1
|
Lebon P, Gelot A, Zhang SY, Casanova JL, Hauw JJ. La panencéphalite sclérosante subaiguë de la rougeole. Med Sci (Paris) 2022; 38:553-561. [DOI: 10.1051/medsci/2022081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
La panencéphalite sclérosante subaiguë (PESS), une complication tardive de la rougeole, est encore présente lors d’épidémies de cette maladie dues aux insuffisances de la vaccination. Après un rappel historique, nous aborderons la physiopathologie de la PESS et l’importance des critères diagnostiques. De nombreux travaux portant sur les paramètres de l’immunité innée et sur ceux des réponses interféron tendent à montrer une baisse de l’activité de l’immunité cellulaire au cours de cette maladie. Nous formulons ici plusieurs hypothèses s’appuyant sur des publications concernant différentes formes de la maladie : congénitales, périnatales, formes à incubation courte, semblables à l’encéphalite aiguë à inclusions (EAI), formes d’évolution rapide, formes retrouvées chez les immunodéprimés ou chez l’adulte. Des formes familiales ont également été identifiées, suggérant une origine génétique. Selon la durée de la période de latence entre rougeole et la PESS, deux groupes de patients ont été individualisés, incitant à des analyses rétrospective et prospective des exomes de ces malades. La connaissance des gènes participant à la maladie devrait être utile pour la compréhension de la physiopathologie de la PESS mais aussi d’autres infections neurologiques tardives dues à des virus à ARN.
Collapse
|
2
|
Duyckaerts C, Maisonobe T, Hauw JJ, Seilhean D. Charcot identifies and illustrates amyotrophic lateral sclerosis. Free Neuropathol 2021; 2:2-12. [PMID: 37284640 PMCID: PMC10209997 DOI: 10.17879/freeneuropathology-2021-3323] [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] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 05/08/2021] [Indexed: 06/08/2023]
Abstract
Jean-Martin Charcot described what he called amyotrophic lateral sclerosis in his 12th and 13th lessons published in 1873 by Bourneville. He distinguished the symptoms that were related to the lesion of the anterior horn of the spinal cord and those that were due to the degeneration (that he named "sclerosis") of its lateral column. He thought that "inflammation" progressed from the lateral column to the anterior horn (but the term inflammation is not to be taken in the current meaning): the lesion of the anterior horn was thus "deuteropathic". An album containing drawings made by Charcot is kept in La Salpêtrière Neuropathology Department. Four drawings are pasted on one of its pages, showing the degeneration of the pyramidal tract. They constitute the original of the engravings illustrating Charcot's 12th lesson. The illustration of the fascicular atrophy of the adductor pollicis presented in the album does not appear in the lessons, even though this alteration is widely discussed and linked to the lesion of the anterior horn, which was supposed to ensure the "nutrition" of the muscle. The technique used by Charcot and his interpretation of the microscopic pictures, as exposed in his lessons, are discussed.
Collapse
Affiliation(s)
- Charles Duyckaerts
- Raymond Escourolle Neuropathology Department, La Salpêtrière Hospital, Assistance Publique des Hôpitaux de Paris, Sorbonne Université, Paris, France
- Alzheimer-Prions team, Paris Brain Institute ICM (INSERM U1127, CNRS UMR7225), Sorbonne Université-UMRS1127), Paris, France
| | - Thierry Maisonobe
- Raymond Escourolle Neuropathology Department, La Salpêtrière Hospital, Assistance Publique des Hôpitaux de Paris, Sorbonne Université, Paris, France
- Clinical Neurophysiology Department, La Salpêtrière Hospital, Assistance Publique des Hôpitaux de Paris, Sorbonne Université, Paris, France
| | | | - Danielle Seilhean
- Raymond Escourolle Neuropathology Department, La Salpêtrière Hospital, Assistance Publique des Hôpitaux de Paris, Sorbonne Université, Paris, France
- ALS: Causes and mechanisms of motor neuron degeneration, Paris Brain Institute ICM (INSERM U1127, CNRS UMR7225, Sorbonne Université-UMRS1127), Paris, France
| |
Collapse
|
3
|
Peckeu L, Delasnerie-Lauprètre N, Brandel JP, Salomon D, Sazdovitch V, Laplanche JL, Duyckaerts C, Seilhean D, Haïk S, Hauw JJ. Accuracy of diagnosis criteria in patients with suspected diagnosis of sporadic Creutzfeldt-Jakob disease and detection of 14-3-3 protein, France, 1992 to 2009. ACTA ACUST UNITED AC 2018; 22. [PMID: 29043964 PMCID: PMC5710122 DOI: 10.2807/1560-7917.es.2017.22.41.16-00715] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [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] [Indexed: 11/20/2022]
Abstract
Diagnostic criteria of Creutzfeldt–Jakob disease (CJD), a rare and fatal transmissible nervous system disease with public health implications, are determined by clinical data, electroencephalogram (EEG), detection of 14-3-3 protein in cerebrospinal fluid (CSF), brain magnetic resonance imaging and prion protein gene examination. The specificity of protein 14-3-3 has been questioned. We reviewed data from 1,572 autopsied patients collected over an 18-year period (1992–2009) and assessed whether and how 14-3-3 detection impacted the diagnosis of sporadic CJD in France, and whether this led to the misdiagnosis of treatable disorders. 14-3-3 detection was introduced into diagnostic criteria for CJD in 1998. Diagnostic accuracy decreased from 92% for the 1992–1997 period to 85% for the 1998–2009 period. This was associated with positive detections of 14-3-3 in cases with negative EEG and alternative diagnosis at autopsy. Potentially treatable diseases were found in 163 patients (10.5%). This study confirms the usefulness of the recent modification of diagnosis criteria by the addition of the results of CSF real-time quaking-induced conversion, a method based on prion seed-induced misfolding and aggregation of recombinant prion protein substrate that has proven to be a highly specific test for diagnosis of sporadic CJD.
Collapse
Affiliation(s)
- Laurene Peckeu
- Assistance publique-Hôpitaux de Paris (AP-HP), Cellule nationale de référence des maladies de Creutzfeldt-Jakob, Groupe Hospitalier Pitié-Salpêtrière, Paris, France.,Institut National de la Santé et de la Recherche Médicale (Inserm), U1127, Paris, France.,Institut du cerveau et de la moelle épinière (ICM), Paris, France.,These authors contributed equally to this study and share first authorship.,Sorbonne Universités, UPMCUniv Paris 06,UMRS 1127, Paris, France
| | - Nicole Delasnerie-Lauprètre
- These authors contributed equally to this study and share first authorship.,Sorbonne Universités, UPMCUniv Paris 06,UMRS 1127, Paris, France.,Assistance publique-Hôpitaux de Paris (AP-HP), Cellule nationale de référence des maladies de Creutzfeldt-Jakob, Groupe Hospitalier Pitié-Salpêtrière, Paris, France.,Institut National de la Santé et de la Recherche Médicale (Inserm), U1127, Paris, France.,Institut du cerveau et de la moelle épinière (ICM), Paris, France
| | - Jean-Philippe Brandel
- Assistance publique-Hôpitaux de Paris (AP-HP), Cellule nationale de référence des maladies de Creutzfeldt-Jakob, Groupe Hospitalier Pitié-Salpêtrière, Paris, France.,Institut du cerveau et de la moelle épinière (ICM), Paris, France.,Sorbonne Universités, UPMCUniv Paris 06,UMRS 1127, Paris, France.,Institut National de la Santé et de la Recherche Médicale (Inserm), U1127, Paris, France
| | - Dominique Salomon
- Institut National de la Santé et de la Recherche Médicale (Inserm), Unité Mixte de Recherche (UMR) 1153, Paris, France
| | - Véronique Sazdovitch
- Assistance publique-Hôpitaux de Paris (AP-HP), Laboratoire de Neuropathologie Raymond Escourolle, Groupe Hospitalier Pitié-Salpêtrière, Paris, France.,Institut du cerveau et de la moelle épinière (ICM), Paris, France.,Sorbonne Universités, UPMCUniv Paris 06,UMRS 1127, Paris, France.,Institut National de la Santé et de la Recherche Médicale (Inserm), U1127, Paris, France
| | - Jean-Louis Laplanche
- Assistance publique-Hôpitaux de Paris (AP-HP), Service de Biochimie et Biologie Moléculaire, Hôpital Lariboisière; Université Paris Descartes, Paris, France
| | - Charles Duyckaerts
- Assistance publique-Hôpitaux de Paris (AP-HP), Laboratoire de Neuropathologie Raymond Escourolle, Groupe Hospitalier Pitié-Salpêtrière, Paris, France.,Institut du cerveau et de la moelle épinière (ICM), Paris, France.,Sorbonne Universités, UPMCUniv Paris 06,UMRS 1127, Paris, France.,Institut National de la Santé et de la Recherche Médicale (Inserm), U1127, Paris, France
| | - Danielle Seilhean
- Assistance publique-Hôpitaux de Paris (AP-HP), Laboratoire de Neuropathologie Raymond Escourolle, Groupe Hospitalier Pitié-Salpêtrière, Paris, France.,Institut du cerveau et de la moelle épinière (ICM), Paris, France.,Sorbonne Universités, UPMCUniv Paris 06,UMRS 1127, Paris, France.,Institut National de la Santé et de la Recherche Médicale (Inserm), U1127, Paris, France
| | - Stéphane Haïk
- Institut National de la Santé et de la Recherche Médicale (Inserm), U1127, Paris, France.,Assistance publique-Hôpitaux de Paris (AP-HP), Laboratoire de Neuropathologie Raymond Escourolle, Groupe Hospitalier Pitié-Salpêtrière, Paris, France.,Assistance publique-Hôpitaux de Paris (AP-HP), Cellule nationale de référence des maladies de Creutzfeldt-Jakob, Groupe Hospitalier Pitié-Salpêtrière, Paris, France.,Sorbonne Universités, UPMCUniv Paris 06,UMRS 1127, Paris, France.,Institut du cerveau et de la moelle épinière (ICM), Paris, France
| | | |
Collapse
|
4
|
Guidoux C, Hauw JJ, Klein I, Labreuche J, Berr C, Duyckaerts C, Amarenco P. Amyloid Angiopathy in Brain Hemorrhage: A Postmortem Neuropathological-Magnetic Resonance Imaging Study. Cerebrovasc Dis 2018; 45:124-131. [DOI: 10.1159/000486554] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Accepted: 12/28/2017] [Indexed: 02/06/2023] Open
Abstract
Background: Risk factors for intracerebral hemorrhage (ICH) include hypertension and cerebral amyloid angiopathy (CAA). The objective of this study was to determine the autopsy prevalence of CAA and the potential overlap with other risk factors among patients who died from ICH and also the correlation of CAA with cerebral microbleeds. Methods: We analyzed 81 consecutive autopsy brains from patients with ICH. Staining for CAA detection was performed. We used an age- and sex-matched control group of routine brain autopsies of nonneurological patients to determine the frequencies of CAA and hypertension. Postmortem 3D T2-weighted gradient-echo magnetic resonance imaging (MRI) with a 1.5-T magnet was performed in 11 brains with ICH (5 with CAA and 6 without) and histological correlation was performed when microbleeds were detected. Results: Hypertension and CAA were found in 69.1 and 24.7% of cases respectively. Among patients with CAA, 65.0% also had hypertension. The prevalence of CAA was similar among non-hypertensive cases and controls (33.3 and 23.1%; p = 0.54), whereas a significant difference was found between hypertensive cases vs. controls (28.9% vs. 0; p = 0.01). MRI documented 48 microbleeds and all 5 brains with CAA had ≥1 microbleed, compared to 3/6 brains without CAA. Among 48 microbleeds on MRI, 45 corresponded histologically to microbleeds surrounding microvessels (23 <200 µm in diameter, 19 between 200 µm and 2 mm, 3 were hemosiderin granules). Conclusions: Both hypertension and CAA frequently coexist in patients with ICH. MRI-detected microbleeds, proven by histological analysis, were twice as common in patients with CAA as in those with hypertensive ICH.
Collapse
|
5
|
Letronne F, Laumet G, Ayral AM, Chapuis J, Demiautte F, Laga M, Vandenberghe ME, Malmanche N, Leroux F, Eysert F, Sottejeau Y, Chami L, Flaig A, Bauer C, Dourlen P, Lesaffre M, Delay C, Huot L, Dumont J, Werkmeister E, Lafont F, Mendes T, Hansmannel F, Dermaut B, Deprez B, Hérard AS, Dhenain M, Souedet N, Pasquier F, Tulasne D, Berr C, Hauw JJ, Lemoine Y, Amouyel P, Mann D, Déprez R, Checler F, Hot D, Delzescaux T, Gevaert K, Lambert JC. ADAM30 Downregulates APP-Linked Defects Through Cathepsin D Activation in Alzheimer's Disease. EBioMedicine 2016; 9:278-292. [PMID: 27333034 PMCID: PMC4972530 DOI: 10.1016/j.ebiom.2016.06.002] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Revised: 05/31/2016] [Accepted: 06/01/2016] [Indexed: 01/12/2023] Open
Abstract
Although several ADAMs (A disintegrin-like and metalloproteases) have been shown to contribute to the amyloid precursor protein (APP) metabolism, the full spectrum of metalloproteases involved in this metabolism remains to be established. Transcriptomic analyses centred on metalloprotease genes unraveled a 50% decrease in ADAM30 expression that inversely correlates with amyloid load in Alzheimer's disease brains. Accordingly, in vitro down- or up-regulation of ADAM30 expression triggered an increase/decrease in Aβ peptides levels whereas expression of a biologically inactive ADAM30 (ADAM30(mut)) did not affect Aβ secretion. Proteomics/cell-based experiments showed that ADAM30-dependent regulation of APP metabolism required both cathepsin D (CTSD) activation and APP sorting to lysosomes. Accordingly, in Alzheimer-like transgenic mice, neuronal ADAM30 over-expression lowered Aβ42 secretion in neuron primary cultures, soluble Aβ42 and amyloid plaque load levels in the brain and concomitantly enhanced CTSD activity and finally rescued long term potentiation alterations. Our data thus indicate that lowering ADAM30 expression may favor Aβ production, thereby contributing to Alzheimer's disease development.
Collapse
Affiliation(s)
- Florent Letronne
- INSERM, U1167, Laboratoire d'Excellence Distalz, F59000 Lille, France; Institut Pasteur de Lille, F59000 Lille, France; Univ. Lille, F59000 Lille, France
| | - Geoffroy Laumet
- INSERM, U1167, Laboratoire d'Excellence Distalz, F59000 Lille, France; Institut Pasteur de Lille, F59000 Lille, France; Univ. Lille, F59000 Lille, France
| | - Anne-Marie Ayral
- INSERM, U1167, Laboratoire d'Excellence Distalz, F59000 Lille, France; Institut Pasteur de Lille, F59000 Lille, France; Univ. Lille, F59000 Lille, France
| | - Julien Chapuis
- INSERM, U1167, Laboratoire d'Excellence Distalz, F59000 Lille, France; Institut Pasteur de Lille, F59000 Lille, France; Univ. Lille, F59000 Lille, France
| | - Florie Demiautte
- INSERM, U1167, Laboratoire d'Excellence Distalz, F59000 Lille, France; Institut Pasteur de Lille, F59000 Lille, France; Univ. Lille, F59000 Lille, France
| | - Mathias Laga
- Department of Medical Protein Research, VIB, Ghent, Belgium; Department of Biochemistry, Ghent University, Ghent, Belgium
| | - Michel E Vandenberghe
- CEA, DSV, I2BM, MIRCen, Fontenay aux Roses, France; CNRS, UMR 9199, Fontenay aux Roses, France
| | - Nicolas Malmanche
- INSERM, U1167, Laboratoire d'Excellence Distalz, F59000 Lille, France; Institut Pasteur de Lille, F59000 Lille, France; Univ. Lille, F59000 Lille, France
| | - Florence Leroux
- Institut Pasteur de Lille, F59000 Lille, France; Univ. Lille, F59000 Lille, France; INSERM U1177, Drugs and Molecules for Living Systems, F5900 Lille, France
| | - Fanny Eysert
- INSERM, U1167, Laboratoire d'Excellence Distalz, F59000 Lille, France; Institut Pasteur de Lille, F59000 Lille, France; Univ. Lille, F59000 Lille, France
| | - Yoann Sottejeau
- INSERM, U1167, Laboratoire d'Excellence Distalz, F59000 Lille, France; Institut Pasteur de Lille, F59000 Lille, France; Univ. Lille, F59000 Lille, France
| | - Linda Chami
- Institut de Pharmacologie Moléculaire et Cellulaire, UMR 7275 CNRS, Laboratoire d'Excellence Distalz, Nice, France; Université de Nice-Sophia-Antipolis, Valbonne, France
| | - Amandine Flaig
- INSERM, U1167, Laboratoire d'Excellence Distalz, F59000 Lille, France; Institut Pasteur de Lille, F59000 Lille, France; Univ. Lille, F59000 Lille, France
| | - Charlotte Bauer
- Institut de Pharmacologie Moléculaire et Cellulaire, UMR 7275 CNRS, Laboratoire d'Excellence Distalz, Nice, France; Université de Nice-Sophia-Antipolis, Valbonne, France
| | - Pierre Dourlen
- INSERM, U1167, Laboratoire d'Excellence Distalz, F59000 Lille, France; Institut Pasteur de Lille, F59000 Lille, France; Univ. Lille, F59000 Lille, France
| | - Marie Lesaffre
- Univ. Lille, CNRS, Institut Pasteur de Lille, UMR 8161 - M3T - Mechanisms of Tumorigenesis and Targeted Therapies, F-59000 Lille, France
| | - Charlotte Delay
- INSERM, U1167, Laboratoire d'Excellence Distalz, F59000 Lille, France; Institut Pasteur de Lille, F59000 Lille, France; Univ. Lille, F59000 Lille, France
| | - Ludovic Huot
- Institut Pasteur de Lille, F59000 Lille, France; Univ. Lille, F59000 Lille, France; Center for Infection and Immunity of Lille, CNRS UMR 8204, INSERM 1019, Lille, France
| | - Julie Dumont
- Institut Pasteur de Lille, F59000 Lille, France; Univ. Lille, F59000 Lille, France; INSERM U1177, Drugs and Molecules for Living Systems, F5900 Lille, France
| | | | | | - Tiago Mendes
- INSERM, U1167, Laboratoire d'Excellence Distalz, F59000 Lille, France; Institut Pasteur de Lille, F59000 Lille, France; Univ. Lille, F59000 Lille, France
| | - Franck Hansmannel
- INSERM, U954, Vandoeuvre-lès-Nancy, France; Department of Hepato-Gastroenterology, University Hospital of Nancy, Université Henri Poincaré 1, Vandoeuvre-lès-Nancy, France
| | - Bart Dermaut
- INSERM, U1167, Laboratoire d'Excellence Distalz, F59000 Lille, France; Institut Pasteur de Lille, F59000 Lille, France; Univ. Lille, F59000 Lille, France
| | - Benoit Deprez
- Institut Pasteur de Lille, F59000 Lille, France; Univ. Lille, F59000 Lille, France; INSERM U1177, Drugs and Molecules for Living Systems, F5900 Lille, France
| | - Anne-Sophie Hérard
- CEA, DSV, I2BM, MIRCen, Fontenay aux Roses, France; CNRS, UMR 9199, Fontenay aux Roses, France
| | - Marc Dhenain
- CEA, DSV, I2BM, MIRCen, Fontenay aux Roses, France; CNRS, UMR 9199, Fontenay aux Roses, France
| | - Nicolas Souedet
- CEA, DSV, I2BM, MIRCen, Fontenay aux Roses, France; CNRS, UMR 9199, Fontenay aux Roses, France
| | - Florence Pasquier
- Univ. Lille, Inserm, U1171, - Degenerative & Vascular Cognitive Disorders, Laboratoire d'Excellence Distalz, F-59000 Lille, France; CHR&U, Lille, France
| | - David Tulasne
- Univ. Lille, CNRS, Institut Pasteur de Lille, UMR 8161 - M3T - Mechanisms of Tumorigenesis and Targeted Therapies, F-59000 Lille, France
| | - Claudine Berr
- INSERM, U1061, Université de Montpellier I, Hôpital La Colombière, Montpellier, France
| | - Jean-Jacques Hauw
- APHP-Raymond Escourolle Neuropathology Laboratory, la salpétrière Hospital, Paris, France
| | - Yves Lemoine
- Institut Pasteur de Lille, F59000 Lille, France; Univ. Lille, F59000 Lille, France; Center for Infection and Immunity of Lille, CNRS UMR 8204, INSERM 1019, Lille, France
| | - Philippe Amouyel
- INSERM, U1167, Laboratoire d'Excellence Distalz, F59000 Lille, France; Institut Pasteur de Lille, F59000 Lille, France; Univ. Lille, F59000 Lille, France; CHR&U, Lille, France
| | - David Mann
- Institute of Brain, Behaviour and Mental Health, University of Manchester, Salford Royal Hospital, Salford, UK
| | - Rebecca Déprez
- Institut Pasteur de Lille, F59000 Lille, France; Univ. Lille, F59000 Lille, France; INSERM U1177, Drugs and Molecules for Living Systems, F5900 Lille, France
| | - Frédéric Checler
- Institut de Pharmacologie Moléculaire et Cellulaire, UMR 7275 CNRS, Laboratoire d'Excellence Distalz, Nice, France; Université de Nice-Sophia-Antipolis, Valbonne, France
| | - David Hot
- Institut Pasteur de Lille, F59000 Lille, France; Univ. Lille, F59000 Lille, France; Center for Infection and Immunity of Lille, CNRS UMR 8204, INSERM 1019, Lille, France
| | - Thierry Delzescaux
- CEA, DSV, I2BM, MIRCen, Fontenay aux Roses, France; CNRS, UMR 9199, Fontenay aux Roses, France
| | - Kris Gevaert
- Department of Medical Protein Research, VIB, Ghent, Belgium; Department of Biochemistry, Ghent University, Ghent, Belgium
| | - Jean-Charles Lambert
- INSERM, U1167, Laboratoire d'Excellence Distalz, F59000 Lille, France; Institut Pasteur de Lille, F59000 Lille, France; Univ. Lille, F59000 Lille, France.
| |
Collapse
|
6
|
Pico F, Labreuche J, Hauw JJ, Seilhean D, Duyckaerts C, Amarenco P. Coronary and Basilar Artery Ectasia Are Associated. Stroke 2016; 47:224-7. [DOI: 10.1161/strokeaha.115.010797] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2015] [Accepted: 09/30/2015] [Indexed: 11/16/2022]
Abstract
Background and Purpose—
Intracranial artery dolichoectasia (IADE) and coronary artery ectasia have been associated with stroke and myocardial infarction, respectively. Only rarely have cases of coexisting IADE and coronary artery ectasia been reported. We investigated this association in a large consecutive autopsy series.
Methods—
Sixteen stroke patients with IADE were identified among 381 stroke patients and were matched with 16 stroke patients without IADE. The heart and coronary arteries from all patients were examined after a prespecified protocol.
Results—
Coronary artery ectasia was observed in 8 of the stroke patients with IADE, and in none of the stroke patients without IADE (
P
=0.008). The diameters of basilar and right coronary arteries were positively correlated (IADE patients,
r
=0.51;
P
=0.003 and coronary artery ectasia patients,
P
=0.006).
Conclusions—
This autopsy study examining the association of coronary artery ectasia and IADE in stroke patients suggests a common pathogenesis.
Collapse
Affiliation(s)
- Fernando Pico
- From AP-HP Pitié Salpêtrière Hospital, Department of Neuropathology Raymond Escourolle, Pierre et Marie Curie University, Paris, France (F.P., J-J.H., D.S, C.D., P.A.); Department of Neurology and Stroke Center, Centre Hospitalier de Versailles, Le Chesnay, France (F.P.); INSERM LVTS (Laboratory for Vascular Translational Science)-1148, Paris, France (F.P., P.A); Department of Neurology and Stroke Centre, AP-HP Bichat University Hospital, Paris-Diderot University and Medical School, Paris, France (J
| | - Julien Labreuche
- From AP-HP Pitié Salpêtrière Hospital, Department of Neuropathology Raymond Escourolle, Pierre et Marie Curie University, Paris, France (F.P., J-J.H., D.S, C.D., P.A.); Department of Neurology and Stroke Center, Centre Hospitalier de Versailles, Le Chesnay, France (F.P.); INSERM LVTS (Laboratory for Vascular Translational Science)-1148, Paris, France (F.P., P.A); Department of Neurology and Stroke Centre, AP-HP Bichat University Hospital, Paris-Diderot University and Medical School, Paris, France (J
| | - Jean-Jacques Hauw
- From AP-HP Pitié Salpêtrière Hospital, Department of Neuropathology Raymond Escourolle, Pierre et Marie Curie University, Paris, France (F.P., J-J.H., D.S, C.D., P.A.); Department of Neurology and Stroke Center, Centre Hospitalier de Versailles, Le Chesnay, France (F.P.); INSERM LVTS (Laboratory for Vascular Translational Science)-1148, Paris, France (F.P., P.A); Department of Neurology and Stroke Centre, AP-HP Bichat University Hospital, Paris-Diderot University and Medical School, Paris, France (J
| | - Danielle Seilhean
- From AP-HP Pitié Salpêtrière Hospital, Department of Neuropathology Raymond Escourolle, Pierre et Marie Curie University, Paris, France (F.P., J-J.H., D.S, C.D., P.A.); Department of Neurology and Stroke Center, Centre Hospitalier de Versailles, Le Chesnay, France (F.P.); INSERM LVTS (Laboratory for Vascular Translational Science)-1148, Paris, France (F.P., P.A); Department of Neurology and Stroke Centre, AP-HP Bichat University Hospital, Paris-Diderot University and Medical School, Paris, France (J
| | - Charles Duyckaerts
- From AP-HP Pitié Salpêtrière Hospital, Department of Neuropathology Raymond Escourolle, Pierre et Marie Curie University, Paris, France (F.P., J-J.H., D.S, C.D., P.A.); Department of Neurology and Stroke Center, Centre Hospitalier de Versailles, Le Chesnay, France (F.P.); INSERM LVTS (Laboratory for Vascular Translational Science)-1148, Paris, France (F.P., P.A); Department of Neurology and Stroke Centre, AP-HP Bichat University Hospital, Paris-Diderot University and Medical School, Paris, France (J
| | - Pierre Amarenco
- From AP-HP Pitié Salpêtrière Hospital, Department of Neuropathology Raymond Escourolle, Pierre et Marie Curie University, Paris, France (F.P., J-J.H., D.S, C.D., P.A.); Department of Neurology and Stroke Center, Centre Hospitalier de Versailles, Le Chesnay, France (F.P.); INSERM LVTS (Laboratory for Vascular Translational Science)-1148, Paris, France (F.P., P.A); Department of Neurology and Stroke Centre, AP-HP Bichat University Hospital, Paris-Diderot University and Medical School, Paris, France (J
| |
Collapse
|
7
|
Hauw JJ, Haik S, Brandel JP. History of Prions and transmission of protein misfolding. Bull Acad Natl Med 2015; 199:787-796. [PMID: 29901879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Since J. Cuillé and P. L. Chelle successfully transmitted scrapie between sheep by experi- mental inoculation in 1936 and D. C. Gajdusek kuru and Creutzfeldt-Jakob disease to chimpanzee in 1966 and 1968, respectively, the nature of the agents causing these " slow virus diseases " remains a mystery. In 1982, S. Prusiner called them " PRIONs " (for " PROteinaceous INfectious particles ") because they appeared lacking the nucleic acids that would classify them viruses. Although infectious or genetic mechanisms were seldom found, most of the rare human PRION diseases appeared " sporadic ". They shared many clinical and neuropathological properties with human neurodegenerative diseases (slow development, prominent nervous system involvement, amyloid deposits, paucity of immune response) the mechanism of which was not considered usually infectious. In 1991, H. Braak showed, in Alzheimer's disease brain, the low spreading of neuropathological tau associated lesions along anatomic pathways. They appear long before the clinical signs. The abnor- mally misfolded proteins characteristics of many neurodegenerative diseases are thought to aggregate after an initial seeding. This leads to their cell-cell transmission and dissemina- tion through neuronal and extra-neuronalpathways, which unexpected extent is under study. Whether the seeding is infectious or not remains debated. This new paradigm for unders- tanding their natural history and phenotypic diversity, which has already led to assess the diagnostic value of skin biopsy, should open the door to new therapeutic approach.
Collapse
|
8
|
Hauw JJ, Tillement JP. [The National Academy of Medicine calls for postmortem brain donation for neurodegenerative research]. Bull Acad Natl Med 2014; 198:145-146. [PMID: 26259293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
|
9
|
Hauw JJ, Tillement JP. L’Académie nationale de médecine appelle au don post mortem de cerveau pour la recherche sur les maladies neurodégénératives. Bulletin de l'Académie Nationale de Médecine 2014. [DOI: 10.1016/s0001-4079(19)31365-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
10
|
Hannaoui S, Gougerot A, Privat N, Levavasseur E, Bizat N, Hauw JJ, Brandel JP, Haïk S. Cycline efficacy on the propagation of human prions in primary cultured neurons is strain-specific. J Infect Dis 2013; 209:1144-8. [PMID: 24265435 DOI: 10.1093/infdis/jit623] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
In prion diseases, a major issue in therapeutic research is the variability of the effect between strains. Stimulated by the report of an antiprion effect in a scrapie model and by ongoing international clinical trials using doxycycline, we studied the efficacy of cyclines against the propagation of human prions. First, we successfully propagated various Creutzfeldt-Jakob disease (CJD) isolates (sporadic, variant, and iatrogenic CJD) in neuronal cultures expressing the human prion protein. Then, we found that doxycycline was the most effective compound, with important variations between isolates. Isolates from sporadic CJD, the most common form of prion disease, showed the highest sensitivity.
Collapse
Affiliation(s)
- Samia Hannaoui
- Université Pierre et Marie Curie - Paris 6, Centre de Recherche de l'Institut du Cerveau et de la Moelle épinière (CRICM), UMRS 975, Equipe "Alzheimer's and Prion Diseases"
| | | | | | | | | | | | | | | |
Collapse
|
11
|
Hauw JJ, Plu I, Seilhean D, Duyckaerts C. [New insights into intracellular inclusions and intracellular proteolysis]. Bull Acad Natl Med 2012; 196:1575-1586. [PMID: 24313013] [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] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Intracellular inclusions seen by the pathologist may have variable significance. Although they are excellent markers of proteolytic disorders, they can also be due to several other mechanisms. This article examines recent data on the morphology, significance and consequences of aging lipofuscins in the brain and retina, neurofibrillary tangles and Lewy bodies, and Birbeck granules associated with Langerhans histiocytosis. Some of these disorders involve increased protein production, misfolding and aggregation, and altered intracellular proteolysis, but other cell constituents may also play a role. Proteolytic mechanisms do not appear to be involved in the formation of Birbeck granules, which helped to reveal the Langerhans origin of histiocytosis X. Analyses of intracellular inclusions, together with genetic and epigenetic studies, are highly informative in various degenerative diseases.
Collapse
|
12
|
Parchi P, de Boni L, Saverioni D, Cohen ML, Ferrer I, Gambetti P, Gelpi E, Giaccone G, Hauw JJ, Höftberger R, Ironside JW, Jansen C, Kovacs GG, Rozemuller A, Seilhean D, Tagliavini F, Giese A, Kretzschmar HA. Consensus classification of human prion disease histotypes allows reliable identification of molecular subtypes: an inter-rater study among surveillance centres in Europe and USA. Acta Neuropathol 2012; 124:517-29. [PMID: 22744790 DOI: 10.1007/s00401-012-1002-8] [Citation(s) in RCA: 153] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2012] [Revised: 05/30/2012] [Accepted: 06/02/2012] [Indexed: 12/27/2022]
Abstract
The current classification of human sporadic prion diseases recognizes six major phenotypic subtypes with distinctive clinicopathological features, which largely correlate at the molecular level with the genotype at the polymorphic codon 129 (methionine, M, or valine, V) in the prion protein gene and with the size of the protease-resistant core of the abnormal prion protein, PrP(Sc) (i.e. type 1 migrating at 21 kDa and type 2 at 19 kDa). We previously demonstrated that PrP(Sc) typing by Western blotting is a reliable means of strain typing and disease classification. Limitations of this approach, however, particularly in the interlaboratory setting, are the association of PrP(Sc) types 1 or 2 with more than one clinicopathological phenotype, which precludes definitive case classification if not supported by further analysis, and the difficulty of fully recognizing cases with mixed phenotypic features. In this study, we tested the inter-rater reliability of disease classification based only on histopathological criteria. Slides from 21 cases covering the whole phenotypic spectrum of human sporadic prion diseases, and also including two cases of variant Creutzfeldt-Jakob disease (CJD), were distributed blindly to 13 assessors for classification according to given instructions. The results showed good-to-excellent agreement between assessors in the classification of cases. In particular, there was full agreement (100 %) for the two most common sporadic CJD subtypes and variant CJD, and very high concordance in general for all pure phenotypes and the most common subtype with mixed phenotypic features. The present data fully support the basis for the current classification of sporadic human prion diseases and indicate that, besides molecular PrP(Sc) typing, histopathological analysis permits reliable disease classification with high interlaboratory accuracy.
Collapse
|
13
|
Peoc'h K, Levavasseur E, Delmont E, De Simone A, Laffont-Proust I, Privat N, Chebaro Y, Chapuis C, Bedoucha P, Brandel JP, Laquerriere A, Kemeny JL, Hauw JJ, Borg M, Rezaei H, Derreumaux P, Laplanche JL, Haïk S. Substitutions at residue 211 in the prion protein drive a switch between CJD and GSS syndrome, a new mechanism governing inherited neurodegenerative disorders. Hum Mol Genet 2012; 21:5417-28. [DOI: 10.1093/hmg/dds377] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
|
14
|
Hauw JJ. [Conclusion of the National Academy of Medicine session topic of sleep]. Bull Acad Natl Med 2011; 195:1645-1647. [PMID: 22812166] [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] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
|
15
|
Cifuentes-Diaz C, Dubourg O, Irinopoulou T, Vigny M, Lachkar S, Decker L, Charnay P, Denisenko N, Maisonobe T, Léger JM, Viala K, Hauw JJ, Girault JA. Nodes of ranvier and paranodes in chronic acquired neuropathies. PLoS One 2011; 6:e14533. [PMID: 21267074 PMCID: PMC3022580 DOI: 10.1371/journal.pone.0014533] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2010] [Accepted: 12/10/2010] [Indexed: 11/18/2022] Open
Abstract
Chronic acquired neuropathies of unknown origin are classified as chronic inflammatory demyelinating polyneuropathies (CIDP) and chronic idiopathic axonal polyneuropathies (CIAP). The diagnosis can be very difficult, although it has important therapeutic implications since CIDP can be improved by immunomodulating treatment. The aim of this study was to examine the possible abnormalities of nodal and paranodal regions in these two types of neuropathies. Longitudinal sections of superficial peroneal nerves were obtained from biopsy material from 12 patients with CIDP and 10 patients with CIAP and studied by immunofluorescence and in some cases electron microscopy. Electron microscopy revealed multiple alterations in the nodal and paranodal regions which predominated in Schwann cells in CIDP and in axons in CIAP. In CIDP paranodin/Caspr immunofluorescence was more widespread than in control nerves, extending along the axon in internodes where it appeared intense. Nodal channels Nav and KCNQ2 were less altered but were also detected in the internodes. In CIAP paranodes, paranodin labeling was irregular and/or decreased. To test the consequences of acquired primary Schwann cells alteration on axonal proteins, we used a mouse model based on induced deletion of the transcription factor Krox-20 gene. In the demyelinated sciatic nerves of these mice we observed alterations similar to those found in CIDP by immunofluorescence, and immunoblotting demonstrated increased levels of paranodin. Finally we examined whether the alterations in paranodin immunoreactivity could have a diagnosis value. In a sample of 16 biopsies, the study of paranodin immunofluorescence by blind evaluators led to correct diagnosis in 70 ± 4% of the cases. This study characterizes for the first time the abnormalities of nodes of Ranvier in CIAP and CIDP, and the altered expression and distribution of nodal and paranodal proteins. Marked differences were observed between CIDP and CIAP and the alterations in paranodin immunofluorescence may be an interesting tool for their differential diagnosis.
Collapse
Affiliation(s)
- Carmen Cifuentes-Diaz
- Institut National de la Santé et de la Recherche Médicale (Inserm), Unité Mixte de Recherche en Santé (UMR-S) 839, Paris, France
- Université Pierre et Marie Curie (UPMC), Paris, France
- Institut du Fer à Moulin, Paris, France
| | - Odile Dubourg
- Laboratoire de Neuropathologie Raymond-Escourolle, Pitié-Salpêtrière Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), Paris, France
- Consultation de Pathologie Neuromusculaire, Centre de Référence de Paris Est, Pitié-Salpêtrière Hospital, AP-HP, Paris, France
| | - Theano Irinopoulou
- Institut National de la Santé et de la Recherche Médicale (Inserm), Unité Mixte de Recherche en Santé (UMR-S) 839, Paris, France
- Université Pierre et Marie Curie (UPMC), Paris, France
- Institut du Fer à Moulin, Paris, France
| | - Marc Vigny
- Institut National de la Santé et de la Recherche Médicale (Inserm), Unité Mixte de Recherche en Santé (UMR-S) 839, Paris, France
- Université Pierre et Marie Curie (UPMC), Paris, France
- Institut du Fer à Moulin, Paris, France
| | - Sylvie Lachkar
- Institut National de la Santé et de la Recherche Médicale (Inserm), Unité Mixte de Recherche en Santé (UMR-S) 839, Paris, France
- Université Pierre et Marie Curie (UPMC), Paris, France
- Institut du Fer à Moulin, Paris, France
| | - Laurence Decker
- Institut de Biologie de l'Ecole Normale Supérieure (IBENS), Inserm U1024, Centre National de la Recherche Scientifique (CNRS) UMR 8197, Ecole Normale Supérieure, Paris, France
| | - Patrick Charnay
- Institut de Biologie de l'Ecole Normale Supérieure (IBENS), Inserm U1024, Centre National de la Recherche Scientifique (CNRS) UMR 8197, Ecole Normale Supérieure, Paris, France
| | - Natalia Denisenko
- Institut National de la Santé et de la Recherche Médicale (Inserm), Unité Mixte de Recherche en Santé (UMR-S) 839, Paris, France
- Université Pierre et Marie Curie (UPMC), Paris, France
- Institut du Fer à Moulin, Paris, France
| | - Thierry Maisonobe
- Laboratoire de Neuropathologie Raymond-Escourolle, Pitié-Salpêtrière Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), Paris, France
- Fédération de Neurophysiologie Clinique and Fédération de Neurologie, Pitié-Salpêtrière Hospital, AP-HP, Paris, France
| | - Jean-Marc Léger
- Consultation de Pathologie Neuromusculaire, Centre de Référence de Paris Est, Pitié-Salpêtrière Hospital, AP-HP, Paris, France
| | - Karine Viala
- Fédération de Neurophysiologie Clinique and Fédération de Neurologie, Pitié-Salpêtrière Hospital, AP-HP, Paris, France
| | - Jean-Jacques Hauw
- Université Pierre et Marie Curie (UPMC), Paris, France
- Laboratoire de Neuropathologie Raymond-Escourolle, Pitié-Salpêtrière Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), Paris, France
| | - Jean-Antoine Girault
- Institut National de la Santé et de la Recherche Médicale (Inserm), Unité Mixte de Recherche en Santé (UMR-S) 839, Paris, France
- Université Pierre et Marie Curie (UPMC), Paris, France
- Institut du Fer à Moulin, Paris, France
| |
Collapse
|
16
|
Hansmannel F, Sillaire A, Kamboh MI, Lendon C, Pasquier F, Hannequin D, Laumet G, Mounier A, Ayral AM, DeKosky ST, Hauw JJ, Berr C, Mann D, Amouyel P, Campion D, Lambert JC. Is the urea cycle involved in Alzheimer's disease? J Alzheimers Dis 2011; 21:1013-21. [PMID: 20693631 DOI: 10.3233/jad-2010-100630] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Since previous observations indicated that the urea cycle may have a role in the Alzheimer's disease (AD) process, we set out to quantify the expression of each gene involved in the urea cycle in control and AD brains and establish whether these genes could be genetic determinants of AD. We first confirmed that all the urea cycle enzyme genes are expressed in the AD brain. The expression of arginase 2 was greater in the AD brain than in the control brain. The presence of the rare arginase 2 allele rs742869 was associated with an increase in the risk of AD in men and with an earlier age-at-onset for both genders. None of the other genes in the pathway appeared to be differentially expressed in the AD brain or act as genetic determinants of the disease.
Collapse
|
17
|
Abstract
The progressive neuronal loss in Alzheimer's disease leads to neurochemical abnormalities which provide the basis for symptomatic treatments. Four cholinesterase inhibitors were released in this indication. Meta-analyses have confirmed a beneficial effect on cognitive functioning and activities of daily living. The NMDA receptor antagonist, memantine, was also approved for the treatment of moderate to severe and may be associated. Progress in the patho-physiology of the disease offers some hope of new treatments acting on the cerebral lesions. The amyloid hypothesis allowed the emergence of active or passive immunotherapies, and of secretase inhibitors or modulators. Recent studies have targeted the P tau protein. The brain plasticity and the uses of stem cells offer more distant hope.
Collapse
Affiliation(s)
- Françoise Forette
- AP-HP, Hôpital Broca, Université Paris V, Fondation Nationale de Gérontologie-ILC, Paris, France.
| | | |
Collapse
|
18
|
Liberski PP, Sikorska B, Hauw JJ, Kopp N, Streichenberger N, Giraud P, Boellaard J, Budka H, Kovacs GG, Ironside J, Brown P. Ultrastructural Characteristics (or Evaluation) of Creutzfeldt-Jakob Disease and Other Human Transmissible Spongiform Encephalopathies or Prion Diseases. Ultrastruct Pathol 2010; 34:351-61. [DOI: 10.3109/01913123.2010.491175] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
19
|
Lapergue B, Demeret S, Denys V, Laplanche JL, Galanaud D, Verny M, Sazdovitch V, Baulac M, Haïk S, Hauw JJ, Bolgert F, Brandel JP, Navarro V. Sporadic Creutzfeldt-Jakob disease mimicking nonconvulsive status epilepticus. Neurology 2010; 74:1995-9. [PMID: 20445151 DOI: 10.1212/wnl.0b013e3181e39703] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- B Lapergue
- Neurological Intensive Care Unit, Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpétrière and Pierre et Marie Curie (Paris VI) University, Paris, France
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
20
|
Soubrier M, Haïk S, Hauw JJ, Corvol JC, Lyon-Caen O, Dougados M. Creutzfeldt-Jakob disease in a patient treated by etanercept for rheumatoid arthritis (RA): just a coincidence? Joint Bone Spine 2010; 77:174-5. [PMID: 20097590 DOI: 10.1016/j.jbspin.2009.05.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2009] [Accepted: 05/27/2009] [Indexed: 11/19/2022]
Abstract
We describe a patient in whom sporadic Creutzfeldt-Jakob disease (sCJD) occurred one year after the onset of etanercept therapy for rheumatoid arthritis (RA). This association could be a chance occurrence. However, TNF-alpha has been implicated in the pathogenesis of neurodegeneration in sCJD and etanercept might worsen the disease. Such an aggravation has been observed in multiple sclerosis, in which TNF-alpha is the key mediator of demyelination. It may be of interest studying the impact of treatment with TNF-alpha antagonists on prevalence and incidence of those neurodegenerative diseases involving TNF-alpha mediation, such as Alzheimer disease.
Collapse
Affiliation(s)
- Martin Soubrier
- Service de rhumatologie, hôpital G. Montpied, place Henri-Dunant, BP 69, 63003 Clermont-Ferrand, France.
| | | | | | | | | | | |
Collapse
|
21
|
Greffard S, Verny M, Bonnet AM, Seilhean D, Hauw JJ, Duyckaerts C. A stable proportion of Lewy body bearing neurons in the substantia nigra suggests a model in which the Lewy body causes neuronal death. Neurobiol Aging 2010; 31:99-103. [DOI: 10.1016/j.neurobiolaging.2008.03.015] [Citation(s) in RCA: 89] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2007] [Revised: 02/27/2008] [Accepted: 03/20/2008] [Indexed: 11/25/2022]
|
22
|
Klein IF, Labreuche J, Lavallée PC, Mazighi M, Duyckaerts C, Hauw JJ, Amarenco P. Is Moderate Atherosclerotic Stenosis in the Middle Cerebral Artery a Cause of or a Coincidental Finding in Ischemic Stroke? Cerebrovasc Dis 2010; 29:140-5. [DOI: 10.1159/000262310] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2009] [Accepted: 09/07/2009] [Indexed: 11/19/2022] Open
|
23
|
Pham CT, de Silva R, Haïk S, Verny M, Sachet A, Forette B, Lees A, Hauw JJ, Duyckaerts C. Tau-positive grains are constant in centenarians' hippocampus. Neurobiol Aging 2009; 32:1296-303. [PMID: 19695742 DOI: 10.1016/j.neurobiolaging.2009.07.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2008] [Revised: 07/03/2009] [Accepted: 07/18/2009] [Indexed: 10/20/2022]
Abstract
The influence of age on the prevalence of argyrophilic grain disease has been analyzed in the hippocampus from 29 centenarians. Argyrophilic grains were detected in 12 cases with Gallyas silver method, in 24 cases with anti-exon 10 (RD4) immunohistochemistry, in all the cases with a phospho-independent anti-tau (piTau) antibody and with a monoclonal antibody against Ser202 of the tau protein (AT8), suggesting a maturation of the grains. Ballooned neurons were found in the hippocampus of 12 cases in which grains were, on average, more abundant. Coiled bodies were found in 26, 15 and 13 cases respectively with piTau antibody, RD4 and Gallyas method. Cases with coiled bodies had a higher density of grains. The mean density of grains did not differ in the patients with or without dementia. The prevalence of tau-positive grains has been underestimated in the very old population. As neurofibrillary tangles, they appear to be a constant accompaniment of age but, contrarily to neurofibrillary tangles, do not seem to be strongly associated with dementia.
Collapse
Affiliation(s)
- Chi-Tuan Pham
- Laboratoire de Neuropathologie Raymond Escourolle, Hôpital de la Pitié-Salpétrière, 47-83 boulevard de l'Hôpital, Paris Cedex 13, France
| | | | | | | | | | | | | | | | | |
Collapse
|
24
|
|
25
|
Brandel JP, Heath CA, Head MW, Levavasseur E, Knight R, Laplanche JL, Langeveld JP, Ironside JW, Hauw JJ, Mackenzie J, Alpérovitch A, Will RG, Haïk S. Variant Creutzfeldt-Jakob disease in France and the United Kingdom: Evidence for the same agent strain. Ann Neurol 2009; 65:249-56. [PMID: 19334063 DOI: 10.1002/ana.21583] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Variant Creutzfeldt-Jakob disease (vCJD) was first reported in the United Kingdom in 1996. Since then, the majority of cases have been observed in the United Kingdom where there was a major epidemic of bovine spongiform encephalopathy. France was the second country affected. To address the hypothesis of the involvement of a common strain of agent, we have compared clinical, neuropathological, and biochemical data on vCJD patients from both countries. METHODS In France and the United Kingdom, epidemiological and clinical data were obtained from analysis of medical records and direct interview of the family of the patients using the same standardized questionnaire in both countries. When brain material was available, we performed with similar methods a comparative study of brain lesions and PrP(res) glycoform ratios in both vCJD populations. RESULTS Clinical data, genetic background, neuropathological finding, and biochemical findings in the 185 patients observed in France (n = 23) and the United Kingdom (n = 162) were similar except for age at death. Currently, blood transfusion is a risk factor identified only in the United Kingdom. INTERPRETATION The close similarity between the cases of vCJD in France and the United Kingdom supports the hypothesis that a common strain of infectious agent is involved in both countries. The 5-year delay in the peak that we observed in France compared with the United Kingdom fits well with the increase in the importation of beef products to France from the United Kingdom between 1985 and 1995.
Collapse
Affiliation(s)
- Jean-Philippe Brandel
- Institut National de la Santé et de la Recherche Médicale, Equipe Avenir Human Prion Diseases, Paris, F-75013, France.
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
26
|
Mazighi M, Labreuche J, Gongora-Rivera F, Duyckaerts C, Hauw JJ, Amarenco P. Autopsy prevalence of proximal extracranial atherosclerosis in patients with fatal stroke. Stroke 2008; 40:713-8. [PMID: 19118247 DOI: 10.1161/strokeaha.108.514349] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE Extracranial atherosclerosis, proximal to the carotid bifurcation and V3 segment of the vertebral artery, is considered to be an infrequent condition with a benign prognosis. However, its prevalence may be underestimated due to lack of data. We aimed to determine the prevalence of proximal extracranial plaques and stenosis in the common carotid artery, innominate and subclavian arteries, and proximal vertebral artery. METHODS We performed a systematic analysis of intra- and extracranial arteries, the aortic arch, and the heart in 339 consecutive autopsies of patients with stroke; 259 patients had brain infarction; 80 patients had brain hemorrhage and were used as control subjects. Clinical history, risk factors, imaging data, and general autopsy reports were analyzed. RESULTS Proximal extracranial plaques and stenosis were present in the arteries of 46.9% and 19.8% of patients, respectively, without a significant difference between brain infarction and brain hemorrhage groups. Proximal extracranial atherosclerosis occurred more frequently in the proximal vertebral artery than in other arteries (stenosis prevalence 12.7% versus 5.3% in the common carotid artery) and in patients with posterior circulation brain infarction (except for the posterior cerebral artery territory). More specifically, atherosclerosis in the proximal vertebral artery was significantly associated with posterior circulation brain infarction (age- and sex-adjusted OR, 2.31; 95% CI, 1.28 to 4.17 for plaques and 2.10; 95% CI, 1.01 to 4.38 for stenosis) using patients with isolated anterior circulation infarctions as control subjects. CONCLUSIONS Proximal extracranial atherosclerosis was frequent and was significantly associated with brainstem infarcts. These findings support the importance of a systematic workup, including the evaluation of proximal extracranial atherosclerotic lesions.
Collapse
|
27
|
Giaccone G, Mangieri M, Capobianco R, Limido L, Hauw JJ, Haïk S, Fociani P, Bugiani O, Tagliavini F. Tauopathy in human and experimental variant Creutzfeldt-Jakob disease. Neurobiol Aging 2008; 29:1864-73. [PMID: 17560687 DOI: 10.1016/j.neurobiolaging.2007.04.026] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2006] [Revised: 04/26/2007] [Accepted: 04/27/2007] [Indexed: 11/23/2022]
Abstract
Cerebral accumulation of hyperphosphorylated tau (phospho-tau) occurs in several neurodegenerative conditions including Alzheimer disease. In prion diseases, phospho-tau deposition has been described in a rare genetic form, Gerstmann-Sträussler-Scheinker disease, but is not considered part of the neuropathological picture of Creutzfeldt-Jakob disease. Aim of this study was to investigate whether changes related to phospho-tau accumulation are present in the brain of patients with variant Creutzfeldt-Jakob disease (vCJD) that shares with Gerstmann-Sträussler-Scheinker disease abundant prion protein (PrP) deposition in amyloid form. The analysis was extended to experimental mouse models of vCJD. We detected a large number of phospho-tau-immunoreactive neuritic profiles, often clustered around PrP amyloid deposits, not only in the cerebral cortex, but also in the cerebellum of all vCJD patients examined, in the absence of Abeta. Although less constantly, phospho-tau was localized in some perikaria and dendrites. The biochemical counterpart was the presence of phospho-tau in the detergent-insoluble fraction of cerebral cortex. Phospho-tau-immunoreactive neuronal profiles were also found in association with PrP deposits in mouse models of vCJD. These findings suggest that the abnormal forms of PrP associated with vCJD trigger a tauopathy, and provide a paradigm for the early stages of tau pathology associated with cerebral amyloidoses, including Alzheimer disease.
Collapse
Affiliation(s)
- G Giaccone
- Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy.
| | | | | | | | | | | | | | | | | |
Collapse
|
28
|
Levavasseur E, Laffont-Proust I, Morain É, Faucheux BA, Privat N, Peoc'h K, Sazdovitch V, Brandel JP, Hauw JJ, Haïk S. Regulating factors of PrP glycosylation in Creutzfeldt-Jakob disease--implications for the dissemination and the diagnosis of human prion strains. PLoS One 2008; 3:e2786. [PMID: 18665216 PMCID: PMC2464735 DOI: 10.1371/journal.pone.0002786] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2008] [Accepted: 07/01/2008] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE The glycoprofile of pathological prion protein (PrP(res)) is widely used as a diagnosis marker in Creutzfeldt-Jakob disease (CJD) and is thought to vary in a strain-specific manner. However, that the same glycoprofile of PrP(res) always accumulates in the whole brain of one individual has been questioned. We aimed to determine whether and how PrP(res) glycosylation is regulated in the brain of patients with sporadic and variant Creutzfeldt-Jakob disease. METHODS PrP(res) glycoprofiles in four brain regions from 134 patients with sporadic or variant CJD were analyzed as a function of the genotype at codon 129 of PRNP and the Western blot type of PrP(res). RESULTS The regional distribution of PrP(res) glycoforms within one individual was heterogeneous in sporadic but not in variant CJD. PrP(res) glycoforms ratio significantly correlated with the genotype at codon 129 of the prion protein gene and the Western blot type of PrP(res) in a region-specific manner. In some cases of sCJD, the glycoprofile of thalamic PrP(res) was undistinguishable from that observed in variant CJD. INTERPRETATION Regulations leading to variations of PrP(res) pattern between brain regions in sCJD patients, involving host genotype and Western blot type of PrP(res) may contribute to the specific brain targeting of prion strains and have direct implications for the diagnosis of the different forms of CJD.
Collapse
Affiliation(s)
| | | | - Émilie Morain
- INSERM, Avenir Team - Human Prion Diseases, Paris, France
| | - Baptiste A. Faucheux
- INSERM, Avenir Team - Human Prion Diseases, Paris, France
- APHP, R. Escourolle Neuropathology Laboratory, Paris, France
| | - Nicolas Privat
- INSERM, Avenir Team - Human Prion Diseases, Paris, France
| | - Katell Peoc'h
- Biochemistry and Molecular Biology Department, Lariboisière Hospital, Paris, France
| | - Véronique Sazdovitch
- INSERM, Avenir Team - Human Prion Diseases, Paris, France
- APHP, R. Escourolle Neuropathology Laboratory, Paris, France
| | | | - Jean-Jacques Hauw
- APHP, R. Escourolle Neuropathology Laboratory, Paris, France
- InVS, French National Center of Reference for Unconventional Transmissible Agents, Paris, France
| | - Stéphane Haïk
- INSERM, Avenir Team - Human Prion Diseases, Paris, France
- APHP, R. Escourolle Neuropathology Laboratory, Paris, France
- InVS, French National Center of Reference for Unconventional Transmissible Agents, Paris, France
- * E-mail:
| |
Collapse
|
29
|
Parchi P, Notari S, Weber P, Schimmel H, Budka H, Ferrer I, Haik S, Hauw JJ, Head MW, Ironside JW, Limido L, Rodriguez A, Ströbel T, Tagliavini F, Kretzschmar HA. Inter-laboratory assessment of PrPSc typing in creutzfeldt-jakob disease: a Western blot study within the NeuroPrion Consortium. Brain Pathol 2008; 19:384-91. [PMID: 18624793 DOI: 10.1111/j.1750-3639.2008.00187.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Molecular typing is of considerable importance for the surveillance and epidemiology of human transmissible spongiform encephalopathies (TSEs). It relies on the detection of distinct protease-resistant prion protein (PrP(Sc)) core fragments that differ in molecular mass and/or glycoform ratio. In this collaborative study, we tested the inter-laboratory agreement in TSE molecular typing. Sixteen characterized brain specimens from sporadic TSEs and variant Creutzfeldt-Jakob disease (vCJD) cases were distributed blindly to seven laboratories for molecular characterization by a defined protocol and classification. Agreement between laboratories in the classification of samples was excellent. In particular, there were no differences in the distinction between PrP(Sc) type 1, type 2A, and type 2B with one exception, which eventually was identified as a case with types 1 and 2 co-occurrence. This shows that the general technique and particular classification system used here are robust and represent a reliable basis for diagnostic and epidemiologic purposes. The subtle further distinction of subtypes among type 1 and type 2 groups requires high-sensitivity gel electrophoresis protocols that are unsuitable for routine diagnostic needs and must be reserved for research investigations. Further research is necessary on the identification and significance of co-occurrence of PrP(Sc) types 1 and 2 within one brain.
Collapse
Affiliation(s)
- Piero Parchi
- Dipartimento di Scienze Neurologiche, Università di Bologna, Bologna, Italy.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
30
|
Haïk S, Galanaud D, Linguraru MG, Peoc’h K, Privat N, Faucheux BA, Ayache N, Hauw JJ, Dormont D, Brandel JP. In Vivo Detection of Thalamic Gliosis. ACTA ACUST UNITED AC 2008; 65:545-9. [DOI: 10.1001/archneur.65.4.545] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
|
31
|
Uro-Coste E, Cassard H, Simon S, Lugan S, Bilheude JM, Perret-Liaudet A, Ironside JW, Haik S, Basset-Leobon C, Lacroux C, Peoch K, Streichenberger N, Langeveld J, Head MW, Grassi J, Hauw JJ, Schelcher F, Delisle MB, Andréoletti O. Beyond PrP res type 1/type 2 dichotomy in Creutzfeldt-Jakob disease. PLoS Pathog 2008; 4:e1000029. [PMID: 18383623] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023] Open
Abstract
Sporadic Creutzfeldt-Jakob disease (sCJD) cases are currently subclassified according to the methionine/valine polymorphism at codon 129 of the PRNP gene and the proteinase K (PK) digested abnormal prion protein (PrPres)identified on Western blotting (type 1 or type 2). These biochemically distinct PrPres types have been considered to represent potential distinct prion strains. However, since cases of CJD show co-occurrence of type 1 and type 2 PrPres in the brain, the basis of this classification system and its relationship to agent strain are under discussion. Different brain are as from 41 sCJD and 12 iatrogenic CJD (iCJD) cases were investigated, using Western blotting for PrPres and two other biochemical assays reflecting the behaviour of the disease-associated form of the prion protein (PrPSc) under variable PK digestion conditions. In 30% of cases, both type 1 and type 2 PrPres were identified. Despite this, the other two biochemical assays found that PrPSc from an individual patient demonstrated uniform biochemical properties. Moreover, in sCJD, four distinct biochemical PrPSc subgroups were identified that correlated with the current sCJD clinico-pathological classification. In iCJD, four similar biochemical clusters were observed, but these did not correlate to any particular PRNP 129 polymorphism or western blot PrPres pattern. The identification of four different PrPSc biochemical subgroups in sCJD and iCJD, irrespective of the PRNP polymorphism at codon 129 and the PrPres isoform provides an alternative biochemical definition of PrPSc diversity and new insight in the perception of Human TSE agents variability.
Collapse
Affiliation(s)
- Emmanuelle Uro-Coste
- INSERM U858, Institut de Médecine Moléculaire de Rangueil and Service d'Anatomie Pathologique et Histologie-Cytologie, C.H.U. Rangueil, Toulouse, France
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
32
|
Mazighi M, Labreuche J, Gongora-Rivera F, Duyckaerts C, Hauw JJ, Amarenco P. Autopsy prevalence of intracranial atherosclerosis in patients with fatal stroke. Stroke 2008; 39:1142-7. [PMID: 18309170 DOI: 10.1161/strokeaha.107.496513] [Citation(s) in RCA: 164] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE The objective of this study was to determine the prevalence of intracranial plaques and stenoses and their causal role in patients with fatal stroke. Intracranial atherosclerosis is considered to be a rare condition with a severe prognosis. However, disease prevalence may be underestimated due to lack of appropriate diagnostic procedures. METHODS We performed a systematic analysis of intra- and extracranial arteries, the aortic arch, and the heart in 339 consecutive autopsies of patients with stroke. Clinical history, risk factors, imaging data, and general autopsy reports were analyzed. Patients with brain hemorrhage (n=80) were used as control subjects. RESULTS Intracranial plaques and stenoses occurred in 62.2% (95% CI, 56.3 to 68.1) and 43.2% (95% CI, 37.2 to 49.3) of patients with brain infarction, respectively, compared with 48.8% (P<0.05) and 17.5% (P<0.001) of patients with brain hemorrhage, respectively. In the 43% of patients with brain infarction with at least one intracranial plaque-inducing luminal stenosis graded >30%, the stenosis was considered to be causal in 5.8% of cases (n=15) because of superimposed clot on ulcerated plaques; 27% of these patients had stenoses graded 30% to 75%. In multivariate analyses, diabetes and male sex were significantly associated with intracranial plaques and stenosis. History of myocardial infarction was significantly associated with intracranial plaques and previous stroke was associated with intracranial stenosis. CONCLUSIONS Intracranial plaques and stenoses are highly prevalent in fatal stroke, and stenoses graded 30% to 75% may be causal. New arterial wall imaging techniques should be used to reevaluate the frequency and role of intracranial artery plaques in living patients with stroke.
Collapse
|
33
|
Forette F, Hauw JJ. [Alzheimer's disease: from brain lesions to new drugs]. Bull Acad Natl Med 2008; 192:363-380. [PMID: 18819689] [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] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
We review the main therapeutic targets in Alzheimer's disease. Current treatments include cholinesterase inhibitors and the glutamate-modulating drug memantin. Other neurotransmitters such as serotonin, histamine and noradrenaline may also be targeted. Although useful, however, these symptomatic treatments do not prevent neuronal degeneration and death. Epidemiological studies suggest that treatments given for other reasons, such as antiinflammatory agents (including NSAIDs), cholesterol-lowering drugs, hormone replacement therapy and antioxidants, may prevent or improve Alzheimer-type dementia, but this is not always borne out in controlled clinical trials. Prevention of hypertension significantly reduces the incidence of vascular dementia and of Alzheimer-type dementia, albeit through an unknown mechanism. Alzheimer's disease is characterized by two main lesions: amyloid plaques and neurofibrillary tangles composed of aggregated A Beta peptides and hyperphosphorylated tau. Active and passive immunization against A beta has given promising results. Other exciting approaches include modulation of A beta processing by inhibiting BACE1 or gamma-secretase or upregulating alpha-secretase; A beta peptide catabolism; inhibition of beta fibrillization; and reducing tau phosphorylation or inhibiting tau aggregation. More remote possibilities include gene therapy and the use of growth factors to increase neurogenesis.
Collapse
Affiliation(s)
- Françoise Forette
- Université Paris V, Hôpital Broca, Fondation nationale de Gérontologie, International Longevity Center (ILC)-France
| | | |
Collapse
|
34
|
Liberski PP, Sikorska B, Hauw JJ, Kopp N, Streichenberger N, Giraud P, Budka H, Boellaard JW, Brown P. Tubulovesicular structures are a consistent (and unexplained) finding in the brains of humans with prion diseases. Virus Res 2008; 132:226-8. [PMID: 18164506 DOI: 10.1016/j.virusres.2007.11.008] [Citation(s) in RCA: 7] [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: 08/09/2007] [Revised: 11/11/2007] [Accepted: 11/11/2007] [Indexed: 11/25/2022]
Abstract
Creutzfeldt-Jakob disease (CJD), Gerstmann-Sträussler-Scheinker disease (GSS) and Fatal Familial Insomnia (FFI) are slow neurodegenerative disorders classified as transmissible spongiform encephalopathies (TSEs) or prion diseases, which appear in sporadic, hereditary or environmentally acquired forms. Tubulovesicular structures (TVS) are ultrastructural particles of unknown origin and chemical composition found in the brains of both animal and human forms of transmissible spongiform encephalopathies or prion diseases. In this paper, we report the results of a search for TVS in a total of 13 cases of sporadic Creutzfeldt-Jakob disease, three cases of Gerstmann-Sträussler-Scheinker disease, two cases of Fatal Familial Insomnia, and individual cases of familial, iatrogenic, and variant CJD (vCJD). TVS were found in all but one sporadic and one familial case of CJD. As controls, we examined 15 cases of Alzheimer's disease (AD), two cases of Pick's disease, and one case of multiple system atrophy. TVS were not present in any of these cases. This study confirms the TSE-specificity of TVS, the morphology of which suggests a possible pathogenetic role and relationship to recently described virion-like arrays of 25nm particles in scrapie-infected tissue cultures.
Collapse
Affiliation(s)
- Pawel P Liberski
- Department of Molecular Pathology and Neuropathology, Medical University of Lodz, PL 92-216 Lodz, Poland.
| | | | | | | | | | | | | | | | | |
Collapse
|
35
|
Abstract
A 59-year-old patient presented with compulsive behaviors and lasting apathy after carbon monoxide intoxication. The apathy could be overcome by external stimulation (self-activation deficit). There was severe neuronal loss bilaterally in the anterior part of the pallidum and in the substantia nigra, pars reticulata. This first clinico-pathological case of a self-activation deficit illustrates the dissociation between motor and behavioral symptoms in lesions of the pallido-nigral complex, with the behavioral symptoms being related to lesions of the substantia nigra, pars reticulata and of the anterior part of the pallidum.
Collapse
Affiliation(s)
- Julien Adam
- Raymond Escourolle Neuropathology Laboratory, Hopital de La Salpetriere, Inserm U679, APHP, Pierre et Marie Curie Paris VI University, Paris, France
| | | | | | | | | |
Collapse
|
36
|
Hauw JJ, De Girolami U, Zekry D. The neuropathology of vascular and mixed dementia and vascular cognitive impairment. Handb Clin Neurol 2008; 89:687-703. [PMID: 18631788 DOI: 10.1016/s0072-9752(07)01262-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Jean-Jacques Hauw
- APHP, Department of Neuropathology, La Salpêtriere Hospital, Pierre and Marie Curie University, Paris, France.
| | | | | |
Collapse
|
37
|
Abstract
Neurodegenerative disorders are characterized by the correlation of clinical symptoms and neuropathological changes in the brain. However, overlaps between distinct entities are becoming more and more evident. We report the coexistence of Alzheimer pathology and alpha-synuclein inclusions in a sporadic, methioninelvaline type 1, Creutzfeldt-Jakob disease (CJD) case. There were neurofibrillary changes in the neocortex and beta amyloid cerebral angiopathy was marked. Several Lewy bodies were present in the substantia nigra, locus ceruleus and the dorsal motor nucleus of the vagus, and alpha-synuclein cytoplasmic inclusions were also found in cortical neurons. These findings raise the debated relationship between Parkinson's disease with dementia, dementia with Lewy bodies and a Lewy body variant of Alzheimer disease. Among the factors that may have contributed to this considerable morphological overlap are the patient's age (79 years at autopsy) and the over 2-year duration of the disease. As the average disease duration in sporadic methionine/valine type 1 CJD is less than 6 months, it seems legitimate to speculate that the initial symptoms resulted from Alzheimer and alpha-synuclein related pathologies. This observation shows that CJD can be present in elderly patients who are suspected of having other neurodegenerative diseases, which could underline the importance of neuropathology-based surveillance systems.
Collapse
Affiliation(s)
- Anne Vital
- Neuropathology Department, Victor Segalen-Bordeaux 2 University, Bordeaux, France.
| | | | | | | | | |
Collapse
|
38
|
Pradat PF, Bruneteau G, Gonzalez de Aguilar JL, Dupuis L, Jokic N, Salachas F, Le Forestier N, Echaniz-Laguna A, Dubourg O, Hauw JJ, Tranchant C, Loeffler JP, Meininger V. Muscle Nogo-a expression is a prognostic marker in lower motor neuron syndromes. Ann Neurol 2007; 62:15-20. [PMID: 17455292 DOI: 10.1002/ana.21122] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE A proportion of patients with pure lower motor neuron syndrome (LMNS) progress to amyotrophic lateral sclerosis (ALS). Early detection of this progression is impossible, which delays the patient's access to treatment. Muscle expression of Nogo-A is a new candidate marker of ALS. We tested whether detection of Nogo-A in a muscle biopsy from patients with LMNS predicts progression to ALS. METHODS Thirty-three patients who had undergone a muscle biopsy during the diagnostic workup of spinal LMNS were observed for 12 months. Nogo-A expression was measured by Western blot in muscle biopsy samples and compared with the final diagnosis. RESULTS Nogo-A expression was detected in 17 patients and was absent in 16 patients. The detection of Nogo-A in muscle biopsy samples from LMNS patients correctly identified patients who further progressed to ALS with 91% accuracy, 94% sensitivity, and 88% specificity. In patients who later developed typical ALS, Nogo-A may be detected as early as 3 months after the onset of symptoms. INTERPRETATION Nogo-A test is able to identify ALS early in the course of the disease when diagnosis is difficult, requiring further progression. Use of the test in clinical practice may shorten the delay before introduction of neuroprotective drugs or inclusion in clinical trials.
Collapse
Affiliation(s)
- Pierre-François Pradat
- Fédération des Maladies du Système Nerveux, Centre référent maladie rare SLA, Hôpital de la Pitié-Salpêtrière, 47-83 Boulevard de l'Hôpital, 75651 Paris, France
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
39
|
Abstract
The concept of vascular dementia has evolved over the past century to include multiple underlying pathophysiological mechanisms. Neuroimaging techniques offer new and better ways to identify the presence of cerebrovascular pathology, although they do not improve our ability to link these changes to the onset of clinical cognitive impairment. Clinical criteria for vascular dementia have also evolved but they remain imperfect. Most epidemiological studies define mixed dementia as the coexistence of Alzheimer's disease and vascular dementia. Clinicopathologic correlations show a clear association between the concomitant presence of vascular and Alzheimer lesions and the severity of cognitive impairment in mixed dementia and provide strong support for the validity of the mixed dementia concept. Mixed dementia is a very frequent disease that remains underdiagnosed, especially in the elderly. The diagnosis of vascular and mixed dementia remains a clinical challenge and cannot be improved without further studies of clinicopathological correlations and functional neuroimaging. Preventive therapeutic interventions include control of vascular risk factors and especially treatment of hypertension.
Collapse
Affiliation(s)
- Dina Zekry
- Laboratoire de neuropathologie Raymond Escourolle, Hôpital de la Salpêtrière, Paris (75).
| | | | | |
Collapse
|
40
|
Abstract
BACKGROUND AND PURPOSE Clinical and imaging studies have reported an independent and intriguing association between intracranial arterial dolichoectasia (IADE) and markers of small-vessel disease (SVD) such as lacune(s). We used a large brain-autopsy collection to investigate the relation between IADE and pathologically assessed cerebral SVD. METHODS The entire arterial tree from the heart to the intracranial small intracerebral arteries was investigated in 381 consecutive autopsies from patients with stroke. Vascular risk factors, heart status (weight, coronary atherosclerosis, and myocardial infarction), prevalence and severity of atherosclerosis from heart to brain (aortic arch, carotid, vertebral, and intracranial arteries), dolichoectasia, cerebral SVD, and brain tissue lesions (lacune(s), état criblé) were evaluated. Analyses were adjusted for age, sex, and heart weight. RESULTS Twenty-three (6%) of 381 patients had IADE, affecting mainly the basilar artery, with a median basilar artery diameter of 6 mm (range, 4 to 9 mm). Patients with IADE had a >2-fold increase in the prevalence of basilar artery plaques and ulcerated plaques in the aortic arch (both P=0.006), but there were no associations with coronary or cervical artery plaques. SVD was more frequent in IADE-positive than in IADE-negative patients (45% vs 18%; P=0.004). The adjusted odds ratio was 3.85 (95% confidence interval, 1.56 to 9.52). Cerebral amyloid angiopathy was not observed in IADE-positive patients. CONCLUSIONS Compared with stroke patients without IADE, those with IADE were more likely to have pathologic evidence of cerebral SVD and its consequences, independent of age, arterial hypertension, or diabetes mellitus. IADE and cerebral SVD may have unidentified biologic processes in common.
Collapse
Affiliation(s)
- Fernando Pico
- Department of Neuropathology Raymond Escourolle, AP-HP Pitié Salpêtrière Hospital, Pierre et Marie Curie University, Paris, France
| | | | | | | | | | | |
Collapse
|
41
|
Abboud H, Labreuche J, Gongora-Riverra F, Jaramillo A, Duyckaerts C, Steg PG, Hauw JJ, Amarenco P. Prevalence and determinants of subdiaphragmatic visceral infarction in patients with fatal stroke. Stroke 2007; 38:1442-6. [PMID: 17379822 DOI: 10.1161/strokeaha.106.476804] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE Arterial thromboembolism is a common cause of both visceral and brain infarctions. Because the cause of brain infarction is unknown in up to 39% of patients, the discovery of subdiaphragmatic visceral infarction (SDVI) in this context is important, but its frequency is unknown. We therefore investigated the prevalence of SDVI in subjects who died from stroke. We also evaluated the yield of SDVI diagnosis for stroke subtyping. METHODS We performed a case-control study using a series of 815 consecutive autopsies of patients who had died from a neurological disease, including 350 with stroke (260 infarcts and 90 hemorrhages). We systematically assessed the presence of renal, splenic, and mesenteric infarction (no case of spinal cord was recorded) and analyzed their determinants in patients with stroke. Patients with other neurological diseases served as the control group. RESULTS Renal infarction was the most frequent SDVI (10.2%), whereas mesenteric infarction was rare (1.1%). At least one SDVI was found in 16.9% of patients with stroke (38.7% of patients with a cardioembolic stroke) and in 5.1% of patients with other neurological diseases (adjusted OR=2.12; 95% CI=1.08 to 4.16). Among patients with stroke, a significant heterogeneity in the prevalence of SDVI was found across etiological stroke subgroups with only three patients (3.3%) with hemorrhagic stroke having an SDVI (2 mesenteric and one renal infarction) compared with 56 patients (21.5%) with ischemic stroke (P<0.0001). Among patients with brain infarction and a SDVI, 76.8% had a definite cardiac source of embolism. CONCLUSIONS In patients with fatal brain infarction, the prevalence of SDVI is higher than previously thought, especially in those with stroke attributed to cardiac emboli. Seeking SDVI may assist in the etiologic diagnosis of brain infarction.
Collapse
Affiliation(s)
- Halim Abboud
- Assistance-Publique Hôpitaux de Paris, Paris, France
| | | | | | | | | | | | | | | |
Collapse
|
42
|
Abstract
BACKGROUND AND PURPOSE Myocardial infarction (MI) is the leading cause of long-term mortality in patients with stroke, yet the prevalence of coronary atherosclerosis in these individuals is unknown. The objective of the study was to establish the prevalence of coronary atherosclerosis and MI after fatal stroke. METHODS Using an autopsy data bank, we studied the prevalence of coronary plaques and coronary stenoses >50% and pathologic evidence of MI in 803 consecutive autopsies of neurologic patients. RESULTS Coronary plaques, coronary stenoses, and MI were present in 72.4%, 37.5%, and 40.8%, respectively, of the 341 patients with stroke and in 26.8%, 10.1%, and 12.8%, respectively, of the 462 patients with other neurologic diseases (P<0.001). Two-thirds of cases of MI were clinically silent and found at autopsy. Compared with other neurologic diseases, and after adjusting for age, gender, and heart weight, the odds ratios (95% confidence intervals) of the presence of coronary plaques, coronary stenosis, and MI in stroke patients were 3.81 (2.66 to 5.46), 2.80 (1.85 to 4.25), and 2.34 (1.58 to 3.46), respectively. The frequency of coronary atherosclerosis and MI was similar between stroke subtypes. The prevalence of coronary plaques, coronary stenosis, and MI was 79.0%, 42.9%, and 46.0%, respectively, in the presence of plaques in any segment of the extracranial and intracranial brain arteries, and 50.8%, 17.9%, and 23.9%, respectively, in the absence of plaques (adjusted P<0.01). Coronary atherosclerosis was also related to the severity of atherosclerosis in any segment of the cerebral arteries (adjusted probability value for linear trend <.005). CONCLUSIONS Coronary atherosclerosis and MI are highly prevalent in patients who died from a stroke regardless of the etiology. They are more frequent when atherosclerosis is present in the carotid and cerebral arteries. They are also common in stroke patients with no evidence of carotid or cerebral atherosclerosis.
Collapse
|
43
|
Huber FM, Bour F, Sazdovitch V, Hauw JJ, Heinemann U, Zanini F, Droste DW, Diederich NJ. Creutzfeldt-Jakob disease with slow progression. A mimickry of progressive supranuclear palsy. Bull Soc Sci Med Grand Duche Luxemb 2007:125-130. [PMID: 18084908] [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] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Sporadic Creutzfeldt-Jakob disease (sCJD) does not always present with typical clinical signs, such as myoclonus in association with periodic sharp-wave complexes. We present a 67-year old female patient with initial falls and vertical gaze palsy, suggesting the diagnosis of Progressive Supranuclear Palsy (PSP). EEG and MRI were not contributory. Typical clinical and paraclinical CJD signs were only seen after 17 months. The diagnosis was confirmed by autopsy. - CJD can be a neurodegenerative chameleon. The present case adds to the scare literature of slowly evolving CJD mimicking Parkinsonism related to tauopathies.
Collapse
Affiliation(s)
- F M Huber
- Department of Neurosciences, Centre Hospitalier de Luxembourg, Luxembourg City, Luxembourg
| | | | | | | | | | | | | | | |
Collapse
|
44
|
Hauw JJ. [The neuropathology of sleep in human neurodegenerative diseases]. Rinsho Shinkeigaku 2006; 46:788-9. [PMID: 17432179] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Affiliation(s)
- Jean-Jacques Hauw
- Raymond Escourolle Neuropathology Laboratory, La Salpêtrière Hospital, Paris, France
| |
Collapse
|
45
|
Chasseigneaux S, Haïk S, Laffont-Proust I, De Marco O, Lenne M, Brandel JP, Hauw JJ, Laplanche JL, Peoc'h K. V180I mutation of the prion protein gene associated with atypical PrPSc glycosylation. Neurosci Lett 2006; 408:165-9. [PMID: 17029785 DOI: 10.1016/j.neulet.2006.08.008] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2006] [Revised: 07/11/2006] [Accepted: 08/05/2006] [Indexed: 11/30/2022]
Abstract
A valine to isoleucine mutation at residue 180 was identified in a French patient with Creutzfeldt-Jakob disease (CJD). The mutation is located in the close vicinity of one of the two N-glycosylation sites of the cellular prion protein (PrP(C)). Western blot analysis revealed accumulation in the brain of the pathogenic proteinase K-resistant PrP (PrP(Sc)) isoform with the notable absence of the diglycosylated band. The mutant protein expressed in CHO cells was correctly glycosylated, suggesting that the atypical glycosylation pattern of PrP(Sc) was not due to the mutation at position 180. These results suggest that the diglycosylated form of the mutant PrP(180I) prevents its conversion into the pathogenic mutant form PrP(Sc180I), supporting a central role of N-linked glycan chains in the PrP conversion process.
Collapse
Affiliation(s)
- Stéphanie Chasseigneaux
- UPRES EA 3621, UFR des Sciences Pharmaceutiques et Biologiques, Université Paris 5 et Service de Biochimie et Biologie Moléculaire, Hôpital Lariboisière, 2 rue A. Paré, 75475 Paris cedex 10, France
| | | | | | | | | | | | | | | | | |
Collapse
|
46
|
Alafuzoff I, Pikkarainen M, Al-Sarraj S, Arzberger T, Bell J, Bodi I, Bogdanovic N, Budka H, Bugiani O, Ferrer I, Gelpi E, Giaccone G, Graeber MB, Hauw JJ, Kamphorst W, King A, Kopp N, Korkolopoulou P, Kovács GG, Meyronet D, Parchi P, Patsouris E, Preusser M, Ravid R, Roggendorf W, Seilhean D, Streichenberger N, Thal DR, Kretzschmar H. Interlaboratory comparison of assessments of Alzheimer disease-related lesions: a study of the BrainNet Europe Consortium. J Neuropathol Exp Neurol 2006; 65:740-57. [PMID: 16896308 DOI: 10.1097/01.jnen.0000229986.17548.27] [Citation(s) in RCA: 86] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
This interlaboratory study evaluated the reproducibility of the assessments of neuritic plaques and neurofibrillary tangles (NFTs)--the hallmark lesions of Alzheimer disease--and compared the staining between the BrainNet Europe centers. To reduce the topography-related inconsistencies in assessments, we used a 2-mm tissue microarray (TMA) technique. The TMA block included 42 core samples taken from 21 paraffin blocks. The assessments were done on Bielschowsky and Gallyas silver stains using an immunohistochemical (IHC) method with antibodies directed to beta-amyloid (IHC/Abeta) and hyperphosphorylated tau (IHC/HPtau). The staining quality and the assessments differed between the participants, being most diverse with Bielschowsky (good/acceptable stain in 53% of centers) followed by Gallyas (good/acceptable stain in 57%) and IHC/Abeta (good/acceptable stain in 71%). The most uniform staining quality and assessment was obtained with the IHC/HPtau method (good/acceptable stain in 94% of centers). The neuropathologic diagnostic protocol (Consortium to Establish a Registry for Alzheimer Disease, Braak and Braak, and the National Institute of Aging and Reagan [NIA-Reagan] Institute) that was used significantly influenced the agreement, being highest with NIA-Reagan (54%) recommendations. This agreement was improved by visualization of NFTs using the IHC/HPtau method. Therefore, the IHC/HPtau methodology to visualize NFTs and neuropil threads should be considered as a method of choice in a future diagnostic protocol for Alzheimer disease.
Collapse
Affiliation(s)
- Irina Alafuzoff
- Department of Neuroscience and Neurology, Kuopio University, Kuopio University Hospital, Finland.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
47
|
Linguraru MG, Ayache N, Bardinet E, Ballester MAG, Galanaud D, Haïk S, Faucheux B, Hauw JJ, Cozzone P, Dormont D, Brandel JP. Differentiation of sCJD and vCJD forms by automated analysis of basal ganglia intensity distribution in multisequence MRI of the brain--definition and evaluation of new MRI-based ratios. IEEE Trans Med Imaging 2006; 25:1052-67. [PMID: 16894998 DOI: 10.1109/tmi.2006.876133] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
We present a method for the analysis of basal ganglia (including the thalamus) for accurate detection of human spongiform encephalopathy in multisequence magnetic resonance imaging (MRI) of the brain. One common feature of most forms of prion protein diseases is the appearance of hyperintensities in the deep grey matter area of the brain in T2-weighted magnetic resonance (MR) images. We employ T1, T2, and Flair-T2 MR sequences for the detection of intensity deviations in the internal nuclei. First, the MR data are registered to a probabilistic atlas and normalized in intensity. Then smoothing is applied with edge enhancement. The segmentation of hyperintensities is performed using a model of the human visual system. For more accurate results, a priori anatomical data from a segmented atlas are employed to refine the registration and remove false positives. The results are robust over the patient data and in accordance with the clinical ground truth. Our method further allows the quantification of intensity distributions in basal ganglia. The caudate nuclei are highlighted as main areas of diagnosis of sporadic Creutzfeldt-Jakob Disease (sCJD), in agreement with the histological data. The algorithm permitted the classification of the intensities of abnormal signals in sCJD patient FLAIR images with a higher hypersignal in caudate nuclei (10/10) and putamen (6/10) than in thalami. Defining normalized MRI measures of the intensity relations between the internal grey nuclei of patients, we robustly differentiate sCJD and variant CJD (vCJD) patients, in an attempt to create an automatic classification tool of human spongiform encephalopathies.
Collapse
|
48
|
Giaccone G, Mangieri M, Hauw JJ, Haı̈k S, Capobianco R, Fociani P, Bugiani O, Tagliavini F. O2–01–08: Tauopathy in variant Creutzfeldt–Jakob disease. Alzheimers Dement 2006. [DOI: 10.1016/j.jalz.2006.05.109] [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: 11/29/2022]
Affiliation(s)
| | | | | | | | | | - Paolo Fociani
- Ospedale Luigi Sacco, Università di MilanoMilanoItaly
| | - Orso Bugiani
- Istituto Nazionale Neurologico Carlo BestaMilanoItaly
| | | |
Collapse
|
49
|
Duyckaerts CJ, Girardot N, Langui D, Raposo G, Buée L, Hauw JJ. S2–02–03: The molecular pathology link between tangles and plaques. Alzheimers Dement 2006. [DOI: 10.1016/j.jalz.2006.05.083] [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: 11/29/2022]
|
50
|
Greffard S, Verny M, Bonnet AM, Beinis JY, Gallinari C, Meaume S, Piette F, Hauw JJ, Duyckaerts C. Motor score of the Unified Parkinson Disease Rating Scale as a good predictor of Lewy body-associated neuronal loss in the substantia nigra. ACTA ACUST UNITED AC 2006; 63:584-8. [PMID: 16606773 DOI: 10.1001/archneur.63.4.584] [Citation(s) in RCA: 214] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND How well the motor symptoms assessed by the motor section of the Unified Parkinson Disease Rating Scale (UPDRS3) reflect the neuronal loss observed in the substantia nigra is not known. OBJECTIVE To study the relationships among the motor symptoms assessed by the UPDRS3, Lewy body-associated neuronal loss in the substantia nigra, and duration of disease. DESIGN Longitudinal, prospective, clinicopathological study. SETTING Long-term care facility of a university hospital. PATIENTS Eighteen elderly patients with a parkinsonian syndrome, studied prospectively but selected post mortem on the basis of the presence of Lewy bodies, and 5 age-matched control subjects. METHODS One map of a section of the substantia nigra, indicating the location of all the nucleolated neuronal profiles, was drawn for each case. Neuronal density was estimated using a tessellation method. The relationship between time and neuronal loss and between neuronal loss and motor symptoms (assessed by the UPDRS3) was studied by means of regression analysis, using linear and exponential models. RESULTS The neuronal density was linearly linked with the UPDRS3 score (r = -0.83 [P<.001]). Each point added to the UPDRS3 score corresponded to an estimated loss of 25 neurons/mm(3). The density of neuronal profiles in the substantia nigra decreased exponentially with time (r = -0.73 [P<.001]). Extrapolation of the curve suggested a presymptomatic phase of 5 years. CONCLUSION The UPDRS3 score is linearly linked to neuronal density, which, in Lewy body diseases, decreases exponentially with time at a similar pace in this series of elderly patients and in the younger patients described in the literature.
Collapse
Affiliation(s)
- Sandrine Greffard
- Geriatric Center, Pitié-Salpêtrière Hospital, Assistance Publique des Hôpitaux de Paris, 47 Boulevard de l'Hôpital, 75651 Paris CEDEX 13, France
| | | | | | | | | | | | | | | | | |
Collapse
|