France
| | - Guilhem Solé
- Neuromuscular Reference Center, Bordeaux University Hospital (Pellegrin), University of Bordeaux, Place Amélie Raba-Léon, 33000, Bordeaux, France
| | - Anthony Behin
- Institute of Myology, Pitié Salpêtrière Hospital, Paris, France
| | | | - Fanny Duval
- Neuromuscular Reference Center, Bordeaux University Hospital (Pellegrin), University of Bordeaux, Place Amélie Raba-Léon, 33000, Bordeaux, France
| | - Robert-Yves Carlier
- U 1179 INSERM, Université Versailles Saint Quentin en Yvelines, Paris-Saclay, France.,Diagnostic and Interventional Medical imaging department, Raymond Poincaré Hospital, Garches, DMU Smart Imaging, GH Université Paris-Saclay, APHP, France.,Nord-Est-Ile-de-France Neuromuscular Reference Center, FHU PHENIX, France
| | - Hélène Prigent
- U 1179 INSERM, Université Versailles Saint Quentin en Yvelines, Paris-Saclay, France.,Physiology Department, Raymond Poincaré University Hospital, Garches, APHP, France.,Nord-Est-Ile-de-France Neuromuscular Reference Center, FHU PHENIX, France
| | - Jean Lacau-Saint-Guily
- Otolaryngology Head Neck Surgery Department, Rothschild Foundation Hospital and Sorbonne university, Paris, France
| | - Arrassi Azzeddine
- Nord-Est-Ile-de-France Neuromuscular Reference Center, FHU PHENIX, France.,Institute of Myology, Pitié Salpêtrière Hospital, Paris, France
| | - Nadjib Taouagh
- Nord-Est-Ile-de-France Neuromuscular Reference Center, FHU PHENIX, France.,Institute of Myology, Pitié Salpêtrière Hospital, Paris, France
| | - Dalil Hamroun
- CHRU de Montpellier, Direction de la Recherche et de l'Innovation, Hôpital La Colombière, Montpellier, France
| | - Guillaume Nicolas
- Neurology Department, Raymond Poincaré University Hospital, Garches, APHP, France.,U 1179 INSERM, Université Versailles Saint Quentin en Yvelines, Paris-Saclay, France
| | - Pascal Laforêt
- Neurology Department, Raymond Poincaré University Hospital, Garches, APHP, France.,U 1179 INSERM, Université Versailles Saint Quentin en Yvelines, Paris-Saclay, France
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26
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Lefeuvre C, Brisset M, Sarlon M, Petit N, Orlikowski D, Clair B, Thiry T, Carlier RY, Prigent H, Nicolas G, Annane D, Laforet P, Pouplin S. Nusinersen treatment in adults with severe spinal muscular atrophy: A real-life retrospective observational cohort study. Rev Neurol (Paris) 2022; 178:234-240. [PMID: 35000792 DOI: 10.1016/j.neurol.2021.10.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 10/27/2021] [Accepted: 10/29/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND OBJECTIVES Spinal muscular atrophy (SMA) is a progressive neurodegenerative disease due to homozygous loss-of-function of the survival motor neuron gene SMN1 with absence of the functional SMN protein. Nusinersen, a costly intrathecally administered drug approved in 2017 in Europe, induces alternative splicing of the SMN2 gene, which then produces functional SMN protein, whose amount generally increases with the number of SMN2 gene copies. METHODS We retrospectively collected data from consecutive wheelchair-bound adults with SMA managed at a single center in 2018-2020. The following were collected at each injection, on days 1, 14, 28, 63, 183, and 303: 32-item Motor Function Measurement (MFM) total score and D2 and D3 subscores; the Canadian Occupational Performance Measure (COPM) performance and satisfaction scores; and lung function tests. The patients were divided into two groups based on whether their MFM total score was<or≥the mean (15.6%). Adverse events were recorded. RESULTS We identified 18 patients who received 4 to 8 Nusinersen injections. No significant improvements occurred over time in any of the MFM scores or lung function test results, which did not differ between groups. The COPM performance score improved significantly from day 0 to day 303 in the high-MFM group and the COPM satisfaction score in the overall population from D0 to D183. Half the patients achieved the minimal clinically important difference for both COPM scores. DISCUSSION The overall stability of conventional motor assessment in this population with advanced disabilities is encouraging to use more sensitive tools based on self-perception and autonomy in daily life activities, such as COPM. Our finding of a significant COPM performance score improvement from days 0 to 303 only in the patients with initial MFM-32 scores above the mean in the population suggests that the severity of the baseline disabilities may affect treatment efficacy. CLASSIFICATION OF EVIDENCE LEVEL IV, retrospective observational cohort study.
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Affiliation(s)
- C Lefeuvre
- Neurology department, Raymond-Poincaré university hospital, AP-HP, Garches, France; Nord-Est-Île-de-France neuromuscular reference center, FHU PHENIX, France; Université Paris-Saclay, UVSQ, ERPHAN, 78000 Versailles, France.
| | - M Brisset
- Neurology department, Raymond-Poincaré university hospital, AP-HP, Garches, France; Nord-Est-Île-de-France neuromuscular reference center, FHU PHENIX, France; Université Paris-Saclay, UVSQ, ERPHAN, 78000 Versailles, France
| | - M Sarlon
- New Technologies Platform, Raymond-Poincaré hospital, AP-HP, Garches, France; Université Paris-Saclay, UVSQ, ERPHAN, 78000 Versailles, France
| | - N Petit
- Neurology department, Raymond-Poincaré university hospital, AP-HP, Garches, France; Université Paris-Saclay, UVSQ, ERPHAN, 78000 Versailles, France
| | - D Orlikowski
- Critical care medical department, Raymond-Poincaré hospital, AP-HP, Garches, France; CIC 1429 AP-HP INSERM, université Versailles-Saint-Quentin-en-Yvelines, Paris-Saclay, France; Université Paris-Saclay, UVSQ, ERPHAN, 78000 Versailles, France
| | - B Clair
- Critical care medical department, Raymond-Poincaré hospital, AP-HP, Garches, France; Université Paris-Saclay, UVSQ, ERPHAN, 78000 Versailles, France
| | - T Thiry
- Diagnostic and interventional medical imaging department, Raymond-Poincaré hospital, DMU smart imaging, GH université Paris-Saclay, AP-HP, Garches, France; Université Paris-Saclay, UVSQ, ERPHAN, 78000 Versailles, France
| | - R-Y Carlier
- U 1179 INSERM, université Versailles-Saint-Quentin-en-Yvelines, Paris-Saclay, France; Diagnostic and interventional medical imaging department, Raymond-Poincaré hospital, DMU smart imaging, GH université Paris-Saclay, AP-HP, Garches, France; Université Paris-Saclay, UVSQ, ERPHAN, 78000 Versailles, France
| | - H Prigent
- Nord-Est-Île-de-France neuromuscular reference center, FHU PHENIX, France; Université Paris-Saclay, UVSQ, ERPHAN, 78000 Versailles, France; Physiology department, Raymond-Poincaré university hospital, AP-HP, Garches, France
| | - G Nicolas
- Neurology department, Raymond-Poincaré university hospital, AP-HP, Garches, France; Nord-Est-Île-de-France neuromuscular reference center, FHU PHENIX, France; U 1179 INSERM, université Versailles-Saint-Quentin-en-Yvelines, Paris-Saclay, France; Université Paris-Saclay, UVSQ, ERPHAN, 78000 Versailles, France
| | - D Annane
- Critical care medical department, Raymond-Poincaré hospital, AP-HP, Garches, France; Université Paris-Saclay, UVSQ, ERPHAN, 78000 Versailles, France
| | - P Laforet
- Neurology department, Raymond-Poincaré university hospital, AP-HP, Garches, France; Nord-Est-Île-de-France neuromuscular reference center, FHU PHENIX, France; U 1179 INSERM, université Versailles-Saint-Quentin-en-Yvelines, Paris-Saclay, France; Université Paris-Saclay, UVSQ, ERPHAN, 78000 Versailles, France
| | - S Pouplin
- New Technologies Platform, Raymond-Poincaré hospital, AP-HP, Garches, France; U 1179 INSERM, université Versailles-Saint-Quentin-en-Yvelines, Paris-Saclay, France; Université Paris-Saclay, UVSQ, ERPHAN, 78000 Versailles, France
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27
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Fayssoil A, Nguyen LS, Stojkovic T, Prigent H, Carlier R, Amthor H, Bergounioux J, Zini J, Damez-Fontaine S, Wahbi K, Laforet P, Nicolas G, Behin A, Bassez G, Leturcq F, Ben Yaou R, Mansencal N, Annane D, Lofaso F, Orlikowski D. Determinants of diaphragm inspiratory motion, diaphragm thickening, and its performance for predicting respiratory restrictive pattern in Duchenne muscular dystrophy. Muscle Nerve 2021; 65:89-95. [PMID: 34618930 DOI: 10.1002/mus.27432] [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: 11/22/2020] [Revised: 09/30/2021] [Accepted: 10/03/2021] [Indexed: 11/06/2022]
Abstract
INTRODUCTION/AIMS Respiratory status is a key determinant of prognosis in patients with Duchenne muscular dystrophy (DMD). We aimed to evaluate the determinants of diaphragm ultrasound and its performance in predicting restrictive respiratory patterns in DMD. METHODS This was a retrospective study of DMD patients followed in our center and admitted for an annual checkup from 2015 to 2018. We included DMD patients who underwent diaphragm ultrasound and pulmonary functional tests. RESULTS This study included 74 patients with DMD. The right diaphragm thickening fraction (TF) was significantly associated with age (P = .001), Walton score (P = .012), inspiratory capacity (IC) (P = .004), upright forced vital capacity (FVC) (P < .0001), supine FVC (P = .038), and maximal inspiratory pressure (MIP) (P = .002). Right diaphragm excursion was significantly associated with age (P < .0001), steroid use (P = .008), history of spinal fusion (P < .0001), body mass index (BMI) (P = .002), Walton score (P < .0001), IC (P < .0001), upright FVC (P < .0001), supine FVC (P < .0001), and MIP (P < .0001). A right diaphragm TF >28% and a right diaphragm excursion>25.4 mm were associated with an FVC >50% with, respectively, an area under the curve (AUC) of 0.95 (P = .001) and 0.93 (P < .001). A left diaphragm TF >26.8% and a left diaphragm excursion >21.5 mm were associated with an FVC >50% with, respectively, an AUC of 0.95 (P = .011) and 0.97 (P < .001). DISCUSSION Diaphragm excursion and diaphragm TF can predict restrictive pulmonary insufficiency in DMD.
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Affiliation(s)
- Abdallah Fayssoil
- Service de Réanimation médico-chirurgicale et Pole ventilation à domicile, CHU Raymond Poincaré, APHP, Université Paris Saclay/UFR Sciences de la santé-Université de Versailles Saint Quentin en Yvelines, Garches, France.,APHP, Nord/Est/Ile-de-France Neuromuscular reference center, Institut de Myologie, Hôpital Pitié-Salpêtrière, Paris, France.,Service de Cardiologie, CHU Ambroise-Paré, AP-HP, Boulogne Billancourt, France.,Inserm U1018, CESP, Team 5 (EpReC, Renal and Cardiovascular Epidemiology), UVSQ, Villejuif, France.,INSERM U1179, END-ICAP, Montigny-le-Bretonneux, France
| | - Lee S Nguyen
- Department of Pharmacology, Sorbonne University, INSERM CIC Paris-Est, AP-HP, ICAN, Regional Pharmacovigilance Center, Pitié-Salpêtrière Hospital, Paris, France.,CMC Ambroise Paré, Research & Innovation (RICAP), Neuilly-sur-Seine, France
| | - Tanya Stojkovic
- APHP, Nord/Est/Ile-de-France Neuromuscular reference center, Institut de Myologie, Hôpital Pitié-Salpêtrière, Paris, France
| | - Helene Prigent
- INSERM U1179, END-ICAP, Montigny-le-Bretonneux, France.,Service de Physiologie - Explorations fonctionnelles, CHU Raymond Poincaré, APHP, Université Paris Saclay/UFR Sciences de la santé-Université de Versailles Saint Quentin en Yvelines, Garches, France
| | - Robert Carlier
- Service de Radiologie, CHU Raymond Poincaré, APHP, Université Paris Saclay/UFR Sciences de la santé-Université de Versailles Saint Quentin en Yvelines, Garches, France
| | - Helge Amthor
- INSERM U1179, END-ICAP, Montigny-le-Bretonneux, France.,Service de Pédiatrie, CHU Raymond Poincaré, APHP, Université Paris Saclay/UFR Sciences de la santé-Université de Versailles Saint Quentin en Yvelines, Garches, France
| | - Jean Bergounioux
- Service de Pédiatrie, CHU Raymond Poincaré, APHP, Université Paris Saclay/UFR Sciences de la santé-Université de Versailles Saint Quentin en Yvelines, Garches, France
| | - Justine Zini
- Service de Pédiatrie, CHU Raymond Poincaré, APHP, Université Paris Saclay/UFR Sciences de la santé-Université de Versailles Saint Quentin en Yvelines, Garches, France
| | - Sebastien Damez-Fontaine
- Service de Pédiatrie, CHU Raymond Poincaré, APHP, Université Paris Saclay/UFR Sciences de la santé-Université de Versailles Saint Quentin en Yvelines, Garches, France
| | - Karim Wahbi
- APHP, Nord/Est/Ile-de-France Neuromuscular reference center, Institut de Myologie, Hôpital Pitié-Salpêtrière, Paris, France.,Cardiology Department, AP-HP, Cochin Hospital, FILNEMUS, Centre de Référence de Pathologie Neuromusculaire Nord/Est/Ile de France, Université Paris Descartes-Sorbonne Paris Cité, Paris, France
| | - Pascal Laforet
- INSERM U1179, END-ICAP, Montigny-le-Bretonneux, France.,Service de Neurologie, CHU Raymond Poincaré, APHP, Université Paris Saclay/UFR Sciences de la santé-Université de Versailles Saint Quentin en Yvelines, Garches, France
| | - Guillaume Nicolas
- Service de Neurologie, CHU Raymond Poincaré, APHP, Université Paris Saclay/UFR Sciences de la santé-Université de Versailles Saint Quentin en Yvelines, Garches, France
| | - Anthony Behin
- APHP, Nord/Est/Ile-de-France Neuromuscular reference center, Institut de Myologie, Hôpital Pitié-Salpêtrière, Paris, France
| | - Guillaume Bassez
- APHP, Nord/Est/Ile-de-France Neuromuscular reference center, Institut de Myologie, Hôpital Pitié-Salpêtrière, Paris, France
| | - France Leturcq
- Department of Genetics and Molecular Biology, AP-HP, Cochin Hospital, Paris, France
| | - Rabah Ben Yaou
- Department of Genetics and Molecular Biology, AP-HP, Cochin Hospital, Paris, France
| | - Nicolas Mansencal
- Service de Cardiologie, CHU Ambroise-Paré, AP-HP, Boulogne Billancourt, France.,Inserm U1018, CESP, Team 5 (EpReC, Renal and Cardiovascular Epidemiology), UVSQ, Villejuif, France
| | - Djillali Annane
- Service de Réanimation médico-chirurgicale et Pole ventilation à domicile, CHU Raymond Poincaré, APHP, Université Paris Saclay/UFR Sciences de la santé-Université de Versailles Saint Quentin en Yvelines, Garches, France
| | - Frédéric Lofaso
- INSERM U1179, END-ICAP, Montigny-le-Bretonneux, France.,Service de Physiologie - Explorations fonctionnelles, CHU Raymond Poincaré, APHP, Université Paris Saclay/UFR Sciences de la santé-Université de Versailles Saint Quentin en Yvelines, Garches, France
| | - David Orlikowski
- Service de Réanimation médico-chirurgicale et Pole ventilation à domicile, CHU Raymond Poincaré, APHP, Université Paris Saclay/UFR Sciences de la santé-Université de Versailles Saint Quentin en Yvelines, Garches, France.,Centre d'Investigation Clinique, UMR 1429, Hôpital Raymond Poincaré, Garches, France
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Vázquez J, Lefeuvre C, Escobar RE, Luna Angulo AB, Miranda Duarte A, Delia Hernandez A, Brisset M, Carlier RY, Leturcq F, Durand-Canard MC, Nicolas G, Laforet P, Malfatti E. Phenotypic Spectrum of Myopathies with Recessive Anoctamin-5 Mutations. J Neuromuscul Dis 2021; 7:443-451. [PMID: 32925086 DOI: 10.3233/jnd-200515] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND Biallelic variants in Anoctamin 5 (ANO5) gene are causative of limb-girdle muscular dystrophy (LGMD) R12 anoctamin5-related, non-dysferlin Miyoshi-like distal myopathy (MMD3), and asymptomatic hyperCKemia. OBJECTIVE To describe clinic, histologic, genetic and imaging features, of ANO5 mutated patients. METHODS Five patients, four from France (P1, P2, P3 and P4) and one from Mexico (P5), from four families were included. P1 and P2, belonging to group 1, had normal muscle strength; Group 2, P3, P4 and P5, presented with muscular weakness. Muscle strength was measured by manual muscle testing, Medical Research Council (MRC) grades 1/5 to 5/5. Laboratory exams included serum CK levels, nerve conduction studies (NCS)/needle electromyography (EMG), pulmonary function tests, EKG and cardiac ultrasound. ANO5 molecular screening was performed with different approaches. RESULTS Group 1 patients showed myalgias with hyperCKemia or isolated hyperCKemia. Group 2 patients presented with limb-girdle or proximo-distal muscular weakness. Serum CK levels ranged from 897 to 5000 UI/L. Muscle biopsy analysis in P4 and P5 showed subsarcolemmal mitochondrial aggregates. Electron microscopy confirmed mitochondrial proliferation and revealed discontinuity of the sarcolemmal membrane. Muscle MRI showed asymmetrical fibro-fatty substitution predominant in the lower limbs.P1 and P2 were compound heterozygous for c.191dupA (p.Asn64Lysfs*15) and c.1898 + G>A; P3 was homozygous for the c.692G>T. (p.Gly231Val); P4 harbored a novel biallelic homozygous exons 1-7 ANO5 gene deletion, and P5 was homozygous for a c.172 C > T (p.(Arg 58 Trp)) ANO5 pathogenic variant. CONCLUSIONS Our cohort confirms the wide clinical variability and enlarge the genetic spectrum of ANO5-related myopathies.
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Affiliation(s)
- José Vázquez
- Department of Medical Genetics, National Rehabilitation Institute, "Luis Guillermo Ibarra Ibarra", México.,APHP, Department of Neurology, Raymond Poincaré Hospital, North-East-Ile-de-France Neuromuscular Pathology Reference Center, U 1179 INSERM, University Saint Quentin en Yvelines Versailles; Paris-Saclay, France
| | - Claire Lefeuvre
- APHP, Department of Neurology, Raymond Poincaré Hospital, North-East-Ile-de-France Neuromuscular Pathology Reference Center, U 1179 INSERM, University Saint Quentin en Yvelines Versailles; Paris-Saclay, France
| | - Rosa Elena Escobar
- Department of Electromyography and Muscle Dystrophies, National Rehabilitation Institute, "Luis Guillermo Ibarra Ibarra", México
| | | | - Antonio Miranda Duarte
- Department of Medical Genetics, National Rehabilitation Institute, "Luis Guillermo Ibarra Ibarra", México
| | - Alma Delia Hernandez
- Department of Pathology, National Rehabilitation Institute, "Luis Guillermo Ibarra Ibarra", México
| | - Marion Brisset
- APHP, Department of Neurology, Raymond Poincaré Hospital, North-East-Ile-de-France Neuromuscular Pathology Reference Center, U 1179 INSERM, University Saint Quentin en Yvelines Versailles; Paris-Saclay, France
| | - Robert-Yves Carlier
- APHP, GH U. Paris Saclay, DMU Smart Imaging, Department of Radiology, Raymond Poincaré teaching Hospital, 104 Bld R. Poincaré, 92380 Garches, France; U 1179 INSERM, Université Paris-Saclay
| | - France Leturcq
- APHP, Department of Genetics, Cochin Hospital, Paris, France
| | - Marie-Christine Durand-Canard
- APHP, Service of Physiological Explorations Raymond Poincaré Hospital, 104 Bld Raymond Poincaré, 92380 Garches, France
| | - Guillaume Nicolas
- APHP, Department of Neurology, Raymond Poincaré Hospital, North-East-Ile-de-France Neuromuscular Pathology Reference Center, U 1179 INSERM, University Saint Quentin en Yvelines Versailles; Paris-Saclay, France
| | - Pascal Laforet
- APHP, Department of Neurology, Raymond Poincaré Hospital, North-East-Ile-de-France Neuromuscular Pathology Reference Center, U 1179 INSERM, University Saint Quentin en Yvelines Versailles; Paris-Saclay, France
| | - Edoardo Malfatti
- APHP, Department of Neurology, Raymond Poincaré Hospital, North-East-Ile-de-France Neuromuscular Pathology Reference Center, U 1179 INSERM, University Saint Quentin en Yvelines Versailles; Paris-Saclay, France
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29
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Pascual-Goñi E, Fehmi J, Lleixà C, Martín-Aguilar L, Devaux J, Höftberger R, Delmont E, Doppler K, Sommer C, Radunovic A, Carvajal A, Smyth S, Williams L, Mazanec R, Potočková V, Hinds N, Cassereau J, Viala K, Lefilliatre M, Nicolas G, Foley P, Leypoldt F, Keddie S, Lunn MP, Zimprich F, Nunkoo VS, Löscher WN, Martínez-Martínez L, Díaz-Manera J, Rojas-Garcia R, Illa I, Rinaldi S, Querol L. Antibodies to the Caspr1/contactin-1 complex in chronic inflammatory demyelinating polyradiculoneuropathy. Brain 2021; 144:1183-1196. [PMID: 33880507 DOI: 10.1093/brain/awab014] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [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: 07/12/2020] [Revised: 10/02/2020] [Accepted: 11/04/2020] [Indexed: 12/19/2022] Open
Abstract
Previous studies have described the clinical, serological and pathological features of patients with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) and antibodies directed against the paranodal proteins neurofascin-155, contactin-1 (CNTN1), contactin-associated protein-1 (Caspr1), or nodal forms of neurofascin. Such antibodies are useful for diagnosis and potentially treatment selection. However, antibodies targeting Caspr1 only or the Caspr1/CNTN1 complex have been reported in few patients with CIDP. Moreover, it is unclear if these patients belong to the same pathophysiological subgroup. Using cell-based assays in routine clinical testing, we identified sera from patients with CIDP showing strong membrane reactivity when both CNTN1 and Caspr1 were co-transfected (but not when CNTN1 was transfected alone). Fifteen patients (10 male; aged between 40 and 75) with antibodies targeting Caspr1/CNTN1 co-transfected cells were enrolled for characterization. The prevalence of anti-Caspr1/CNTN1 antibodies was 1.9% (1/52) in the Sant Pau CIDP cohort, and 4.3% (1/23) in a German cohort of acute-onset CIDP. All patients fulfilled European Federation of Neurological Societies/Peripheral Nerve Society (EFNS/PNS) definite diagnostic criteria for CIDP. Seven (47%) were initially diagnosed with Guillain-Barré syndrome due to an acute-subacute onset. Six (40%) patients had cranial nerve involvement, eight (53%) reported neuropathic pain and 12 (80%) ataxia. Axonal involvement and acute denervation were frequent in electrophysiological studies. Complete response to intravenous immunoglobulin was not observed, while most (90%) responded well to rituximab. Enzyme-linked immunosorbent assay (ELISA) and teased nerve fibre immunohistochemistry confirmed reactivity against the paranodal Caspr1/CNTN1 complex. Weaker reactivity against Caspr1 transfected alone was also detected in 10/15 (67%). Sera from 13 of these patients were available for testing by ELISA. All 13 samples reacted against Caspr1 by ELISA and this reactivity was enhanced when CNTN1 was added to the Caspr1 ELISA. IgG subclasses were also investigated by ELISA. IgG4 was the predominant subclass in 10 patients, while IgG3 was predominant in other three patients. In conclusion, patients with antibodies to the Caspr1/CNTN1 complex display similar serological and clinical features and constitute a single subgroup within the CIDP syndrome. These antibodies likely target Caspr1 primarily and are detected with Caspr1-only ELISA, but reactivity is optimal when CNTN1 is added to Caspr1 in cell-based assays and ELISA.
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Affiliation(s)
- Elba Pascual-Goñi
- Neuromuscular Diseases Unit, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Spain
| | - Janev Fehmi
- Nuffield Department of Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Oxford, UK
| | - Cinta Lleixà
- Neuromuscular Diseases Unit, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Spain
| | - Lorena Martín-Aguilar
- Neuromuscular Diseases Unit, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Spain
| | - Jérôme Devaux
- Institut de Neurosciences de Montpellier, Hospital Saint Eloi, Montpelier, France
| | - Romana Höftberger
- Division of Neuropathology and Neurochemistry, Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - Emilien Delmont
- Referral Centre for ALS and Neuromuscular Diseases, Hospital La Timone, Marseille, France
| | - Kathrin Doppler
- Department of Neurology, University Hospital Würzburg, Würzburg, Germany
| | - Claudia Sommer
- Department of Neurology, University Hospital Würzburg, Würzburg, Germany
| | | | | | - Shane Smyth
- Mater Misericordiae University Hospital, Dublin, Republic of Ireland
| | - Laura Williams
- Mater Misericordiae University Hospital, Dublin, Republic of Ireland
| | - Radim Mazanec
- Department of Neurology, Medical Faculty of Charles University and University Hospital Motol, Prague, Czech Republic
| | - Veronika Potočková
- Department of Neurology, Medical Faculty of Charles University and University Hospital Motol, Prague, Czech Republic
| | - Nigel Hinds
- Abertawe Bro Morgannwg University Health Board, Swansea, Wales, UK
| | - Julien Cassereau
- Reference Centre for Neuromuscular Diseases, Department of Neurology, Angers University Hospital, Angers, France
| | - Karine Viala
- Department of Clinical Neurophysiology, Hospital de la Pitié-Salpêtrière. Paris, France
| | | | - Guillaume Nicolas
- Department of Neurology, Hôpital Raymond-Poincaré, Université Versailles-Saint-Quentin-en-Yvelines, Garches, France
| | - Peter Foley
- Anne Rowling Regenerative Neurology Clinic, University of Edinburgh, Edinburgh, UK
| | - Frank Leypoldt
- Institute of Clinical Chemistry, University Hospital Schleswig-Holstein, Kiel, Germany.,Department of Neurology, Christian-Albrechts-Universität zu Kiel, Kiel, Germany
| | - Stephen Keddie
- Centre for Neuromuscular Diseases, National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
| | - Michael P Lunn
- Centre for Neuromuscular Diseases, National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
| | - Fritz Zimprich
- Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - Vharoon Sharma Nunkoo
- Department of Neurology, Municipal University Hospital Dr. Gavril Curteanu, Oradea, Romania
| | | | - Laura Martínez-Martínez
- Department of Immunology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Jordi Díaz-Manera
- Neuromuscular Diseases Unit, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Spain.,Centro para la Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Spain
| | - Ricard Rojas-Garcia
- Neuromuscular Diseases Unit, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Spain.,Centro para la Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Spain
| | - Isabel Illa
- Neuromuscular Diseases Unit, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Spain.,Centro para la Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Spain
| | - Simon Rinaldi
- Nuffield Department of Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Oxford, UK
| | - Luis Querol
- Neuromuscular Diseases Unit, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Spain.,Centro para la Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Spain
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Lefeuvre C, Clément G, Azzedine A, Nadjib T, Marie DA, Nicolas G, Laforet P. Registre français de la maladie de Pompe : une cohorte de 210 patients adultes. Rev Neurol (Paris) 2021. [DOI: 10.1016/j.neurol.2021.02.259] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Pouliquen C, Nicolas G, Bideau B, Bideau N. Impact of Power Output on Muscle Activation and 3D Kinematics During an Incremental Test to Exhaustion in Professional Cyclists. Front Sports Act Living 2021; 2:516911. [PMID: 33778484 PMCID: PMC7988189 DOI: 10.3389/fspor.2020.516911] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Accepted: 12/21/2020] [Indexed: 11/29/2022] Open
Abstract
This study aimed to quantify the influence of an increase in power output (PO) on joint kinematics and electromyographic (EMG) activity during an incremental test to exhaustion for a population of professional cyclists. The hip flexion/extension and internal/external rotation as well as knee abduction/adduction ranges of motion were significantly decreased at 100% of the maximal aerobic power (MAP). EMG analysis revealed a significant increase in the root mean square (RMS) for all muscles from 70% of the MAP. Gastrocnemius muscles [lateralis gastrocnemius (GasL) and medialis gastrocnemius (GasM)] were the less affected by the increase of PO. Cross-correlation method showed a significant increase in the lag angle values for VM in the last stage compared to the first stage, meaning that the onset of the activation started earlier during the pedaling cycle. Statistical Parametric Mapping (SPM) demonstrated that from 70% MAP, biceps femoris (BF), tibialis anterior (TA), gluteus maximus (GM), and rectus femoris (RF) yielded larger ranges of the crank cycle on which the level of recruitment was significantly increased. This study revealed specific muscular and kinematic coordination for professional cyclists in response to PO increase.
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Affiliation(s)
- Camille Pouliquen
- M2S Laboratory (Movement, Sports & Health), University Rennes 2, ENS Rennes, Bruz, France.,MIMETIC - Analysis-Synthesis Approach for Virtual Human Simulation, INRIA Rennes - Bretagne Atlantique, Rennes, France
| | - Guillaume Nicolas
- M2S Laboratory (Movement, Sports & Health), University Rennes 2, ENS Rennes, Bruz, France.,MIMETIC - Analysis-Synthesis Approach for Virtual Human Simulation, INRIA Rennes - Bretagne Atlantique, Rennes, France
| | - Benoit Bideau
- M2S Laboratory (Movement, Sports & Health), University Rennes 2, ENS Rennes, Bruz, France.,MIMETIC - Analysis-Synthesis Approach for Virtual Human Simulation, INRIA Rennes - Bretagne Atlantique, Rennes, France
| | - Nicolas Bideau
- M2S Laboratory (Movement, Sports & Health), University Rennes 2, ENS Rennes, Bruz, France.,MIMETIC - Analysis-Synthesis Approach for Virtual Human Simulation, INRIA Rennes - Bretagne Atlantique, Rennes, France
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Brisset M, Durand MC, Iosif A, Hanachi M, Palazzo C, Carlier RY, Laforêt P, Nicolas G. Bariatric surgery related proximal myopathy: A partially reversible complication. Rev Neurol (Paris) 2021; 177:1183-1188. [PMID: 33640114 DOI: 10.1016/j.neurol.2020.10.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 10/19/2020] [Accepted: 10/28/2020] [Indexed: 11/27/2022]
Abstract
Deficiency neuropathies and rhabdomyolysis have previously been reported after bariatric surgery (BS) but never myopathies. We report cases of five patients with morbid obesity who developed within 2 to 4 months of a BS, proximal myopathy following significant and rapid weight loss worsened by postoperative gastrointestinal complications. Muscle weakness concerned lower limbs in particular in quadriceps and less frequently in upper limbs and diaphragm, sometimes mimicked a Guillain-Barré syndrome. Muscle biopsy performed in 1 patient, revealed selective atrophy of type 2 fibers. Weakness slowly decreased with refeeding with vitamins supplementation. We enlarge here the clinical pattern of post-BS complications.
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Affiliation(s)
- M Brisset
- Department of Neurology, Raymond-Poincaré Hospital, AP-HP, 104, boulevard Raymond-Poincaré, 92380 Garches, France.
| | - M C Durand
- Department of Physiology, Raymond-Poincaré Hospital, AP-HP, 104, boulevard Raymond-Poincaré, 92380 Garches, France
| | - A Iosif
- Department of Neurology, Raymond-Poincaré Hospital, AP-HP, 104, boulevard Raymond-Poincaré, 92380 Garches, France
| | - M Hanachi
- Department of Clinical nutrition, Raymond-Poincaré Hospital, AP-HP, 104, boulevard Raymond-Poincaré, 92380 Garches, France
| | - C Palazzo
- Department of Rehabilitation, Cochin Hospital, AP-HP, 27, rue du Faubourg Saint-Jacques, 75014 Paris, France
| | - R-Y Carlier
- Department of Imagery, Raymond-Poincaré Hospital, AP-HP, 104, boulevard Raymond-Poincaré, 92380 Garches, France
| | - P Laforêt
- Paris-Est Neuromuscular Center, GH Pitié-Salpêtrière, AP-HP, 75013 Paris, France
| | - G Nicolas
- Department of Neurology, Raymond-Poincaré Hospital, AP-HP, 104, boulevard Raymond-Poincaré, 92380 Garches, France
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Baba T, Joyce M, Boibluche S, Hu X, McGrath D, Dubois R, Nicolas G, Prioux J. Aerobic fitness and isokinetic knee strength of semi-professional rugby union players: a comparison between backs and forwards. J Sports Med Phys Fitness 2021; 61:636-644. [PMID: 33472345 DOI: 10.23736/s0022-4707.21.11235-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND This study aimed to describe the physical fitness characteristics of semi-professional rugby union (RU) players using VO<inf>2max</inf> (mL. min-1. kg-1), knee peak torque (PT), mean power (MP), hamstring: quadriceps (H:Q) ratio and basic anthropometrics characteristics and to compare backs and forwards across these same characteristics. METHODS VO<inf>2max</inf> and ventilatory threshold (VT) as a percentage of VO<inf>2max</inf> were measured using the Bruce protocol maximal graded test. Knee strength test PT, MP and H:Q were analyzed using the isokinetic dynamometer test. Basic anthropometrics measures were obtained by measures of body mass, height (from Tanita Body Composition Analysis; Tanita Corp., Tokyo, Japan). While fat mass was measured using skinfold thicknesses taking from different body parts. Twenty-five semi-professional players aged (26.3±0.9 years) from the same team were recruited for the study. Mean experimental values from maximal graded test and isokinetic dynamometer test were analyzed using t-tests from the SigmaStat 3.11 program (Systat Software Inc., San Jose, CA, USA). RESULTS The results showed that forwards were significant taller (P=0.036), heavier (P=0.01), with greater fat mass (P=0.001) than backs. Backs had a greater VO<inf>2max</inf> (P=0.02) than forwards. With forwards having a greater (P=0.01) eccentric H PT. CONCLUSIONS This study presents important information for players and athletic coordinators as to the differences between backs and forwards across physiological and strength measures. This information can greatly inform the individualized training protocol and preparation of current and future players across different positions and different levels.
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Affiliation(s)
- Thierry Baba
- Department of Physical Education and Sports Sciences, University of Limerick, Limerick, Ireland -
| | - Micheál Joyce
- Department of Physical Education and Sports Sciences, University of Limerick, Limerick, Ireland
| | - Simon Boibluche
- Department of Strength and Conditioning, Rugby club de Vannes, Vannes, France
| | - Xiaopan Hu
- Department of Sport Science and Physical Education, École Normale Supérieure de Rennes (ENS), Rennes, France
| | - David McGrath
- Department of Physical Education and Sports Sciences, University of Limerick, Limerick, Ireland
| | - Romain Dubois
- Laboratory of Physical Activity, Performance and Health, University of Pau and the Adour Region, Tarbes, France
| | - Guillaume Nicolas
- Department of Sport Science and Physical Education, École Normale Supérieure de Rennes (ENS), Rennes, France
| | - Jacques Prioux
- Department of Sport Science and Physical Education, École Normale Supérieure de Rennes (ENS), Rennes, France
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Magnin E, Ayrignac X, Nicolas G. Diffuse neurofibrillary tangles with calcification: A single entity or two disorders in a single patient? Rev Neurol (Paris) 2021; 177:439-440. [PMID: 33478741 DOI: 10.1016/j.neurol.2020.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 09/15/2020] [Indexed: 11/30/2022]
Affiliation(s)
- E Magnin
- Department of neurology, university hospital of Besançon, 3, boulevard, Alexandre-Fleming, 25030 Besançon, France; Clinical and integrative neuroscience, research laboratory 481, Bourgogne Franche-Comté University, Besançon, France.
| | - X Ayrignac
- Inserm, département de neurologie, CRC sclérose en plaques, université de Montpellier, CHU de Montpellier, 80, avenue Augustin-Fliche, 34295 Montpellier, France
| | - G Nicolas
- UNIROUEN, Inserm U1245, department of neurology and CNR-MAJ, Normandy Center for Genomic and Personalized Medicine, Rouen university hospital, Normandie university, 76000 Rouen, France
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Lagendijk J, Beijst C, Woutjan B, Erik H, Bart S, Cezar A, Bjoern W, David S, Pierre G, Nicolas G, Thomas D, Martino B, Jurgen M, Volkmar S, Andre S, Oliver L, Peter V, Marc V, Hugo D, Dennis K. PH-0527: The design of an MR-PET for radiotherapy treatment simulation. The search for small tumour volumes. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00549-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Delmont E, Brodovitch A, Kouton L, Allou T, Beltran S, Brisset M, Camdessanché JP, Cauquil C, Cirion J, Dubard T, Echaniz-Laguna A, Grapperon AM, Jauffret J, Juntas-Morales R, Kremer LD, Kuntzer T, Labeyrie C, Lanfranco L, Maisonobe T, Mavroudakis N, Mecharles-Darrigol S, Nicolas G, Noury JB, Perie M, Rajabally YA, Remiche G, Rouaud V, Tard C, Salort-Campana E, Verschueren A, Viala K, Wang A, Attarian S, Boucraut J. Antibodies against the node of Ranvier: a real-life evaluation of incidence, clinical features and response to treatment based on a prospective analysis of 1500 sera. J Neurol 2020; 267:3664-3672. [PMID: 32676765 DOI: 10.1007/s00415-020-10041-z] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 06/26/2020] [Accepted: 06/30/2020] [Indexed: 11/29/2022]
Abstract
INTRODUCTION IgG4 antibodies against neurofascin (Nfasc155 and Nfasc140/186), contactin (CNTN1) and contactin-associated protein (Caspr1) are described in specific subtypes of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). Our objective was to assess, in a real-life practice, the incidence, the clinical features and the response to treatment of these forms of CIDP. METHODS 1500 sera of patients suspected of having CIDP from France, Belgium and Switzerland were prospectively tested using a flow cytometry technique. The characteristics of patients with antibodies against the node of Ranvier were compared to 100 seronegative CIDP from our department. RESULTS IgG4 antibodies against Nfasc155, CNTN1, and Caspr1 were, respectively, detected in 15 (prevalence 1%), 10 (0.7%) and 2 (0.2%) sera. Antibodies specific of the Nfasc140/186 were not detected. All subjects with antibodies against the node of Ranvier fulfilled diagnostic criteria for CIDP. CIDP with anti-Nfasc155 were younger, had more sensory ataxia and postural tremor than seronegative CIDP. CIDP with anti-CNTN1 had more frequent subacute onset and facial paralysis, commoner renal involvement with membranous glomerulonephritis and greater disability, than seronegative CIDP. CIDP with anti-Caspr1 had more frequent respiratory failure and cranial nerve involvement but not more neuropathic pain than seronegative CIDP. Intravenous immunoglobulins were ineffective in most seropositive patients. Rituximab produced dramatic improvement in disability and decreased antibodies titres in 13 seropositive patients (8 with anti-Nfasc155 and 5 with anti-CNTN1 antibodies). CONCLUSIONS Although rare, anti-paranodal antibodies are clinically valuable, because they are associated with specific phenotypes and therapeutic response.
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Affiliation(s)
- Emilien Delmont
- Referral Centre for Neuromuscular Diseases and ALS, La Timone Hospital, 264 Rue Saint Pierre, 13005, Marseille, France. .,Timone Neuroscience Institute, UMR CNRS 7289, Aix-Marseille University, 13005, Marseille, France.
| | - Alexandre Brodovitch
- Referral Centre for Neuromuscular Diseases and ALS, La Timone Hospital, 264 Rue Saint Pierre, 13005, Marseille, France.,Immunology Laboratory, La Conception Hospital, Marseille, France
| | - Ludivine Kouton
- Referral Centre for Neuromuscular Diseases and ALS, La Timone Hospital, 264 Rue Saint Pierre, 13005, Marseille, France
| | | | | | | | | | - Cécile Cauquil
- Department of Neurology, CHU Bicetre, APHP, Paris, France
| | | | | | | | - Aude-Marie Grapperon
- Referral Centre for Neuromuscular Diseases and ALS, La Timone Hospital, 264 Rue Saint Pierre, 13005, Marseille, France
| | | | | | - Laurent Daniel Kremer
- Department of Neurology, Strasbourg, France.,INSERM U1119, Biopathologie de la Myéline, Neuroprotection et Stratégies Thérapeutiques, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Strasbourg, France
| | - Thierry Kuntzer
- Nerve Muscle Unit, Department of Clinical Neurosciences, Lausanne University Hospital, Lausanne, Switzerland
| | | | | | - Thierry Maisonobe
- Department of Neurology, APHP, Hôpital Pitié Salpêtrière, Paris, France
| | - Nicolas Mavroudakis
- Department of Neurology, Centre de Référence Neuromusculaire, Hôpital Erasme, Université Libre de Bruxelles, Bruxelles, Belgium
| | | | | | | | - Maud Perie
- Department of Neurology, Clermont-Ferrand, France
| | | | - Gauthier Remiche
- Department of Neurology, Centre de Référence Neuromusculaire, Hôpital Erasme, Université Libre de Bruxelles, Bruxelles, Belgium
| | | | | | - Emmanuelle Salort-Campana
- Referral Centre for Neuromuscular Diseases and ALS, La Timone Hospital, 264 Rue Saint Pierre, 13005, Marseille, France
| | - Annie Verschueren
- Referral Centre for Neuromuscular Diseases and ALS, La Timone Hospital, 264 Rue Saint Pierre, 13005, Marseille, France
| | | | - Adrien Wang
- Department of Neurology, Hôpital Foch, Paris, France
| | - Shahram Attarian
- Referral Centre for Neuromuscular Diseases and ALS, La Timone Hospital, 264 Rue Saint Pierre, 13005, Marseille, France
| | - José Boucraut
- Timone Neuroscience Institute, UMR CNRS 7289, Aix-Marseille University, 13005, Marseille, France.,Immunology Laboratory, La Conception Hospital, Marseille, France
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Lefeuvre C, Schaeffer S, Carlier RY, Fournier M, Chapon F, Biancalana V, Nicolas G, Malfatti E, Laforêt P. Glycogenin-1 deficiency mimicking limb-girdle muscular dystrophy. Mol Genet Metab Rep 2020; 24:100597. [PMID: 32477874 PMCID: PMC7251390 DOI: 10.1016/j.ymgmr.2020.100597] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 03/25/2020] [Revised: 04/29/2020] [Accepted: 04/29/2020] [Indexed: 10/27/2022] Open
Abstract
Glycogen storage disease type XV (GSD XV) is a recently described muscle glycogenosis due to glycogenin-1 (GYG1) deficiency characterized by the presence of polyglucosan bodies on muscle biopsy (Polyglucosan body myopathy-2, PGBM2). Here we describe a 44 year-old man with limb-girdle muscle weakness mimicking a limb-girdle muscular dystrophy (LGMD), and early onset exertional myalgia. Neurologic examination revealed a waddling gait with hyperlordosis, bilateral asymmetric scapular winging, mild asymmetric deltoid and biceps brachii weakness, and pelvic-girdle weakness involving the gluteal muscles and, to a lesser extent, the quadriceps. Serum creatine kinase levels were slightly elevated. Electrophysiological examination showed a myopathic pattern. There was no cardiac or respiratory involvement. Whole-body muscle MRI revealed atrophy and fat replacement of the tongue, biceps brachii, pelvic girdle and erector spinae. A deltoid muscle biopsy showed the presence of PAS-positive inclusions that remained non-digested with alpha-amylase treatment. Electron microscopy studies confirmed the presence of polyglucosan bodies. A diagnostic gene panel designed by the Genetic Diagnosis Laboratory of Strasbourg University Hospital (France) for 210 muscular disorders genes disclosed two heterozygous, pathogenic GYG1 gene mutations (c.304G>C;p.(Asp102His) + c.164_165del). Considering the clinical heterogeneity found in the previously described 38 GYG-1 deficient patients, we suggest that GYG1 should be systematically included in targeted NGS gene panels for LGMDs, distal myopathies, and metabolic myopathies.
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Affiliation(s)
- Claire Lefeuvre
- Neurology Department, Raymond Poincaré University Hospital, Garches, APHP, France.,Centre de Référence de Pathologie Neuromusculaire Nord-Est-Ile-de-France, France
| | | | - Robert-Yves Carlier
- Radiology Department, DMU Smart Imaging Raymond Poincaré Hospital, Garches, GH, Université Paris Saclay, APHP, France.,U 1179 INSERM, Université Versailles Saint Quentin en Yvelines, Paris, Saclay, France
| | | | - Françoise Chapon
- Anatomo-pathology Department, Caen Universitary Hospital, INSERM U 1075, France
| | - Valérie Biancalana
- Laboratoire Diagnostic Génétique, Faculté de Médecine-CHRU, Strasbourg, France.,Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), INSERM U964, CNRS UMR 7104, Fédération de Médecine Translationnelle de Strasbourg, Université de Strasbourg, Illkirch, France
| | - Guillaume Nicolas
- Neurology Department, Raymond Poincaré University Hospital, Garches, APHP, France.,Centre de Référence de Pathologie Neuromusculaire Nord-Est-Ile-de-France, France.,U 1179 INSERM, Université Versailles Saint Quentin en Yvelines, Paris, Saclay, France
| | - Edoardo Malfatti
- Neurology Department, Raymond Poincaré University Hospital, Garches, APHP, France.,Centre de Référence de Pathologie Neuromusculaire Nord-Est-Ile-de-France, France.,U 1179 INSERM, Université Versailles Saint Quentin en Yvelines, Paris, Saclay, France
| | - Pascal Laforêt
- Neurology Department, Raymond Poincaré University Hospital, Garches, APHP, France.,Centre de Référence de Pathologie Neuromusculaire Nord-Est-Ile-de-France, France.,U 1179 INSERM, Université Versailles Saint Quentin en Yvelines, Paris, Saclay, France
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Goeb JL, Even C, Nicolas G, Gohier B, Dubas F, Garré JB. Psychiatric side effects of interferon-β in multiple sclerosis. Eur Psychiatry 2020; 21:186-93. [PMID: 16386408 DOI: 10.1016/j.eurpsy.2005.09.013] [Citation(s) in RCA: 70] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2003] [Accepted: 09/15/2005] [Indexed: 11/16/2022] Open
Abstract
AbstractPsychiatric disorders, especially depression, are frequent in patients with multiple sclerosis (MS). They are attributed both to the psychosocial impact of a chronic, usually progressive, disabling illness and to cerebral demyelination. Besides, drugs such as corticosteroids and possibly interferon (IFN) may also have depressogenic effects. Major depressive disorders and/or suicidal ideation are a major concern and efforts to identify and minimize these reactions are of much importance. Psychiatric side effects, particularly depression, are widely reported with IFN-α and have been suspected with IFN-β but are not yet fully established. Our review of the literature revealed that most studies discard an association between IFN-β and depression or suicide. However, few patients, especially those with a history of depression, might be at higher risk for depression when treated with IFN-β. Overall, considering the uncertainty of a link between IFN-β and depression and/or suicide, as well as the complete remission of psychiatric complications after IFN discontinuation and/or antidepressant treatment, physicians should closely monitor the psychiatric status of patients, but should not refrain from including them in IFN-β treatment programs, even when they have past or present depression.
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Affiliation(s)
- J-L Goeb
- Service de Psychiatrie de l'Enfant et de l'Adolescent, CHRU, 2, avenue Oscar-Lambret, F-59037 Lille, France.
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Nadjar Y, Souvannanorath S, Maisonobe T, Brisset M, De Lonlay P, Schiff M, Viala K, Boutron A, Nicolas G, Laforêt P. Sensory neuronopathy as a major clinical feature of mitochondrial trifunctional protein deficiency in adults. Rev Neurol (Paris) 2020; 176:380-386. [PMID: 32253025 DOI: 10.1016/j.neurol.2019.11.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 08/22/2019] [Accepted: 11/07/2019] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Mitochondrial trifunctional protein deficiency (MTPD) is a long-chain fatty acid oxidation disorder characterized by co-existence of rhabdomyolysis episodes and peripheral neuropathy. Two phenotypes are described: generalized mitochondrial trifunctional protein deficiency (gMTPD) and isolated long-chain-3-hydroxyacyl-CoA dehydrogenase deficiency (iLCHADD) that is always associated with the c.1528G>C mutation. Peripheral neuropathy of MTPD is commonly described in children as axonal, length-dependent and sensorimotor. OBJECTIVES To report clinical and electrophysiological features of four independent adult MTPD patients with peripheral neuropathy. RESULTS Onset of the disease was characterized in all patients by rhabdomyolysis episodes occurring during childhood preceded by severe hypoglycemic episodes in three patients. Peripheral nerve involvement manifesting as sensory ataxia appeared later, during adolescence or adulthood. In all cases, electroneuromyogram showed no length-dependent sensory potentials decrease characteristic of sensory neuronopathy ("ganglionopathy"). All patients harbored at least one c.1528G>C mutation. DISCUSSION We describe MTPD as a newly hereditary etiology of sensory neuronopathy in adults, specifically in patients with c.1528G>C mutation. MTPD should be screened for by performing plasma acylcarnitines in patients with chronic sensory neuronopathy and additional suggestive features such as exercise intolerance or retinopathy.
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Affiliation(s)
- Y Nadjar
- Département de neurologie, centre de référence des maladies lysosomales, UF neuro-génétique et métabolisme, groupe hospitalier Pitié-Salpêtrière, Assistance publique-Hôpitaux de Paris, Paris, France.
| | - S Souvannanorath
- Centre de référence des maladies neuromusculaires, hôpital Henri-Mondor, Assistance publique-Hôpitaux de Pars, Créteil, France.
| | - T Maisonobe
- Département de neurophysiologie clinique, groupe hospitalier Pitié-Salpêtrière, Assistance publique-Hôpitaux de Paris, Paris, France.
| | - M Brisset
- Département de neurologie, hôpital Raymond-Poincaré, Garches, France; Inserm U1179 Versailles Saint-Quentin-en-Yvelines university, 78180 Montigny-le-Bretonneux, France.
| | - P De Lonlay
- Reference center for inborn errors of metabolism, Necker-Enfants-Malades university hospital, AP-HP, Paris Descartes university, INSERM UMR_S1151, 75015 Paris, France.
| | - M Schiff
- Reference center for inborn errors of metabolism, Robert-Debré university hospital, AP-HP, Paris Diderot university, INSERM U1141, 75019 Paris, France.
| | - K Viala
- Département de neurophysiologie clinique, groupe hospitalier Pitié-Salpêtrière, Assistance publique-Hôpitaux de Paris, Paris, France.
| | - A Boutron
- Service de biochimie, hôpital de Bicêtre, CHU Paris - GH Paris-Sud, Paris, France.
| | - G Nicolas
- Département de neurologie, hôpital Raymond-Poincaré, Garches, France; Inserm U1179 Versailles Saint-Quentin-en-Yvelines university, 78180 Montigny-le-Bretonneux, France.
| | - P Laforêt
- Département de neurologie, hôpital Raymond-Poincaré, Garches, France; Inserm U1179 Versailles Saint-Quentin-en-Yvelines university, 78180 Montigny-le-Bretonneux, France.
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Antwi K, Nicolas G, Fani M, Heye T, Pattou F, Grossman A, Chanson P, Reubi JC, Perren A, Gloor B, Vogt DR, Wild D, Christ E. 68Ga-Exendin-4 PET/CT Detects Insulinomas in Patients With Endogenous Hyperinsulinemic Hypoglycemia in MEN-1. J Clin Endocrinol Metab 2019; 104:5843-5852. [PMID: 31298706 DOI: 10.1210/jc.2018-02754] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 07/08/2019] [Indexed: 01/15/2023]
Abstract
CONTEXT Surgical intervention is advised in patients with multiple endocrine neoplasia type-1 (MEN-1) and nonfunctioning pancreatic neuroendocrine tumors (PanNETs) with a size ≥20 mm. Functioning PanNETs, such as in patients with endogenous hyperinsulinemic hypoglycemia (EHH) due to (one or multiple) insulinomas, should be treated surgically independent of size. Preoperative localization of insulinomas is critical for surgery. OBJECTIVE To evaluate the feasibility and sensitivity of 68Ga-DOTA-exendin-4 positron emission tomography (PET)/CT in the detection of clinically relevant lesions in patients with MEN-1 and EHH in combination with MRI. DESIGN Post hoc subgroup analysis of a larger prospective imaging study with 52 patients with EHH. PATIENTS Six of 52 consecutive patients with EHH and genetically proven MEN-1 mutation were included. INTERVENTIONS All patients received one 68Ga-DOTA-exendin-4 PET/CT and one MRI scan within 3 to 4 days. Thereafter, surgery was performed based on all imaging results. MAIN OUTCOME MEASURES Lesion-based sensitivity of PET/CT and MRI for detection of clinically relevant lesions was calculated. Readers were unaware of other results. The reference standard was surgery with histology and treatment outcome. True positive (i.e., clinically relevant lesions) was defined as PanNETs ≥20 mm or insulinoma. RESULTS In six patients, 37 PanNETs were confirmed by histopathology. Sensitivity (95% CI) in the detection of clinically relevant lesions for combined PET/CT plus MRI, MRI, and PET/CT was 92.3% (64% to 99.8%), 38.5% (13.9% to 68.4%), and 84.6% (54.6% to 98.1%), respectively (P = 0.014 for the comparison of PET/CT plus MRI vs MRI). Postsurgery, EHH resolved in all patients. CONCLUSION 68Ga-DOTA-exendin-4 PET/CT is feasible in patients with MEN-1 and EHH. The combination with MRI is superior to MRI alone in the detection of insulinomas and may guide the surgical strategy.
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Affiliation(s)
- Kwadwo Antwi
- Clinic of Radiology and Nuclear Medicine, University Hospital Basel, Basel, Switzerland
| | - Guillaume Nicolas
- Clinic of Radiology and Nuclear Medicine, University Hospital Basel, Basel, Switzerland
- Center for Neuroendocrine and Endocrine Tumors, University Hospital Basel, Basel, Switzerland
| | - Melpomeni Fani
- Clinic of Radiology and Nuclear Medicine, University Hospital Basel, Basel, Switzerland
| | - Tobias Heye
- Clinic of Radiology and Nuclear Medicine, University Hospital Basel, Basel, Switzerland
| | - Francois Pattou
- Department of General and Endocrine Surgery, Lille University Hospital, Lille France
| | - Ashley Grossman
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford, United Kingdom
- Neuroendocrine Unit, Royal Free Hospital, London, United Kingdom
| | - Philippe Chanson
- Assistance Publique-Hôpitaux de Paris, Service d'Endocrinologie et des Maladies de la Reproduction, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
- UMR S-1185, Université Paris Sud, Université Paris-Saclay, Le Kremlin-Bicêtre, France
| | | | - Aurel Perren
- Department of Pathology, University of Bern, Bern, Switzerland
| | - Beat Gloor
- Department of Visceral Surgery, University Hospital of Bern, Inselspital, Bern, Switzerland
| | - Deborah R Vogt
- Clinical Trial Unit, Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Damian Wild
- Clinic of Radiology and Nuclear Medicine, University Hospital Basel, Basel, Switzerland
- Center for Neuroendocrine and Endocrine Tumors, University Hospital Basel, Basel, Switzerland
| | - Emanuel Christ
- Center for Neuroendocrine and Endocrine Tumors, University Hospital Basel, Basel, Switzerland
- Division of Endocrinology, Diabetology and Metabolism, University Hospital Basel, Basel, Switzerland
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Zamboglou C, Fassbender TF, Steffan L, Schiller F, Fechter T, Carles M, Kiefer S, Rischke HC, Reichel K, Schmidt-Hegemann NS, Ilhan H, Chirindel AF, Nicolas G, Henkenberens C, Derlin T, Bronsert P, Mavroidis P, Chen RC, Meyer PT, Ruf J, Grosu AL. Validation of different PSMA-PET/CT-based contouring techniques for intraprostatic tumor definition using histopathology as standard of reference. Radiother Oncol 2019; 141:208-213. [PMID: 31431386 DOI: 10.1016/j.radonc.2019.07.002] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 06/28/2019] [Accepted: 07/02/2019] [Indexed: 12/15/2022]
Abstract
PURPOSE Accurate definition of the intraprostatic gross tumor volume (GTV) is crucial for diagnostic and therapeutic approaches in patients with primary prostate cancer (PCa). The optimal methodology for contouring of GTV using Prostate specific membrane antigen positron emission tomography (PSMA-PET) information has not yet been defined. METHODS AND MATERIALS PCa patients who underwent a [68Ga]PSMA-11-PET/CT followed by radical prostatectomy were prospectively enrolled (n = 20). Six observer teams with different levels of experience and using different PET image scaling techniques performed manual contouring of GTV. Additionally, semi-automatic segmentation of GTVs was performed using SUVmax thresholds of 20-50%. Coregistered histopathological gross tumor volume (GTV-Histo) served as reference. Inter-observer agreement was assessed by calculating the Dice similarity coefficient (DSC). RESULTS Most contouring methods provided high sensitivity and specificity. For manual delineation, scaling the PET images from SUVmin-max: 0-5 resulted in high sensitivity (>86%). The highest specificity (100%) was obtained by scaling the PET images from SUVmin-max: 0-SUVmax. High interobserver agreement (median DSC 0.8) was observed when using the same PET image scaling technique (PET images SUVmin-max: 0-5). For semi-automatic segmentation, a low SUVmax threshold of 20% optimized sensitivity (SUVmax threshold 20%, 100% sensitivity, 32% of prostatic volume), whereas a higher threshold optimized specificity (SUVmax threshold 40%-50%, 100% specificity). CONCLUSIONS Contouring of regions with high tracer-uptake resulted in very high specificities and should be used for biopsy guidance. Both manual and semi-automatic approaches using validated SUV scaling (SUVmin-max: 0-5) or thresholding (20%) may provide high sensitivity, and should be considered for PSMA-PET-based focal therapy approaches.
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Affiliation(s)
- Constantinos Zamboglou
- Department of Radiation Oncology, Medical Center - University of Freiburg, Faculty of Medicine. University of Freiburg, Germany; German Cancer Consortium (DKTK), Partner Site Freiburg, Germany; Berta-Ottenstein-Programme, Faculty of Medicine, University of Freiburg, Germany
| | - Thomas F Fassbender
- Department of Nuclear Medicine, Medical Center - University of Freiburg, Faculty of Medicine. University of Freiburg, Germany.
| | - Lina Steffan
- Department of Radiation Oncology, Medical Center - University of Freiburg, Faculty of Medicine. University of Freiburg, Germany; German Cancer Consortium (DKTK), Partner Site Freiburg, Germany
| | - Florian Schiller
- Department of Nuclear Medicine, Medical Center - University of Freiburg, Faculty of Medicine. University of Freiburg, Germany
| | - Tobias Fechter
- Division of Medical Physics, Department of Radiation Oncology, Medical Center - University of Freiburg, Faculty of Medicine. University of Freiburg, Germany
| | - Montserrat Carles
- Division of Medical Physics, Department of Radiation Oncology, Medical Center - University of Freiburg, Faculty of Medicine. University of Freiburg, Germany
| | - Selina Kiefer
- Department of Pathology, Medical Center - University of Freiburg, Faculty of Medicine. University of Freiburg, Germany; German Cancer Consortium (DKTK), Partner Site Freiburg, Germany
| | - Hans C Rischke
- Department of Radiation Oncology, Medical Center - University of Freiburg, Faculty of Medicine. University of Freiburg, Germany; German Cancer Consortium (DKTK), Partner Site Freiburg, Germany
| | - Kathrin Reichel
- Department of Urology, Medical Center - University of Freiburg, Faculty of Medicine. University of Freiburg, Germany
| | | | - Harun Ilhan
- Department of Nuclear Medicine, University Hospital, LMU Munich, Germany
| | - Alin F Chirindel
- Department of Radiology and Nuclear Medicine, University Hospital Basel, Switzerland
| | - Guillaume Nicolas
- Department of Radiology and Nuclear Medicine, University Hospital Basel, Switzerland
| | | | - Thorsten Derlin
- Department of Nuclear Medicine, Hannover Medical School, Germany
| | - Peter Bronsert
- Department of Pathology, Medical Center - University of Freiburg, Faculty of Medicine. University of Freiburg, Germany; German Cancer Consortium (DKTK), Partner Site Freiburg, Germany
| | | | - Ronald C Chen
- Department of Radiation Oncology, University North Carolina - Chapel Hill, USA
| | - Philipp T Meyer
- Department of Nuclear Medicine, Medical Center - University of Freiburg, Faculty of Medicine. University of Freiburg, Germany
| | - Juri Ruf
- Department of Nuclear Medicine, Medical Center - University of Freiburg, Faculty of Medicine. University of Freiburg, Germany
| | - Anca L Grosu
- Department of Radiation Oncology, Medical Center - University of Freiburg, Faculty of Medicine. University of Freiburg, Germany; German Cancer Consortium (DKTK), Partner Site Freiburg, Germany
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Ghaleb Y, Elbitar S, Loste A, El Khoury P, Abou-Khalil Y, Nicolas G, Le Borgne M, Moulin P, Di-Filippo M, Charriere S, Iliozer H, Rabès J, Boileau C, Abifadel M, Varret M. Implication Of Lrp6 Variants In Familial Hypercholesterolemia. Atherosclerosis 2019. [DOI: 10.1016/j.atherosclerosis.2019.06.231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Brisset M, Ben Yaou R, Carlier RY, Chanut A, Nicolas G, Romero NB, Wahbi K, Decrocq C, Leturcq F, Laforêt P, Malfatti E. X-linked Emery-Dreifuss muscular dystrophy manifesting with adult onset axial weakness, camptocormia, and minimal joint contractures. Neuromuscul Disord 2019; 29:678-683. [PMID: 31474437 DOI: 10.1016/j.nmd.2019.06.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 06/01/2019] [Accepted: 06/14/2019] [Indexed: 11/17/2022]
Abstract
Emery-Dreifuss muscular dystrophy is an early-onset, slowly progressive myopathy characterized by the development of multiple contractures, muscle weakness and cardiac dysfunction. We present here the case of a 65-year-old male patient with a 20 year history of slowly progressive camptocormia, bradycardia and shortness of breath. Examination showed severe spine extensor and neck flexor muscle weakness with slight upper limb proximal weakness. Cardiologic assessment revealed slow atrial fibrillation. Whole body MRI demonstrated adipose substitution of the paravertebral, limb girdle and peroneal muscles as well as the tongue. Emerin immunohistochemistry on patient muscle biopsy revealed the absence of nuclear envelope labeling confirmed by Western Blot. Genetic analysis showed a hemizygous duplication of 5 bases in exon 6 of the EMD, emerin, gene on the X chromosome. This is an unusual presentation of X-linked Emery-Dreifuss muscular dystrophy with adult onset, predominant axial muscles involvement and minimal joint contractures. Diagnosis was prompted by the analysis of emerin on muscle biopsy.
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Affiliation(s)
- Marion Brisset
- APHP, Department of Neurology, Raymond Poincaré Hospital, Centre de Référence de Pathologie Neuromusculaire Nord-Est-Ile-de-France, 104 Bld Raymond Poincaré, 92380 Garches, France
| | - Rabah Ben Yaou
- APHP, Centre de Référence de Pathologie Neuromusculaire Nord-Est-Ile-de-France, Institut de Myologie, G.H. Pitié-Salpêtrière, F-75013 Paris, France; Université Sorbonne, INSERM U974, Center of Research in Myology, Institut de Myologie, G.H. Pitié-Salpêtrière Paris F-75013, France
| | - Robert-Yves Carlier
- APHP, Medical imaging Department, Raymond Poincaré teaching Hospital, GHU GH HUPIFO, 104 Bld Raymond Poincaré, 92380 Garches, France; Service de Neurologie, U1179 UVSQ-INSERM Handicap Neuromusculaire: Physiologie, Biothérapie et Pharmacologie appliquées, UFR Simone Veil-Santé, Université Versailles-Saint-Quentin-en-Yvelines, Pôle neuro-locomoteur, Hôpital Raymond Poincaré, Paris-Saclay, 104 boulevard Raymond Poincaré, 92380 Garches, France
| | - Anaїs Chanut
- Unité de Morphologie Neuromusculaire, Institut de Myologie, Groupe Hospitalier Universitaire La Pitié-Salpêtrière, Paris, France
| | - Guillaume Nicolas
- APHP, Department of Neurology, Raymond Poincaré Hospital, Centre de Référence de Pathologie Neuromusculaire Nord-Est-Ile-de-France, 104 Bld Raymond Poincaré, 92380 Garches, France; Service de Neurologie, U1179 UVSQ-INSERM Handicap Neuromusculaire: Physiologie, Biothérapie et Pharmacologie appliquées, UFR Simone Veil-Santé, Université Versailles-Saint-Quentin-en-Yvelines, Pôle neuro-locomoteur, Hôpital Raymond Poincaré, Paris-Saclay, 104 boulevard Raymond Poincaré, 92380 Garches, France
| | - Norma B Romero
- APHP, Centre de Référence de Pathologie Neuromusculaire Nord-Est-Ile-de-France, Institut de Myologie, G.H. Pitié-Salpêtrière, F-75013 Paris, France; Université Sorbonne, INSERM U974, Center of Research in Myology, Institut de Myologie, G.H. Pitié-Salpêtrière Paris F-75013, France; Unité de Morphologie Neuromusculaire, Institut de Myologie, Groupe Hospitalier Universitaire La Pitié-Salpêtrière, Paris, France
| | - Karim Wahbi
- APHP, Department of Cardiology, Cochin Hospital, 75015 Paris, France
| | - Camille Decrocq
- Department of Physiology, Foch Hospital, 40 Rue Worth, 92150 Suresnes, France
| | - France Leturcq
- APHP, Laboratoire de Génétique et Biologie moléculaire, HUPC Cochin, Paris, France
| | - Pascal Laforêt
- APHP, Department of Neurology, Raymond Poincaré Hospital, Centre de Référence de Pathologie Neuromusculaire Nord-Est-Ile-de-France, 104 Bld Raymond Poincaré, 92380 Garches, France; Service de Neurologie, U1179 UVSQ-INSERM Handicap Neuromusculaire: Physiologie, Biothérapie et Pharmacologie appliquées, UFR Simone Veil-Santé, Université Versailles-Saint-Quentin-en-Yvelines, Pôle neuro-locomoteur, Hôpital Raymond Poincaré, Paris-Saclay, 104 boulevard Raymond Poincaré, 92380 Garches, France
| | - Edoardo Malfatti
- APHP, Department of Neurology, Raymond Poincaré Hospital, Centre de Référence de Pathologie Neuromusculaire Nord-Est-Ile-de-France, 104 Bld Raymond Poincaré, 92380 Garches, France; Service de Neurologie, U1179 UVSQ-INSERM Handicap Neuromusculaire: Physiologie, Biothérapie et Pharmacologie appliquées, UFR Simone Veil-Santé, Université Versailles-Saint-Quentin-en-Yvelines, Pôle neuro-locomoteur, Hôpital Raymond Poincaré, Paris-Saclay, 104 boulevard Raymond Poincaré, 92380 Garches, France.
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von Niederhäusern PA, Pezold S, Nahum U, Seppi C, Nicolas G, Rissi M, Haerle SK, Cattin PC. Augmenting camera images with gamma detector data : A novel approach to support sentinel lymph node biopsy. EJNMMI Phys 2019; 6:10. [PMID: 31214811 PMCID: PMC6582166 DOI: 10.1186/s40658-019-0245-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 05/06/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Squamous cell carcinoma in the head and neck region is one of the most widespread cancers with high morbidity. Classic treatment comprises the complete removal of the lymphatics together with the cancerous tissue. Recent studies have shown that such interventions are only required in 30% of the patients. Sentinel lymph node biopsy is an alternative method to stage the malignancy in a less invasive manner and to avoid overtreatment. In this paper, we present a novel approach that enables a future augmented reality device which improves the biopsy procedure by visual means. METHODS We propose a co-calibration scheme for axis-aligned miniature cameras with pinholes of a gamma ray collimating and sensing device and show results gained by experiments, based on a calibration target visible for both modalities. RESULTS Visual inspection and quantitative evaluation of the augmentation of optical camera images with gamma information are congruent with known gamma source landmarks. CONCLUSIONS Combining a multi-pinhole collimator with axis-aligned miniature cameras to augment optical images using gamma detector data is promising. As such, our approach might be applicable for breast cancer and melanoma staging as well, which are also based on sentinel lymph node biopsy.
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Affiliation(s)
| | - Simon Pezold
- Department of Biomedical Engineering, University of Basel, Allschwil, CH-4123, Switzerland
| | - Uri Nahum
- Department of Biomedical Engineering, University of Basel, Allschwil, CH-4123, Switzerland
| | - Carlo Seppi
- Department of Biomedical Engineering, University of Basel, Allschwil, CH-4123, Switzerland
| | - Guillaume Nicolas
- University Hospital Basel, Radiology & Nuclear Medicine Clinic, Basel, CH-4031, Switzerland
| | | | - Stephan K Haerle
- Center for Head and Neck Surgical Oncology and Reconstructive Surgery, Hirslanden Clinic, Lucerne, CH-6006, Switzerland
| | - Philippe C Cattin
- Department of Biomedical Engineering, University of Basel, Allschwil, CH-4123, Switzerland
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Cordillet S, Bideau N, Bideau B, Nicolas G. Estimation of 3D Knee Joint Angles during Cycling Using Inertial Sensors: Accuracy of a Novel Sensor-to-Segment Calibration Procedure Based on Pedaling Motion. Sensors (Basel) 2019; 19:s19112474. [PMID: 31151200 PMCID: PMC6603641 DOI: 10.3390/s19112474] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 05/22/2019] [Accepted: 05/25/2019] [Indexed: 01/12/2023]
Abstract
This paper presents a novel sensor-to-segment calibration procedure for inertial sensor-based knee joint kinematics analysis during cycling. This procedure was designed to be feasible in-field, autonomously, and without any external operator or device. It combines a static standing up posture and a pedaling task. The main goal of this study was to assess the accuracy of the new sensor-to-segment calibration method (denoted as the 'cycling' method) by calculating errors in terms of body-segment orientations and 3D knee joint angles using inertial measurement unit (IMU)-based and optoelectronic-based motion capture. To do so, 14 participants were evaluated during pedaling motion at a workload of 100 W, which enabled comparisons of the cycling method with conventional calibration methods commonly employed in gait analysis. The accuracy of the cycling method was comparable to that of other methods concerning the knee flexion/extension angle, and did not exceed 3.8°. However, the cycling method presented the smallest errors for knee internal/external rotation (6.65 ± 1.94°) and abduction/adduction (5.92 ± 2.85°). This study demonstrated that a calibration method based on the completion of a pedaling task combined with a standing posture significantly improved the accuracy of 3D knee joint angle measurement when applied to cycling analysis.
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Affiliation(s)
- Sébastien Cordillet
- M2S Laboratory (Movement, Sports & Health), University Rennes 2, ENS Rennes, 35170 Bruz, France.
- MIMETIC-Analysis-Synthesis Approach for Virtual Human Simulation, INRIA Rennes-Bretagne Atlantique, IRISA_D6-MEDIA ET INTERACTIONS, 35000 Rennes, France.
| | - Nicolas Bideau
- M2S Laboratory (Movement, Sports & Health), University Rennes 2, ENS Rennes, 35170 Bruz, France.
- MIMETIC-Analysis-Synthesis Approach for Virtual Human Simulation, INRIA Rennes-Bretagne Atlantique, IRISA_D6-MEDIA ET INTERACTIONS, 35000 Rennes, France.
| | - Benoit Bideau
- M2S Laboratory (Movement, Sports & Health), University Rennes 2, ENS Rennes, 35170 Bruz, France.
- MIMETIC-Analysis-Synthesis Approach for Virtual Human Simulation, INRIA Rennes-Bretagne Atlantique, IRISA_D6-MEDIA ET INTERACTIONS, 35000 Rennes, France.
| | - Guillaume Nicolas
- M2S Laboratory (Movement, Sports & Health), University Rennes 2, ENS Rennes, 35170 Bruz, France.
- MIMETIC-Analysis-Synthesis Approach for Virtual Human Simulation, INRIA Rennes-Bretagne Atlantique, IRISA_D6-MEDIA ET INTERACTIONS, 35000 Rennes, France.
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Haering D, Pontonnier C, Bideau N, Nicolas G, Dumont G. Using Torque-Angle and Torque–Velocity Models to Characterize Elbow Mechanical Function: Modeling and Applied Aspects. J Biomech Eng 2019; 141:2730877. [DOI: 10.1115/1.4043447] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Indexed: 11/08/2022]
Abstract
Characterization of muscle mechanism through the torque-angle and torque–velocity relationships is critical for human movement evaluation and simulation. in vivo determination of these relationships through dynamometric measurements and modeling is based on physiological and mathematical aspects. However, no investigation regarding the effects of the mathematical model and the physiological parameters underneath these models was found. The purpose of the current study was to compare the capacity of various torque-angle and torque–velocity models to fit experimental dynamometric measurement of the elbow and provide meaningful mechanical and physiological information. Therefore, varying mathematical function and physiological muscle parameters from the literature were tested. While a quadratic torque-angle model seemed to increase predicted to measured elbow torque fitting, a new power-based torque–velocity parametric model gave meaningful physiological values to interpret with similar fitting results to a classical torque–velocity model. This model is of interest to extract modeling and clinical knowledge characterizing the mechanical behavior of such a joint.
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Affiliation(s)
- Diane Haering
- IBHGC, ENSAM ParisTech, Paris F-75014, France e-mail:
| | - Charles Pontonnier
- Univ Rennes, CNRS, INRIA, IRISA, UMR6074, Rennes F-35000, France e-mail:
| | - Nicolas Bideau
- Univ Rennes, M2S, EA1274, Rennes F-35000, France e-mail:
| | | | - Georges Dumont
- Univ Rennes, CNRS, INRIA, IRISA, UMR6074, Rennes F-35000 France e-mail:
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Cordillet S, Bideau N, Menard M, Nicolas G. Gyro-based lower limb asymmetry during a 4-km time trial on a velodrome among high level female cyclists. Comput Methods Biomech Biomed Engin 2019. [DOI: 10.1080/10255842.2020.1714941] [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: 10/24/2022]
Affiliation(s)
- S. Cordillet
- M2S Laboratory, Univ Rennes, Avenue Robert Schuman, Campus de Ker Lann, Bruz, France
| | - N. Bideau
- M2S Laboratory, Univ Rennes, Avenue Robert Schuman, Campus de Ker Lann, Bruz, France
| | - M. Menard
- M2S Laboratory, Univ Rennes, Avenue Robert Schuman, Campus de Ker Lann, Bruz, France
| | - G. Nicolas
- M2S Laboratory, Univ Rennes, Avenue Robert Schuman, Campus de Ker Lann, Bruz, France
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Rottenburger C, Nicolas G, McDougall L, Kaul F, Cachovan M, Schibli R, Geistlich S, Behe M, Wild D, Christ E. SUN-334 Evaluation of the CCK-2 Receptor Agonist 177Lu-PP-F11N for PRRT of Medullary Thyroid Carcinoma: Results of a Phase 0 "Lumed" Study. J Endocr Soc 2019. [PMCID: PMC6552824 DOI: 10.1210/js.2019-sun-334] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Introduction: Despite the introduction of new molecular targeted therapies, there is still an unmet need for an effective systemic therapy for advanced medullary thyroid carcinoma (MTC). As MTC expresses cholecystokinine-2 (CCK-2) receptors at a high incidence and density, targeting the CCK-2 receptor with radiolabelled gastrin analogues is a potential approach for radionuclide therapy. Unfortunately, kidney and bone marrow toxicity precluded therapeutic applications of CCK-2 receptor specific radiotracers until now. The aim of this prospective study is the feasibility testing of targeting CCK-2 receptors with the novel gastrin analogue [177Lu-DOTA-(DGlu)6-Ala-Tyr-Gly-Trp-Nleu-Asp-PheNH2] (177Lu-PP-F11N) in six patients with advanced MTC (ClinicalTrials.gov: NCT02088645). Subjects and Methods: Six patients received two injections of 1 GBq 177Lu-PP-F11N, one injection with and the other without Physiogel (Gelofusin = plasma expander for nephroprotection) infusion. Planar scintigraphy and SPECT/CT scans were performed at several time points for up to 72 h post injection in order to calculate tumour- and organ doses using 3D voxel- and MIRD based dosimetry (Dosimetry Research Tool v5.2, Siemens Medical Solutions, USA). Blood samples were taken for bone marrow dose calculations. ECG, blood count and blood chemistry were measured up to 12 weeks after the second administration of 177Lu-PP-F11N in order to evaluate adverse events. Results: Adverse reactions (mainly hypotension, flushing and hypokalemia) were self-limiting and not higher than grade 1, according to CTCAE version 4.03. In all patients, 177Lu-PP-F11N accumulation was visible in tumor tissue, in the kidneys, stomach and the colon. Altogether, 14 tumours were eligible for dosimetry. The median (range) radiation dose for tumours, kidneys and bone marrow was 0.88 Gy/GBq (0.69-2.85), 0.090 (0.045-0.115) and 0.010 (0.008-0.016). These resulted in median tumour-to-kidney dose ratios of 12.8 (6.0-52.4) (without Physiogel) and 12.4 (6.4-29.8) (with Physiogel), which was not significantly different. The median tumour-to-bone marrow dose ratio was 87.9 (52.8-316.4). Discussion/Conclusion: The administration of the novel CCK-2 receptor ligand 177Lu-PP-F11N was safe in all six examined patients. Visualization of metastasized/recurrent disease in all patients provides evidence that CCK-2 receptor targeting with 177Lu-PP-F11N is feasible in patients with MTC. The dosimetry results indicate tumour doses that could enable radionuclide therapy. Dosimetry results for kidneys and bone marrow revealed low organ doses, as well as excellent tumour-to-kidney and tumour-to-bone marrow ratios. Further studies will be necessary to evaluate the theranostic potential of 177Lu-PP-F11N in patients with CCK-2 receptor expressing tumours.
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Affiliation(s)
| | - Guillaume Nicolas
- Division of Nuclear Medicine, University Hosp of Basel, Basel, , Switzerland
| | - Lisa McDougall
- Division of Nuclear Medicine, University Hosp of Basel, Basel, , Switzerland
| | - Felix Kaul
- Division of Nuclear Medicine, University Hosp of Basel, Basel, , Switzerland
| | | | - Roger Schibli
- Center for Radiopharmaceutical Scicencs, Paul Scherrer Institute, Villigen, , Switzerland
| | - Susanne Geistlich
- Center for Radiopharmaceutical Scicencs, Paul Scherrer Institute, Villigen, , Switzerland
| | - Martin Behe
- Center for Radiopharmaceutical Scicencs, Paul Scherrer Institute, Villigen, , Switzerland
| | - Damian Wild
- Division of Nuclear Medicine, University Hosp of Basel, Basel, , Switzerland
| | - Emanuel Christ
- Interdisciplinary Endocrinology, University Hosp of Basel, Basel, , Switzerland
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Guinard E, Durand MC, Laforêt P, Malfatti E, Nicolas G, Brisset M. Diagnostic d’un pseudo-botulisme chez un patient atteint d’une amyotrophie spinale. Rev Neurol (Paris) 2019. [DOI: 10.1016/j.neurol.2019.01.162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
Molecular imaging has found numerous applications in oncology as many tumours express or activate tumour specific target molecules or pathways. This relatively new imaging technique results in a better localisation of tumours and improved tumour staging, especially in the setting of hybrid imaging that is in combination with morphological imaging such as computed tomography. In well differentiated neuroendocrine tumours, somatostatin receptor imaging, as one of the first examples of receptor targeted imaging in humans, plays an important role in the diagnostic work-up of these patients. In poorly differentiated neuroendocrine tumours or medullary thyroid carcinoma, 18F-fluorodeoxyglucose PET/CT and dihydroxyphenylalanine PET/CT play an important role due to the limitations of the somatostatin receptor imaging in these tumour entities. These limitations prompted the development of innovations such as radiolabelled somatostatin receptor antagonists for imaging all types of NET and glucagon-like peptide-1 receptor agonists for the imaging of insulinomas. The current review summarises the actual state of knowledge in the field.
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Affiliation(s)
- Kwadwo Antwi
- Division of Nuclear Medicine, University Hospital Basel, Basel, Switzerland
| | - Guillaume Nicolas
- Division of Nuclear Medicine, University Hospital Basel, Basel, Switzerland / Centre for Neuroendocrine and Endocrine Tumours, University Hospital Basel, Basel, Switzerland
| | - Damian Wild
- Division of Nuclear Medicine, University Hospital Basel, Basel, Switzerland/ Centre for Neuroendocrine and Endocrine Tumours, University Hospital Basel, Basel, Switzerland
| | - Emanuel Christ
- Centre for Neuroendocrine and Endocrine Tumours, University Hospital Basel, Basel, Switzerland/ Division of Endocrinology, Diabetology and Metabolism, University Hospital Basel, Basel, Switzerland
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