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Poulen G, Chan-Seng E, Sanrey E, Coubes P. A Case of Successful Pallidal Deep Brain Stimulation in ANO3 Dystonia. Mov Disord 2024; 39:746-747. [PMID: 38341631 DOI: 10.1002/mds.29721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 12/21/2023] [Accepted: 01/02/2024] [Indexed: 02/12/2024] Open
Affiliation(s)
- Gaëtan Poulen
- Stereotactic and Functional Neurosurgery Department, University Medical Center Gui de Chauliac, Montpellier, France
- Research Unit (URCMA: Unité de Recherche sur les Comportements et Mouvements Anormaux), Montpellier, France
- MMDN, University of Montpellier, EPHE, INSERM, Montpellier, France
| | - Emilie Chan-Seng
- Stereotactic and Functional Neurosurgery Department, University Medical Center Gui de Chauliac, Montpellier, France
- Research Unit (URCMA: Unité de Recherche sur les Comportements et Mouvements Anormaux), Montpellier, France
| | - Emily Sanrey
- Stereotactic and Functional Neurosurgery Department, University Medical Center Gui de Chauliac, Montpellier, France
- Research Unit (URCMA: Unité de Recherche sur les Comportements et Mouvements Anormaux), Montpellier, France
| | - Philippe Coubes
- Stereotactic and Functional Neurosurgery Department, University Medical Center Gui de Chauliac, Montpellier, France
- Research Unit (URCMA: Unité de Recherche sur les Comportements et Mouvements Anormaux), Montpellier, France
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Poulen G, Mercedes-Alvarez B, Rigau V, Coubes P. Bilateral periventricular nodular heterotopia and cortical dysplasia due to filamin 1 gene mutation: An invasive EEG exploration and histopathologic study. Epileptic Disord 2024; 26:240-243. [PMID: 37905434 DOI: 10.1002/epd2.20177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 10/25/2023] [Accepted: 10/27/2023] [Indexed: 11/02/2023]
Affiliation(s)
- Gaëtan Poulen
- Epilepsy Monitoring and Surgery Unit, Département de neurochirurgie, Unité « Pathologie Cérébrales Résistantes », Centre Hospitalo-Universitaire Gui de Chauliac, Montpellier, France
- Research Unit (URCMA: Unité de Recherche sur les Comportements et Mouvements Anormaux), Centre Hospitalo-Universitaire Gui de Chauliac, Montpellier, France
- MMDN, University of Montpellier, EPHE, INSERM, Montpellier, France
| | - Blanca Mercedes-Alvarez
- Epilepsy Monitoring and Surgery Unit, Département de neurochirurgie, Unité « Pathologie Cérébrales Résistantes », Centre Hospitalo-Universitaire Gui de Chauliac, Montpellier, France
| | - Valérie Rigau
- Département d'Anatomo-Pathologie, Centre Hospitalo-Universitaire Gui de Chauliac, Montpellier, France
| | - Philippe Coubes
- Epilepsy Monitoring and Surgery Unit, Département de neurochirurgie, Unité « Pathologie Cérébrales Résistantes », Centre Hospitalo-Universitaire Gui de Chauliac, Montpellier, France
- Research Unit (URCMA: Unité de Recherche sur les Comportements et Mouvements Anormaux), Centre Hospitalo-Universitaire Gui de Chauliac, Montpellier, France
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Poulen G, Gélisse P, Chan-Seng E, Moser PO, Genton P, Crespel A, Coubes P. Globus Pallidus Internus (GPi) Neuromodulation is Not Effective in Unverricht-Lundborg Disease to Control Myoclonia. Mov Disord 2024. [PMID: 38469950 DOI: 10.1002/mds.29787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 02/15/2024] [Accepted: 02/28/2024] [Indexed: 03/13/2024] Open
Affiliation(s)
- Gaëtan Poulen
- Epilepsy Monitoring and Surgery Unit, Département de Neurochirurgie, Unité "Pathologies Cérébrales Résistantes", Centre Hospitalo-Universitaire Gui de Chauliac, Montpellier, France
- Research Unit (URCMA: Unité de Recherche sur les Comportements et Mouvements Anormaux), Centre Hospitalo-Universitaire Gui de Chauliac, Montpellier, France
- MMDN, University of Montpellier, EPHE, INSERM, Montpellier, France
| | - Philippe Gélisse
- Epilepsy Monitoring and Surgery Unit, Département de Neurochirurgie, Unité "Pathologies Cérébrales Résistantes", Centre Hospitalo-Universitaire Gui de Chauliac, Montpellier, France
- Research Unit (URCMA: Unité de Recherche sur les Comportements et Mouvements Anormaux), Centre Hospitalo-Universitaire Gui de Chauliac, Montpellier, France
| | - Emilie Chan-Seng
- Epilepsy Monitoring and Surgery Unit, Département de Neurochirurgie, Unité "Pathologies Cérébrales Résistantes", Centre Hospitalo-Universitaire Gui de Chauliac, Montpellier, France
- Research Unit (URCMA: Unité de Recherche sur les Comportements et Mouvements Anormaux), Centre Hospitalo-Universitaire Gui de Chauliac, Montpellier, France
| | - Pierre-Olivier Moser
- Epilepsy Monitoring and Surgery Unit, Département de Neurochirurgie, Unité "Pathologies Cérébrales Résistantes", Centre Hospitalo-Universitaire Gui de Chauliac, Montpellier, France
- Research Unit (URCMA: Unité de Recherche sur les Comportements et Mouvements Anormaux), Centre Hospitalo-Universitaire Gui de Chauliac, Montpellier, France
| | - Pierre Genton
- Neurology Department, Centre Hospitalier du Pays d'Aix, Aix-en-Provence, France
| | - Arielle Crespel
- Epilepsy Monitoring and Surgery Unit, Département de Neurochirurgie, Unité "Pathologies Cérébrales Résistantes", Centre Hospitalo-Universitaire Gui de Chauliac, Montpellier, France
- Research Unit (URCMA: Unité de Recherche sur les Comportements et Mouvements Anormaux), Centre Hospitalo-Universitaire Gui de Chauliac, Montpellier, France
| | - Philippe Coubes
- Epilepsy Monitoring and Surgery Unit, Département de Neurochirurgie, Unité "Pathologies Cérébrales Résistantes", Centre Hospitalo-Universitaire Gui de Chauliac, Montpellier, France
- Research Unit (URCMA: Unité de Recherche sur les Comportements et Mouvements Anormaux), Centre Hospitalo-Universitaire Gui de Chauliac, Montpellier, France
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François‐Heude M, Poulen G, Flamand Roze E, Nguyen Morel M, Gras D, Roch‐Toreilles I, Quintard A, Baroux G, Meyer P, Coubes P, Milesi C, Cambonie G, Baleine J, Sola C, Delye B, Dimopoulou E, Sanchez S, Gasnier M, Touati S, Zamora A, Pontal D, Leboucq N, Kouyoumdjian V, Lebasnier A, Sanquer S, Mariano‐Goulart D, Roujeau T, Roubertie A. Intraputaminal Gene Delivery in Two Patients with Aromatic L-Amino Acid Decarboxylase Deficiency. Mov Disord Clin Pract 2023; 10:811-818. [PMID: 37205256 PMCID: PMC10187009 DOI: 10.1002/mdc3.13685] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 12/24/2022] [Accepted: 01/20/2023] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND Aromatic l-amino acid decarboxylase deficiency (AADCD) is a rare, early-onset, dyskinetic encephalopathy mostly reflecting a defective synthesis of brain dopamine and serotonin. Intracerebral gene delivery (GD) provided a significant improvement among AADCD patients (mean age, ≤6 years). OBJECTIVE We describe the clinical, biological, and imaging evolution of two AADCD patients ages >10 years after GD. METHODS Eladocagene exuparvovec, a recombinant adeno-associated virus containing the human complimentary DNA encoding the AADC enzyme, was administered into bilateral putamen by stereotactic surgery. RESULTS Eighteen months after GD, patients showed improvement in motor, cognitive and behavioral function, and in quality of life. Cerebral l-6-[18F] fluoro-3, 4-dihydroxyphenylalanine uptake was increased at 1 month, persisting at 1 year compared to baseline. CONCLUSION Two patients with a severe form of AADCD had an objective motor and non-motor benefit from eladocagene exuparvovec injection even when treated after the age of 10 years, as in the seminal study.
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Affiliation(s)
| | - Gaetan Poulen
- Département de NeurochirurgieCHU MontpellierMontpellierFrance
| | - Emmanuel Flamand Roze
- Assistance Publique ‐ Hôpitaux de Paris CHU Pitié‐SalpêtrièreDMU Neurosciences et Sorbonne Université, INSERM, CNRS, Institut du Cerveau et de la MoelleParisFrance
| | - Marie‐Ange Nguyen Morel
- Service de Neurologie PédiatriqueHôpital Couple Mère Enfant, CHU Grenoble AlpesLa TroncheFrance
| | - Domitille Gras
- U1141 Neurodiderot, Équipe 5 inDev, Inserm, CEA, UP, UNIACT, Neurospin, Joliot, DRF, CEA‐SaclayParisFrance
| | | | | | | | - Pierre Meyer
- CHU Montpellier, Département de NeuropédiatrieUniv MontpellierMontpellierFrance
- PhyMedExp, CNRS, INSERM, Université de MontpellierMontpellierFrance
| | - Philippe Coubes
- Département de NeurochirurgieCHU MontpellierMontpellierFrance
| | - Christophe Milesi
- Département de Réanimation PédiatriqueCHU MontpellierMontpellierFrance
| | - Gilles Cambonie
- Département de Réanimation PédiatriqueCHU MontpellierMontpellierFrance
| | - Julien Baleine
- Département de Réanimation PédiatriqueCHU MontpellierMontpellierFrance
| | - Chrystelle Sola
- Département d'Anesthésie‐RéanimationCHU Montpellier; Institute of Functional Genomics (IGF), Université de Montpellier, CNRS, INSERMMontpellierFrance
| | - Bénédicte Delye
- Département d'Anesthésie‐RéanimationCHU Gui de ChauliacMontpellierFrance
| | - Evgenia Dimopoulou
- CHU Montpellier, Département de NeuropédiatrieUniv MontpellierMontpellierFrance
| | - Stéphanie Sanchez
- CHU Montpellier, Département de NeuropédiatrieUniv MontpellierMontpellierFrance
| | | | - Souad Touati
- CHU Montpellier, Département de NeuropédiatrieUniv MontpellierMontpellierFrance
| | - Alberto Zamora
- CHU Montpellier, Département de NeuropédiatrieUniv MontpellierMontpellierFrance
| | - Daniel Pontal
- CHU Montpellier, Département de NeuropédiatrieUniv MontpellierMontpellierFrance
| | - Nicolas Leboucq
- Département de NeuroradiologieCHU MontpellierMontpellierFrance
| | | | - Adrien Lebasnier
- Département de Médecine NucléaireCHU MontpellierMontpellierFrance
| | | | | | - Thomas Roujeau
- Département de NeurochirurgieCHU MontpellierMontpellierFrance
| | - Agathe Roubertie
- CHU Montpellier, Département de NeuropédiatrieUniv MontpellierMontpellierFrance
- INM, Univ Montpellier, INSERM U 1298MontpellierFrance
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Cif L, Demailly D, Gehin C, Chan Seng E, Dornadic M, Huby S, Poulen G, Roubertie A, Villessot M, Roujeau T, Coubes P. Deep brain stimulation effect in genetic dyskinetic cerebral palsy: The case of ADCY5- related disease. Mol Genet Metab 2023; 138:106970. [PMID: 36610259 DOI: 10.1016/j.ymgme.2022.106970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 11/06/2022] [Accepted: 12/11/2022] [Indexed: 12/31/2022]
Abstract
BACKGROUND Cerebral Palsy (CP) represents a frequent cause of disability in childhood. Early in life, genetic disorders may present with motor dysfunction and diagnosed as CP. Establishing the primary, genetic etiology allows more accurate prognosis, genetic counselling, and planning for symptomatic interventions in homogeneous etiological groups. Deep brain stimulation (DBS) is recommended in refractory movement disorders, including isolated pediatric dystonias. For dystonia evolving in more complex associations in genetic CP, the effect of DBS is still understudied and currently only sporadically described. OBJECTIVES To report the effect of DBS applied to the globus pallidus pars interna (GPi) in children with complex movement disorders caused by pathogenic ADCY5 variants, diagnosed as dyskinetic CP previous to genetic diagnostic. METHODS We conducted a retrospective study on evolution of treatment with DBS in ADCY5-related disease. A standardized proforma including the different type of movement disorders and associated neurological signs was completed at each follow-up time, based on video recordings, as well as functional assessments used in children with CP. RESULTS Four children (mean of age, 13 ± 2.9 years) received GPi-DBS. The same de novo pathogenic missense variant (c.1252C > T, p.R418W) was identified in three out of four and a splice site variant (c.2088 + 2G > T) in one subject. Developmental delay and overlapping features including axial hypotonia, chorea, dystonic attacks, myoclonus, and cranial dyskinesia were present. The median age at DBS was 9 years and follow-up with DBS, 2.6 years. We identified a pattern of clinical response with early suppression of dystonic attacks, followed by improvement of myoclonus and facial dyskinesia. Effect on chorea was delayed and more limited. Two patients gained notable functional benefit related to sitting, standing, gait, use of upper limbs and speech. CONCLUSION ADCY5-related disease may benefit from GPi-DBS. The most significant clinical response relates to the early and sustained benefit on dystonic attacks and a variable but still positive response on the other hyperkinetic features. Genetic etiology of CP will contribute to further elucidate genotype-phenotype correlations and to refine DBS indication as network-related symptomatic interventions.
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Affiliation(s)
- Laura Cif
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Hospital, Montpellier, France.
| | - Diane Demailly
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Hospital, Montpellier, France
| | - Claire Gehin
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Hospital, Montpellier, France
| | - Emilie Chan Seng
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Hospital, Montpellier, France
| | - Morgan Dornadic
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Hospital, Montpellier, France; Département de Neurologie, Centre Hospitalier Universitaire Montpellier, Montpellier, France
| | - Sophie Huby
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Hospital, Montpellier, France; Département de Neurologie, Centre Hospitalier Universitaire Montpellier, Montpellier, France
| | - Gaetan Poulen
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Hospital, Montpellier, France
| | - Agathe Roubertie
- Department of Neuropaediatrics, Gui de Chauliac Hospital, Montpellier University Hospital, University of Montpellier, Montpellier, France
| | - Matthieu Villessot
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Hospital, Montpellier, France; Département de Neurologie, Centre Hospitalier Universitaire Montpellier, Montpellier, France
| | - Thomas Roujeau
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Hospital, Montpellier, France
| | - Philippe Coubes
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Hospital, Montpellier, France
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Ribeiro L, Chan-Seng E, Gil V, Sanrey E, Coubes P, Poulen G. Submammary Implantation of Internal Pulse Generators for Deep Brain Stimulation: Long-Term Follow-up of Device Acceptance and Quality of Life in Women. World Neurosurg 2022; 167:e1025-e1031. [PMID: 36058486 DOI: 10.1016/j.wneu.2022.08.126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 08/28/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND A submammary approach to implanting pulse generators is innovative and has yielded good aesthetic results in the current literature. It was our aim to make a comparison of patient device acceptance, tolerance, and complications between submammary and abdominal device locations in deep brain stimulation. METHODS Twenty-five and 28 patients were included in the submammary and abdominal groups, respectively. Our primary criterion was patient acceptance that was calculated using total Florida Patient Acceptance Survey (FPAS) scores in each group. Secondarily, tolerance was assessed in the submammary group by means of a specific questionnaire. RESULTS Total FPAS scores from the submammary group [total FPAS: 77.1 versus 74.7, P = 0.29] revealed no significant difference when compared with the abdominal group. The same similarities were observed regarding the 4 subscales: return to function [16.3 versus 15.8, P = 0.53], device-related distress [22.0 versus 21.3, P = 0.31], body image concerns [9.2 versus 8.6, P = 0.14], and positive appraisal [17.8 versus 17.4, P = 0.58]. Tolerance was reported as good by the majority of the women from the submammary group. There was no evidence of higher infection rates in the submammary implantation (SMI) group. CONCLUSIONS SMI is a satisfactory alternative to other deep brain stimulation locations. SMI is a feasible option for any young woman who is eligible for deep brain stimulation.
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Affiliation(s)
- Lucas Ribeiro
- Unité "Pathologies cérébrales résistantes", Department of Neurosurgery, CHU Gui De Chauliac, Montpellier, France; Unité de Recherche sur les Comportements et mouvements anormaux, Institut de Génomique Fonctionnelle, CHU Montpellier, Montpellier, France
| | - Emilie Chan-Seng
- Unité "Pathologies cérébrales résistantes", Department of Neurosurgery, CHU Gui De Chauliac, Montpellier, France; Unité de Recherche sur les Comportements et mouvements anormaux, Institut de Génomique Fonctionnelle, CHU Montpellier, Montpellier, France
| | - Valérie Gil
- Unité "Pathologies cérébrales résistantes", Department of Neurosurgery, CHU Gui De Chauliac, Montpellier, France; Unité de Recherche sur les Comportements et mouvements anormaux, Institut de Génomique Fonctionnelle, CHU Montpellier, Montpellier, France
| | - Emily Sanrey
- Unité "Pathologies cérébrales résistantes", Department of Neurosurgery, CHU Gui De Chauliac, Montpellier, France; Unité de Recherche sur les Comportements et mouvements anormaux, Institut de Génomique Fonctionnelle, CHU Montpellier, Montpellier, France
| | - Philippe Coubes
- Unité "Pathologies cérébrales résistantes", Department of Neurosurgery, CHU Gui De Chauliac, Montpellier, France; Unité de Recherche sur les Comportements et mouvements anormaux, Institut de Génomique Fonctionnelle, CHU Montpellier, Montpellier, France
| | - Gaëtan Poulen
- Unité "Pathologies cérébrales résistantes", Department of Neurosurgery, CHU Gui De Chauliac, Montpellier, France; Unité de Recherche sur les Comportements et mouvements anormaux, Institut de Génomique Fonctionnelle, CHU Montpellier, Montpellier, France.
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Poulen G, Rolland A, Chan-Seng E, Sanrey E, Gélisse P, Crespel A, Coubes P. Microendoscopic transventricular deep brain stimulation of the anterior nucleus of the thalamus as a safe treatment in intractable epilepsy: A feasibility study. Rev Neurol (Paris) 2022; 178:886-895. [PMID: 36153255 DOI: 10.1016/j.neurol.2022.03.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 03/20/2022] [Accepted: 03/21/2022] [Indexed: 10/14/2022]
Abstract
INTRODUCTION Deep brain stimulation (DBS) of the anterior nucleus of the thalamus (ANT) is proposed in patients with severe intractable epilepsy. When used, the transventricular approach increases the risk of bleeding due the anatomy around the entry point in the thalamus. To avoid such a complication, we used a transventricular microendoscopic technique. METHODS We performed a retrospective study of nine adult patients who were surgically treated for refractory epilepsy between 2010 and 2019 by DBS of the anterior thalamic nucleus. RESULTS Endoscopy provides a direct visual control of the entry point of the lead in the thalamus through the ventricle by avoiding ependymal vessels. No hemorrhage was recorded and accuracy was systematically checked by intraoperative stereotactic MRI. We reported a responder rate improvement in 88.9% of patients at 1 year and in 87.5% at 2 years. We showed a significant decrease in global seizure count per month one year after DBS (68.1%; P=0.013) leading to an overall improvement in quality of life. No major adverse effect was recorded during the follow-up. ANT DBS showed a prominent significant effect with a decrease of the number of generalized seizures. CONCLUSION We aimed at a better ANT/lead collimation using a vertical transventricular approach under microendoscopic monitoring. This technique permitted to demonstrate the safety and the accuracy of the procedure.
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Affiliation(s)
- G Poulen
- Unité "Pathologies cérébrales résistantes", department of neurosurgery, Montpellier university hospital, Montpellier, France; Unité de recherche sur les comportements et mouvements anormaux, department of neurosurgery, Montpellier university hospital, Montpellier, France.
| | - A Rolland
- Unité "Pathologies cérébrales résistantes", department of neurosurgery, Montpellier university hospital, Montpellier, France; Unité de recherche sur les comportements et mouvements anormaux, department of neurosurgery, Montpellier university hospital, Montpellier, France
| | - E Chan-Seng
- Unité "Pathologies cérébrales résistantes", department of neurosurgery, Montpellier university hospital, Montpellier, France; Unité de recherche sur les comportements et mouvements anormaux, department of neurosurgery, Montpellier university hospital, Montpellier, France
| | - E Sanrey
- Unité "Pathologies cérébrales résistantes", department of neurosurgery, Montpellier university hospital, Montpellier, France; Unité de recherche sur les comportements et mouvements anormaux, department of neurosurgery, Montpellier university hospital, Montpellier, France
| | - P Gélisse
- Unité "Pathologies cérébrales résistantes", department of neurosurgery, Montpellier university hospital, Montpellier, France; Unité de recherche sur les comportements et mouvements anormaux, department of neurosurgery, Montpellier university hospital, Montpellier, France
| | - A Crespel
- Unité "Pathologies cérébrales résistantes", department of neurosurgery, Montpellier university hospital, Montpellier, France; Unité de recherche sur les comportements et mouvements anormaux, department of neurosurgery, Montpellier university hospital, Montpellier, France
| | - P Coubes
- Unité "Pathologies cérébrales résistantes", department of neurosurgery, Montpellier university hospital, Montpellier, France; Unité de recherche sur les comportements et mouvements anormaux, department of neurosurgery, Montpellier university hospital, Montpellier, France
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Poulen G, Coubes P. Commentary: Are Transventricular Approaches Associated With Increased Hemorrhage? A Comparative Study in a Series of 624 Deep Brain Stimulation Surgeries. Oper Neurosurg (Hagerstown) 2022; 23:e189-e190. [PMID: 35972110 DOI: 10.1227/ons.0000000000000326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 05/05/2022] [Indexed: 02/04/2023] Open
Affiliation(s)
- Gaëtan Poulen
- Unité "Pathologies cérébrales résistantes", Department of Neurosurgery, Montpellier University Hospital, Montpellier, France.,Unité de Recherche sur les Comportements et mouvements anormaux, Department of Neurosurgery, Montpellier University Hospital, Montpellier, France
| | - Philippe Coubes
- Unité "Pathologies cérébrales résistantes", Department of Neurosurgery, Montpellier University Hospital, Montpellier, France.,Unité de Recherche sur les Comportements et mouvements anormaux, Department of Neurosurgery, Montpellier University Hospital, Montpellier, France
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Cif L, Demailly D, Vasques X, Verbizier DD, Coubes P, Gorman K, Kurian MA. Freezing of gait as a complication of pallidal deep brain stimulation in
DYT‐
KMT2B
patients with evidence of striatonigral degeneration. Mov Disord Clin Pract 2022; 9:992-996. [PMID: 36247903 PMCID: PMC9547127 DOI: 10.1002/mdc3.13519] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 04/18/2022] [Accepted: 05/27/2022] [Indexed: 11/25/2022] Open
Affiliation(s)
- Laura Cif
- Département de Neurochirurgie, Unité des Pathologies Cérébrales Résistantes, Unité de Recherche sur les Comportements et Mouvements Anormaux, Hôpital Gui de Chauliac Centre Hospitalier Universitaire Montpellier Montpellier France
| | - Diane Demailly
- Département de Neurochirurgie, Unité des Pathologies Cérébrales Résistantes, Unité de Recherche sur les Comportements et Mouvements Anormaux, Hôpital Gui de Chauliac Centre Hospitalier Universitaire Montpellier Montpellier France
| | - Xavier Vasques
- Laboratoire de Recherche en Neurosciences Cliniques Montpellier France
- IBM Technology France
| | - Delphine de Verbizier
- Département de Médecine Nucléaire Hôpital Gui de Chauliac, Centre Hospitalier Universitaire Montpellier Montpellier France
| | - Philippe Coubes
- Département de Neurochirurgie, Unité des Pathologies Cérébrales Résistantes, Unité de Recherche sur les Comportements et Mouvements Anormaux, Hôpital Gui de Chauliac Centre Hospitalier Universitaire Montpellier Montpellier France
| | - Kathleen Gorman
- Developmental Neurosciences UCL Great Ormond Street Institute of Child Health, Zayed Centre for Research into Rare Disease in Children London WC1N 1DZ UK
- Department of Neurology Great Ormond Street Hospital London UK
| | - Manju A. Kurian
- Developmental Neurosciences UCL Great Ormond Street Institute of Child Health, Zayed Centre for Research into Rare Disease in Children London WC1N 1DZ UK
- Department of Neurology Great Ormond Street Hospital London UK
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Villessot M, Demailly D, Chan-Seng E, Poulen G, Huby S, Roujeau T, Dornadic M, Vérin M, Riou A, Coubes P, Cif L. Unpredicted failure of deep brain stimulation by the impedance measures in a child with severe PANK2- gene related generalized dystonia. Brain Stimul 2022; 15:921-923. [PMID: 35690387 DOI: 10.1016/j.brs.2022.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 04/05/2022] [Accepted: 06/06/2022] [Indexed: 11/26/2022] Open
Affiliation(s)
- Matthieu Villessot
- Département de Neurochirurgie, Centre Hospitalier Universitaire Montpellier, Montpellier, France; Département de Neurologie, Centre Hospitalier Universitaire Montpellier, Montpellier, France
| | - Diane Demailly
- Département de Neurochirurgie, Centre Hospitalier Universitaire Montpellier, Montpellier, France
| | - Emilie Chan-Seng
- Département de Neurochirurgie, Centre Hospitalier Universitaire Montpellier, Montpellier, France
| | - Gaëtan Poulen
- Département de Neurochirurgie, Centre Hospitalier Universitaire Montpellier, Montpellier, France
| | - Sophie Huby
- Département de Neurochirurgie, Centre Hospitalier Universitaire Montpellier, Montpellier, France; Département de Neurologie, Centre Hospitalier Universitaire Montpellier, Montpellier, France
| | - Thomas Roujeau
- Département de Neurochirurgie, Centre Hospitalier Universitaire Montpellier, Montpellier, France
| | - Morgan Dornadic
- Département de Neurochirurgie, Centre Hospitalier Universitaire Montpellier, Montpellier, France; Département de Neurologie, Centre Hospitalier Universitaire Montpellier, Montpellier, France
| | - Marc Vérin
- Department of Neurology and Reference Center for Rare Intellectual Disability Medical Genetics Department, Rennes University Hospital, Behaviour and Basal Ganglia Research Unit, University of Rennes, Rennes, France
| | - Audrey Riou
- Department of Neurology and Reference Center for Rare Intellectual Disability Medical Genetics Department, Rennes University Hospital, Behaviour and Basal Ganglia Research Unit, University of Rennes, Rennes, France
| | - Philippe Coubes
- Département de Neurochirurgie, Centre Hospitalier Universitaire Montpellier, Montpellier, France
| | - Laura Cif
- Département de Neurochirurgie, Centre Hospitalier Universitaire Montpellier, Montpellier, France.
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11
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Fernandez B, Gautier A, Koumaré IB, Fabre JM, Coubes P, Poulen G. Transcutaneous ventriculo-peritoneal shunt catheter extrusion with silent bowel perforation following digestive surgery: a case report. Br J Neurosurg 2022:1-4. [PMID: 35174740 DOI: 10.1080/02688697.2022.2039373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 12/28/2021] [Accepted: 02/02/2022] [Indexed: 11/10/2022]
Abstract
This case report provides an account of transcutaneous ventriculo-peritoneal (VP) shunt extrusion with silent bowel perforation occurring 2 years post digestive surgery. A 22-year-old man treated since childhood for post-infectious hydrocephalus was referred to our neurosurgery department for an inflammatory wound to the right hypochondrium caused by an abandoned calcified VP shunt. This VP shunt was surgically removed without complications. The perforated bowel required no direct repair. Progress is favorable at 1 year follow-up.
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Affiliation(s)
- Benjamin Fernandez
- Department of Hepato-Biliary and Pancreatic Surgery and Liver Transplantation, Haut-Lévêque Hospital, CHU Bordeaux, France
| | | | - Izoudine B Koumaré
- Unité "Pathologies cérébrales résistantes", Department of Neurosurgery, CHU Gui De Chauliac, Montpellier, France
- Unité de Recherche sur les Comportements et mouvements anormaux, CHU Montpellier, France
| | | | - Philippe Coubes
- Unité "Pathologies cérébrales résistantes", Department of Neurosurgery, CHU Gui De Chauliac, Montpellier, France
- Unité de Recherche sur les Comportements et mouvements anormaux, CHU Montpellier, France
- Institut de Génomique Fonctionnelle, Montpellier, France
- CNRS UMR5203, Montpellier, France
- INSERM U661, Montpellier, France
| | - Gaëtan Poulen
- Unité "Pathologies cérébrales résistantes", Department of Neurosurgery, CHU Gui De Chauliac, Montpellier, France
- Unité de Recherche sur les Comportements et mouvements anormaux, CHU Montpellier, France
- Institut de Génomique Fonctionnelle, Montpellier, France
- CNRS UMR5203, Montpellier, France
- INSERM U661, Montpellier, France
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12
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Cif L, Demailly D, Lin JP, Barwick KE, Sa M, Abela L, Malhotra S, Chong WK, Steel D, Sanchis-Juan A, Ngoh A, Trump N, Meyer E, Vasques X, Rankin J, Allain MW, Applegate CD, Attaripour Isfahani S, Baleine J, Balint B, Bassetti JA, Baple EL, Bhatia KP, Blanchet C, Burglen L, Cambonie G, Seng EC, Bastaraud SC, Cyprien F, Coubes C, d'Hardemare V, Doja A, Dorison N, Doummar D, Dy-Hollins ME, Farrelly E, Fitzpatrick DR, Fearon C, Fieg EL, Fogel BL, Forman EB, Fox RG, Gahl WA, Galosi S, Gonzalez V, Graves TD, Gregory A, Hallett M, Hasegawa H, Hayflick SJ, Hamosh A, Hully M, Jansen S, Jeong SY, Krier JB, Krystal S, Kumar KR, Laurencin C, Lee H, Lesca G, François LL, Lynch T, Mahant N, Martinez-Agosto JA, Milesi C, Mills KA, Mondain M, Morales-Briceno H, Ostergaard JR, Pal S, Pallais JC, Pavillard F, Perrigault PF, Petersen AK, Polo G, Poulen G, Rinne T, Roujeau T, Rogers C, Roubertie A, Sahagian M, Schaefer E, Selim L, Selway R, Sharma N, Signer R, Soldatos AG, Stevenson DA, Stewart F, Tchan M, Verma IC, de Vries BBA, Wilson JL, Wong DA, Zaitoun R, Zhen D, Znaczko A, Dale RC, de Gusmão CM, Friedman J, Fung VSC, King MD, Mohammad SS, Rohena L, Waugh JL, Toro C, Raymond FL, Topf M, Coubes P, Gorman KM, Kurian MA. KMT2B-related disorders: expansion of the phenotypic spectrum and long-term efficacy of deep brain stimulation. Brain 2021; 143:3242-3261. [PMID: 33150406 DOI: 10.1093/brain/awaa304] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 06/28/2020] [Accepted: 07/13/2020] [Indexed: 12/31/2022] Open
Abstract
Heterozygous mutations in KMT2B are associated with an early-onset, progressive and often complex dystonia (DYT28). Key characteristics of typical disease include focal motor features at disease presentation, evolving through a caudocranial pattern into generalized dystonia, with prominent oromandibular, laryngeal and cervical involvement. Although KMT2B-related disease is emerging as one of the most common causes of early-onset genetic dystonia, much remains to be understood about the full spectrum of the disease. We describe a cohort of 53 patients with KMT2B mutations, with detailed delineation of their clinical phenotype and molecular genetic features. We report new disease presentations, including atypical patterns of dystonia evolution and a subgroup of patients with a non-dystonic neurodevelopmental phenotype. In addition to the previously reported systemic features, our study has identified co-morbidities, including the risk of status dystonicus, intrauterine growth retardation, and endocrinopathies. Analysis of this study cohort (n = 53) in tandem with published cases (n = 80) revealed that patients with chromosomal deletions and protein truncating variants had a significantly higher burden of systemic disease (with earlier onset of dystonia) than those with missense variants. Eighteen individuals had detailed longitudinal data available after insertion of deep brain stimulation for medically refractory dystonia. Median age at deep brain stimulation was 11.5 years (range: 4.5-37.0 years). Follow-up after deep brain stimulation ranged from 0.25 to 22 years. Significant improvement of motor function and disability (as assessed by the Burke Fahn Marsden's Dystonia Rating Scales, BFMDRS-M and BFMDRS-D) was evident at 6 months, 1 year and last follow-up (motor, P = 0.001, P = 0.004, and P = 0.012; disability, P = 0.009, P = 0.002 and P = 0.012). At 1 year post-deep brain stimulation, >50% of subjects showed BFMDRS-M and BFMDRS-D improvements of >30%. In the long-term deep brain stimulation cohort (deep brain stimulation inserted for >5 years, n = 8), improvement of >30% was maintained in 5/8 and 3/8 subjects for the BFMDRS-M and BFMDRS-D, respectively. The greatest BFMDRS-M improvements were observed for trunk (53.2%) and cervical (50.5%) dystonia, with less clinical impact on laryngeal dystonia. Improvements in gait dystonia decreased from 20.9% at 1 year to 16.2% at last assessment; no patient maintained a fully independent gait. Reduction of BFMDRS-D was maintained for swallowing (52.9%). Five patients developed mild parkinsonism following deep brain stimulation. KMT2B-related disease comprises an expanding continuum from infancy to adulthood, with early evidence of genotype-phenotype correlations. Except for laryngeal dysphonia, deep brain stimulation provides a significant improvement in quality of life and function with sustained clinical benefit depending on symptoms distribution.
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Affiliation(s)
- Laura Cif
- Département de Neurochirurgie, Unité des Pathologies Cérébrales Résistantes, Unité de Recherche sur les Comportements et Mouvements Anormaux, Hôpital Gui de Chauliac, Centre Hospitalier Régional Montpellier, Montpellier, France.,Faculté de médecine, Université de Montpellier, France
| | - Diane Demailly
- Département de Neurochirurgie, Unité des Pathologies Cérébrales Résistantes, Unité de Recherche sur les Comportements et Mouvements Anormaux, Hôpital Gui de Chauliac, Centre Hospitalier Régional Montpellier, Montpellier, France.,Faculté de médecine, Université de Montpellier, France
| | - Jean-Pierre Lin
- Complex Motor Disorder Service, Children's Neurosciences Department, Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK.,Children's Neuromodulation Group, Women and Children's Health Institute, Faculty of life Sciences and Medicine (FOLSM), King's Health Partners, London, UK
| | - Katy E Barwick
- Molecular Neurosciences, Developmental Neurosciences, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Mario Sa
- Complex Motor Disorder Service, Children's Neurosciences Department, Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Lucia Abela
- Molecular Neurosciences, Developmental Neurosciences, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Sony Malhotra
- Institute of Structural and Molecular Biology, Department of Biological Sciences, Birkbeck College, University of London, London, UK
| | - Wui K Chong
- Developmental Imaging and Biophysics, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Dora Steel
- Molecular Neurosciences, Developmental Neurosciences, UCL Great Ormond Street Institute of Child Health, London, UK.,Department of Neurology, Great Ormond Street Hospital, London, UK
| | - Alba Sanchis-Juan
- NIHR BioResource, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.,Department of Haematology, NHS Blood and Transplant Centre, University of Cambridge, Cambridge, UK
| | - Adeline Ngoh
- Molecular Neurosciences, Developmental Neurosciences, UCL Great Ormond Street Institute of Child Health, London, UK.,Department of Neurology, Great Ormond Street Hospital, London, UK
| | - Natalie Trump
- Molecular Neurosciences, Developmental Neurosciences, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Esther Meyer
- Molecular Neurosciences, Developmental Neurosciences, UCL Great Ormond Street Institute of Child Health, London, UK
| | | | - Julia Rankin
- Clinical Genetics, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | - Meredith W Allain
- Division of Medical Genetics, Department of Pediatrics, Stanford University, Palo Alto, CA, USA
| | - Carolyn D Applegate
- McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Sanaz Attaripour Isfahani
- Human Motor Control Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Julien Baleine
- Unité de Soins Intensifs et Réanimation Pédiatrique et Néonatale, Hôpital Universitaire de Montpellier, Montpellier, France
| | - Bettina Balint
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, UK.,Department of Neurology, University Hospital Heidelberg, Heidelberg, Germany
| | - Jennifer A Bassetti
- Division of Medical Genetics, Department of Pediatrics, Weill Cornell Medical College, New York, NY, USA
| | - Emma L Baple
- Clinical Genetics, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK.,Institute of Biomedical and Clinical Science RILD Wellcome Wolfson Centre, University of Exeter Medical School, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | - Kailash P Bhatia
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, UK
| | - Catherine Blanchet
- Département d'Oto-Rhino-Laryngologie et Chirurgie Cervico-Faciale, Hôpital Universitaire de Montpellier, Montpellier, France
| | - Lydie Burglen
- Département de génétique médicale, APHP Hôpital Armand Trousseau, Paris, France
| | - Gilles Cambonie
- Unité de Soins Intensifs et Réanimation Pédiatrique et Néonatale, Hôpital Universitaire de Montpellier, Montpellier, France
| | - Emilie Chan Seng
- Département de Neurochirurgie, Unité des Pathologies Cérébrales Résistantes, Unité de Recherche sur les Comportements et Mouvements Anormaux, Hôpital Gui de Chauliac, Centre Hospitalier Régional Montpellier, Montpellier, France.,Faculté de médecine, Université de Montpellier, France
| | | | - Fabienne Cyprien
- Département de Neurochirurgie, Unité des Pathologies Cérébrales Résistantes, Unité de Recherche sur les Comportements et Mouvements Anormaux, Hôpital Gui de Chauliac, Centre Hospitalier Régional Montpellier, Montpellier, France.,Faculté de médecine, Université de Montpellier, France
| | - Christine Coubes
- Département de Génétique médicale, Maladies rares et médecine personnalisée, CHU Montpellier, Montpellier, France
| | - Vincent d'Hardemare
- Unité Dyspa, Neurochirurgie Pédiatrique, Hôpital Fondation Rothschild, Paris, France
| | | | - Asif Doja
- Division of Neurology, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
| | - Nathalie Dorison
- Unité Dyspa, Neurochirurgie Pédiatrique, Hôpital Fondation Rothschild, Paris, France
| | - Diane Doummar
- Neuropédiatrie, Centre de référence neurogénétique mouvement anormaux de l'enfant, Hôpital Armand Trousseau, AP-HP, Sorbonne Université, France
| | - Marisela E Dy-Hollins
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.,Department of Neurology, Harvard Medical School, Boston, MA, USA
| | - Ellyn Farrelly
- Division of Medical Genetics, Department of Pediatrics, Stanford University, Palo Alto, CA, USA.,Department of Pediatrics, Lucile Packard Children's Hospital at Stanford, CA, USA
| | - David R Fitzpatrick
- Human Genetics Unit, Medical and Developmental Genetics, University of Edinburgh Western General Hospital, Edinburgh, Scotland, UK
| | - Conor Fearon
- Department of Neurology, The Dublin Neurological Institute at the Mater Misericordiae University Hospital, Dublin, Ireland
| | - Elizabeth L Fieg
- Division of Genetics, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Brent L Fogel
- Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.,Department of Human Genetics, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Eva B Forman
- Department of Paediatric Neurology and Clinical Neurophysiology, Children's Health Ireland at Temple Street, Dublin, Ireland
| | - Rachel G Fox
- Department of Molecular and Medical Genetics, Oregon Health and Science University, Portland, OR, USA
| | | | - William A Gahl
- Undiagnosed Diseases Program, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
| | - Serena Galosi
- Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy
| | - Victoria Gonzalez
- Département de Neurochirurgie, Unité des Pathologies Cérébrales Résistantes, Unité de Recherche sur les Comportements et Mouvements Anormaux, Hôpital Gui de Chauliac, Centre Hospitalier Régional Montpellier, Montpellier, France.,Faculté de médecine, Université de Montpellier, France
| | - Tracey D Graves
- Department of Neurology, Hinchingbrooke Hospital, North West Anglia NHS Foundation Trust, Huntingdon, UK
| | - Allison Gregory
- Department of Molecular and Medical Genetics, Oregon Health and Science University, Portland, OR, USA
| | - Mark Hallett
- Human Motor Control Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Harutomo Hasegawa
- Complex Motor Disorder Service, Children's Neurosciences Department, Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK.,Children's Neuromodulation Group, Women and Children's Health Institute, Faculty of life Sciences and Medicine (FOLSM), King's Health Partners, London, UK
| | - Susan J Hayflick
- Department of Molecular and Medical Genetics, Oregon Health and Science University, Portland, OR, USA.,Department of Paediatrics, Oregon Health and Science University, Portland, OR, USA
| | - Ada Hamosh
- McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Marie Hully
- Département de Neurologie, APHP-Necker-Enfants Malades, Paris, France
| | - Sandra Jansen
- Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Suh Young Jeong
- Department of Molecular and Medical Genetics, Oregon Health and Science University, Portland, OR, USA
| | - Joel B Krier
- Division of Genetics, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Sidney Krystal
- Département de Neuroradiologie, Hôpital Fondation Rothschild, Paris
| | - Kishore R Kumar
- Translational Genomics Group, Kinghorn Centre for Clinical Genomics, Garvan Institute of Medical Research, Darlinghurst, NSW, Australia.,Department of Neurogenetics, Kolling Institute, University of Sydney and Royal North Shore Hospital, St Leonards, NSW, Australia.,Molecular Medicine Laboratory, Concord Hospital, Sydney, NSW, Australia
| | - Chloé Laurencin
- Département de Neurologie, Hôpital Neurologique Pierre Wertheimer, Lyon, France
| | - Hane Lee
- Department of Human Genetics, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.,Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Gaetan Lesca
- Département de Génétique, Hôpital Universitaire de Lyon, Lyon, France
| | | | - Timothy Lynch
- Department of Neurology, The Dublin Neurological Institute at the Mater Misericordiae University Hospital, Dublin, Ireland.,UCD School of Medicine and Medical Science, University College Dublin, Dublin, Ireland
| | - Neil Mahant
- Movement Disorders Unit, Department of Neurology, Westmead Hospital, Westmead, NSW, Australia
| | - Julian A Martinez-Agosto
- Department of Human Genetics, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.,Division of Medical Genetics, Department of Pediatrics, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Christophe Milesi
- Unité de Soins Intensifs et Réanimation Pédiatrique et Néonatale, Hôpital Universitaire de Montpellier, Montpellier, France
| | - Kelly A Mills
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Michel Mondain
- Département d'Oto-Rhino-Laryngologie et Chirurgie Cervico-Faciale, Hôpital Universitaire de Montpellier, Montpellier, France
| | - Hugo Morales-Briceno
- Movement Disorders Unit, Department of Neurology, Westmead Hospital, Westmead, NSW, Australia.,Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | | | - John R Ostergaard
- Centre for Rare Diseases, Aarhus University Hospital, Aarhus, Denmark
| | - Swasti Pal
- Institute of Genetics and Genomics, Sir Ganga Ram Hospital, Rajender Nagar, New Delhi, India
| | - Juan C Pallais
- Division of Genetics, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Frédérique Pavillard
- Département d'Anesthésie-Réanimation Gui de Chauliac, Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | - Pierre-Francois Perrigault
- Département d'Anesthésie-Réanimation Gui de Chauliac, Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | | | - Gustavo Polo
- Département de Neurochirurgie Fonctionnelle, Hôpital Neurologique et Neurochirurgical, Pierre Wertheimer, Lyon, France
| | - Gaetan Poulen
- Département de Neurochirurgie, Unité des Pathologies Cérébrales Résistantes, Unité de Recherche sur les Comportements et Mouvements Anormaux, Hôpital Gui de Chauliac, Centre Hospitalier Régional Montpellier, Montpellier, France.,Faculté de médecine, Université de Montpellier, France
| | - Tuula Rinne
- Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Thomas Roujeau
- Département de Neurochirurgie, Unité des Pathologies Cérébrales Résistantes, Unité de Recherche sur les Comportements et Mouvements Anormaux, Hôpital Gui de Chauliac, Centre Hospitalier Régional Montpellier, Montpellier, France
| | - Caleb Rogers
- Department of Molecular and Medical Genetics, Oregon Health and Science University, Portland, OR, USA
| | - Agathe Roubertie
- Département de Neuropédiatrie, Hôpital Universitaire de Montpellier, Montpellier, France.,INSERM U1051, Institut des Neurosciences de Montpellier, Montpellier, France
| | - Michelle Sahagian
- Division of Neurology, Rady Children's Hospital San Diego, CA, USA.,Department of Neuroscience, University of California San Diego, CA, USA
| | - Elise Schaefer
- Medical Genetics, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Laila Selim
- Cairo University Children Hospital, Pediatric Neurology and Metabolic division, Cairo, Egypt
| | - Richard Selway
- Department of Neurosurgery, King's College Hospital, London, UK
| | - Nutan Sharma
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.,Department of Neurology, Harvard Medical School, Boston, MA, USA.,Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA
| | - Rebecca Signer
- Department of Human Genetics, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Ariane G Soldatos
- Undiagnosed Diseases Program, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
| | - David A Stevenson
- Division of Medical Genetics, Department of Pediatrics, Stanford University, Palo Alto, CA, USA
| | - Fiona Stewart
- Department of Genetic Medicine, Belfast Health and Social Care Trust, Belfast, UK
| | - Michel Tchan
- Sydney Medical School, University of Sydney, Sydney, NSW, Australia.,Department of Genetics, Westmead Hospital, Westmead, NSW, Australia
| | | | - Ishwar C Verma
- Institute of Genetics and Genomics, Sir Ganga Ram Hospital, Rajender Nagar, New Delhi, India
| | - Bert B A de Vries
- Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jenny L Wilson
- Division of Pediatric Neurology, Department of Pediatrics, Oregon Health and Science University, Portland, OR, USA
| | - Derek A Wong
- Division of Medical Genetics, Department of Pediatrics, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Raghda Zaitoun
- Department of Paediatrics, Neurology Division, Ain Shams University Hospital, Cairo, Egypt
| | - Dolly Zhen
- Department of Molecular and Medical Genetics, Oregon Health and Science University, Portland, OR, USA
| | - Anna Znaczko
- Department of Genetic Medicine, Belfast Health and Social Care Trust, Belfast, UK
| | - Russell C Dale
- Department of Paediatric Neurology, The Children's Hospital at Westmead, NSW, Australia.,Faculty of Medicine and Health, Sydney Medical School, University of Sydney, Sydney NSW, Australia
| | - Claudio M de Gusmão
- Department of Neurology, Harvard Medical School, Boston, MA, USA.,Department of Neurology, Boston Children's Hospital, Boston, MA, USA
| | - Jennifer Friedman
- Division of Neurology, Rady Children's Hospital San Diego, CA, USA.,Department of Neuroscience, University of California San Diego, CA, USA.,Departments of Paediatrics, University of California, San Diego, CA, USA.,Rady Children's Institute for Genomic Medicine, San Diego, CA, USA
| | - Victor S C Fung
- Movement Disorders Unit, Department of Neurology, Westmead Hospital, Westmead, NSW, Australia.,Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - Mary D King
- Department of Paediatric Neurology and Clinical Neurophysiology, Children's Health Ireland at Temple Street, Dublin, Ireland.,UCD School of Medicine and Medical Science, University College Dublin, Dublin, Ireland
| | - Shekeeb S Mohammad
- Department of Paediatric Neurology, The Children's Hospital at Westmead, NSW, Australia.,Faculty of Medicine and Health, Sydney Medical School, University of Sydney, Sydney NSW, Australia
| | - Luis Rohena
- Division of Medical Genetics, Department of Pediatrics, San Antonio Military Medical Center, San Antonio, TX, USA.,Department of Pediatrics, Long School of Medicine, UT Health, San Antonio, TX, USA
| | - Jeff L Waugh
- Division of Pediatric Neurology, Department of Pediatrics, University of Texas Southwestern, Dallas, TX, USA
| | - Camilo Toro
- Undiagnosed Diseases Program, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
| | - F Lucy Raymond
- NIHR BioResource, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.,Department of Medical Genetics, Cambridge Institute for Medical Research, University of Cambridge, Cambridge, UK
| | - Maya Topf
- Institute of Structural and Molecular Biology, Department of Biological Sciences, Birkbeck College, University of London, London, UK
| | - Philippe Coubes
- Département de Neurochirurgie, Unité des Pathologies Cérébrales Résistantes, Unité de Recherche sur les Comportements et Mouvements Anormaux, Hôpital Gui de Chauliac, Centre Hospitalier Régional Montpellier, Montpellier, France.,Faculté de médecine, Université de Montpellier, France
| | - Kathleen M Gorman
- Molecular Neurosciences, Developmental Neurosciences, UCL Great Ormond Street Institute of Child Health, London, UK.,Department of Neurology, Great Ormond Street Hospital, London, UK
| | - Manju A Kurian
- Molecular Neurosciences, Developmental Neurosciences, UCL Great Ormond Street Institute of Child Health, London, UK.,Department of Neurology, Great Ormond Street Hospital, London, UK
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Charroud C, Poulen G, Sanrey E, Menjot de Champfleur N, Deverdun J, Coubes P, Le Bars E. Task- and Rest-based Functional Brain Connectivity in Food-related Reward Processes among Healthy Adolescents. Neuroscience 2021; 457:196-205. [PMID: 33484819 DOI: 10.1016/j.neuroscience.2021.01.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 01/11/2021] [Accepted: 01/11/2021] [Indexed: 12/16/2022]
Abstract
It is known that the nucleus accumbens, orbitofrontal cortex and insula play a role in food-related reward processes. Although their interconnectedness would be an ideal topic for understanding food intake mechanisms, it nevertheless remains unclear especially in adolescent. Therefore, this study aims to investigate the effect of hunger on functional connectivity in healthy adolescents using task- and rest-based imaging. Fifteen participants underwent two MRI sessions, pre-lunch (hunger) and post-lunch (satiety), including food cue task and resting-state. During task- and rest-based imaging, functional connectivity was greater when hungry as opposed to satiated between the right posterior insula/nucleus accumbens, suggesting involvement of salient interoceptive stimuli signals. During task-based imaging, an increase was observed in functional connectivity when hungry as opposed to satiated between the medial and lateral orbitofrontal cortex which contributes to the perception of food deprivation as a frustration. A decrease was identified when hungry as opposed to satiated in functional connectivity in the right anterior orbitofrontal/accumbens and posterior insula/medial orbitofrontal cortices reflecting suppression of the affective and sensorial information. Conversely, functional connectivity was increased during aversive stimuli between the right medial orbitofrontal cortex and right posterior insula when hungry as opposed to satiated. This suggests that the value of valence could occur in the shift in connectivity between these two regions. In addition, during rest-based imaging, a left-sided lateralization was reported (accumbens/lateral orbitofrontal and accumbens/posterior insula) when hungry as opposed to satiated which may represent changes in internal state due to focus on the benefit of an upcoming meal.
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Affiliation(s)
- Céline Charroud
- Unité de recherche sur les comportements et mouvements anormaux (URCMA, IGF, INSERM U661 UMR 5203), Department of Neurosurgery, Montpellier University Hospital Center, Gui de Chauliac Hospital, University of Montpellier, Montpellier, France.
| | - Gaëtan Poulen
- Unité de recherche sur les comportements et mouvements anormaux (URCMA, IGF, INSERM U661 UMR 5203), Department of Neurosurgery, Montpellier University Hospital Center, Gui de Chauliac Hospital, University of Montpellier, Montpellier, France; Unité de pathologie cérébrale résistante, Department of Neurosurgery, Montpellier University Hospital Center, Montpellier, France
| | - Emily Sanrey
- Unité de recherche sur les comportements et mouvements anormaux (URCMA, IGF, INSERM U661 UMR 5203), Department of Neurosurgery, Montpellier University Hospital Center, Gui de Chauliac Hospital, University of Montpellier, Montpellier, France; Unité de pathologie cérébrale résistante, Department of Neurosurgery, Montpellier University Hospital Center, Montpellier, France
| | - Nicolas Menjot de Champfleur
- Institut d'Imagerie Fonctionnelle Humaine, I2FH, Department of Neuroradiology, Montpellier University Hospital Center, Gui de Chauliac Hospital, University of Montpellier, Montpellier, France
| | - Jérémy Deverdun
- Institut d'Imagerie Fonctionnelle Humaine, I2FH, Department of Neuroradiology, Montpellier University Hospital Center, Gui de Chauliac Hospital, University of Montpellier, Montpellier, France
| | - Philippe Coubes
- Unité de recherche sur les comportements et mouvements anormaux (URCMA, IGF, INSERM U661 UMR 5203), Department of Neurosurgery, Montpellier University Hospital Center, Gui de Chauliac Hospital, University of Montpellier, Montpellier, France; Unité de pathologie cérébrale résistante, Department of Neurosurgery, Montpellier University Hospital Center, Montpellier, France
| | - Emmanuelle Le Bars
- Institut d'Imagerie Fonctionnelle Humaine, I2FH, Department of Neuroradiology, Montpellier University Hospital Center, Gui de Chauliac Hospital, University of Montpellier, Montpellier, France
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14
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Steel D, Zech M, Zhao C, Barwick KES, Burke D, Demailly D, Kumar KR, Zorzi G, Nardocci N, Kaiyrzhanov R, Wagner M, Iuso A, Berutti R, Škorvánek M, Necpál J, Davis R, Wiethoff S, Mankad K, Sudhakar S, Ferrini A, Sharma S, Kamsteeg EJ, Tijssen MA, Verschuuren C, van Egmond ME, Flowers JM, McEntagart M, Tucci A, Coubes P, Bustos BI, Gonzalez-Latapi P, Tisch S, Darveniza P, Gorman KM, Peall KJ, Bötzel K, Koch JC, Kmieć T, Plecko B, Boesch S, Haslinger B, Jech R, Garavaglia B, Wood N, Houlden H, Gissen P, Lubbe SJ, Sue CM, Cif L, Mencacci NE, Anderson G, Kurian MA, Winkelmann J. Loss-of-Function Variants in HOPS Complex Genes VPS16 and VPS41 Cause Early Onset Dystonia Associated with Lysosomal Abnormalities. Ann Neurol 2020; 88:867-877. [PMID: 32808683 DOI: 10.1002/ana.25879] [Citation(s) in RCA: 64] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 07/31/2020] [Accepted: 08/09/2020] [Indexed: 02/02/2023]
Abstract
OBJECTIVES The majority of people with suspected genetic dystonia remain undiagnosed after maximal investigation, implying that a number of causative genes have not yet been recognized. We aimed to investigate this paucity of diagnoses. METHODS We undertook weighted burden analysis of whole-exome sequencing (WES) data from 138 individuals with unresolved generalized dystonia of suspected genetic etiology, followed by additional case-finding from international databases, first for the gene implicated by the burden analysis (VPS16), and then for other functionally related genes. Electron microscopy was performed on patient-derived cells. RESULTS Analysis revealed a significant burden for VPS16 (Fisher's exact test p value, 6.9 × 109 ). VPS16 encodes a subunit of the homotypic fusion and vacuole protein sorting (HOPS) complex, which plays a key role in autophagosome-lysosome fusion. A total of 18 individuals harboring heterozygous loss-of-function VPS16 variants, and one with a microdeletion, were identified. These individuals experienced early onset progressive dystonia with predominant cervical, bulbar, orofacial, and upper limb involvement. Some patients had a more complex phenotype with additional neuropsychiatric and/or developmental comorbidities. We also identified biallelic loss-of-function variants in VPS41, another HOPS-complex encoding gene, in an individual with infantile-onset generalized dystonia. Electron microscopy of patient-derived lymphocytes and fibroblasts from both patients with VPS16 and VPS41 showed vacuolar abnormalities suggestive of impaired lysosomal function. INTERPRETATION Our study strongly supports a role for HOPS complex dysfunction in the pathogenesis of dystonia, although variants in different subunits display different phenotypic and inheritance characteristics. ANN NEUROL 2020;88:867-877.
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Affiliation(s)
- Dora Steel
- Department of Developmental Neurosciences, UCL Great Ormond Street Institute of Child Health, London, UK.,Department of Neurology, Great Ormond Street Hospital, London, UK
| | - Michael Zech
- Institute of Neurogenomics, Helmholtz Zentrum München, Munich, Germany.,Institute of Human Genetics, Technical University of Munich, Munich, Germany
| | - Chen Zhao
- Institute of Neurogenomics, Helmholtz Zentrum München, Munich, Germany
| | - Katy E S Barwick
- Department of Developmental Neurosciences, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Derek Burke
- Enzyme Laboratory, Great Ormond Street Hospital for Children, London, UK
| | - Diane Demailly
- Unités des Pathologies Cérébrales Résistantes, Département de Neurochirurgie, Centre Hospitalier Universitaire, Montpellier, France
| | - Kishore R Kumar
- Department of Neurogenetics, Kolling Institute of Medical Research, University of Sydney and Northern Sydney Local Health District, Sydney, New South Wales, Australia.,Molecular Medicine Laboratory, Concord Repatriation General Hospital, Concord, New South Wales, Australia.,Translational Genomics, Kinghorn Centre for Clinical Genomics, Garvan Institute for Medical Research, Sydney, New South Wales, Australia.,Department of Neurogenetics, University of Sydney and Northern Sydney Local Health District, Sydney, New South Wales, Australia
| | - Giovanna Zorzi
- Department of Child Neurology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Nardo Nardocci
- Department of Child Neurology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Rauan Kaiyrzhanov
- Department of Neuromuscular Diseases, University College London, Queen Square, Institute of Neurology, London, UK
| | - Matias Wagner
- Institute of Neurogenomics, Helmholtz Zentrum München, Munich, Germany.,Institute of Human Genetics, Technical University of Munich, Munich, Germany
| | - Arcangela Iuso
- Institute of Neurogenomics, Helmholtz Zentrum München, Munich, Germany.,Institute of Human Genetics, Technical University of Munich, Munich, Germany
| | - Riccardo Berutti
- Institute of Human Genetics, Technical University of Munich, Munich, Germany
| | - Matej Škorvánek
- Department of Neurology, P. J. Safarik University, Kosice, Slovak Republic.,Department of Neurology, University Hospital of L. Pasteur, Kosice, Slovak Republic
| | - Ján Necpál
- Department of Neurology, Zvolen Hospital, Zvolen, Slovakia
| | - Ryan Davis
- Department of Neurogenetics, Kolling Institute of Medical Research, University of Sydney and Northern Sydney Local Health District, Sydney, New South Wales, Australia.,Translational Genomics, Kinghorn Centre for Clinical Genomics, Garvan Institute for Medical Research, Sydney, New South Wales, Australia.,Department of Neurogenetics, University of Sydney and Northern Sydney Local Health District, Sydney, New South Wales, Australia
| | - Sarah Wiethoff
- UCL Queen Square Institute of Neurology, London, UK.,Department of Neurodegenerative Disease, Hertie-Institute for Clinical Brain Research and Center for Neurology, University of Tübingen, Tübingen, Germany
| | - Kshitij Mankad
- Department of Radiology, Great Ormond Street Hospital for Children, London, UK
| | - Sniya Sudhakar
- Department of Radiology, Great Ormond Street Hospital for Children, London, UK
| | - Arianna Ferrini
- Department of Developmental Neurosciences, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Suvasini Sharma
- Neurology Division, Department of Pediatrics, Lady Hardinge Medical College and Associated Kalawati Saran Children's Hospital, New Delhi, India
| | - Erik-Jan Kamsteeg
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Marina A Tijssen
- Department of Neurology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Corien Verschuuren
- Expertise Center Movement Disorders Groningen, University Medical Center Groningen, Groningen, The Netherlands.,Department of Genetics, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Martje E van Egmond
- Department of Neurology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.,Expertise Center Movement Disorders Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | | | | | | | - Philippe Coubes
- Unités des Pathologies Cérébrales Résistantes, Département de Neurochirurgie, Centre Hospitalier Universitaire, Montpellier, France
| | - Bernabe I Bustos
- Ken and Ruth Davee Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Paulina Gonzalez-Latapi
- Ken and Ruth Davee Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Stephen Tisch
- Department of Neurology, St. Vincent's Hospital, Sydney, Australia
| | - Paul Darveniza
- Department of Neurology, St. Vincent's Hospital, Sydney, Australia
| | - Kathleen M Gorman
- Department of Neurology and Clinical Neurophysiology, Children's Health Ireland at Temple Street, Dublin, Ireland.,UCD School of Medicine and Medical Science, University College Dublin, Dublin, Ireland
| | | | - Kai Bötzel
- Department of Neurology, Ludwig Maximilian University, Munich, Germany
| | - Jan C Koch
- Department of Neurology, University Medical Center Göttingen, Göttingen, Germany
| | - Tomasz Kmieć
- Department of Neurology and Epileptology, Children's Memorial Health Institute, Warsaw, Poland
| | - Barbara Plecko
- Department of Pediatrics and Adolescent Medicine, Division of General Pediatrics, Medical University of Graz, Graz, Austria
| | - Sylvia Boesch
- Department of Neurology, Medical University Innsbruck, Innsbruck, Austria
| | - Bernhard Haslinger
- Klinik und Poliklinik für Neurologie, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Robert Jech
- Department of Neurology, Charles University, 1st Faculty of Medicine and General University Hospital in Prague, Prague, Czech Republic
| | - Barbara Garavaglia
- Department of Child Neurology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Nick Wood
- UCL Queen Square Institute of Neurology, London, UK
| | - Henry Houlden
- Department of Neuromuscular Diseases, University College London, Queen Square, Institute of Neurology, London, UK
| | - Paul Gissen
- Genetics and Genomic Medicine, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Steven J Lubbe
- Ken and Ruth Davee Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Carolyn M Sue
- Department of Neurogenetics, Kolling Institute of Medical Research, University of Sydney and Northern Sydney Local Health District, Sydney, New South Wales, Australia.,Translational Genomics, Kinghorn Centre for Clinical Genomics, Garvan Institute for Medical Research, Sydney, New South Wales, Australia.,Department of Neurogenetics, University of Sydney and Northern Sydney Local Health District, Sydney, New South Wales, Australia.,Department of Neurology, Royal North Shore Hospital, Northern Sydney Local Health District, Sydney, New South Wales, Australia
| | - Laura Cif
- Unités des Pathologies Cérébrales Résistantes, Département de Neurochirurgie, Centre Hospitalier Universitaire, Montpellier, France
| | - Niccolò E Mencacci
- Ken and Ruth Davee Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Glenn Anderson
- Department of Histopathology, Great Ormond Street Hospital for Children, London, UK
| | - Manju A Kurian
- Department of Developmental Neurosciences, UCL Great Ormond Street Institute of Child Health, London, UK.,Department of Neurology, Great Ormond Street Hospital, London, UK
| | - Juliane Winkelmann
- Institute of Neurogenomics, Helmholtz Zentrum München, Munich, Germany.,Institute of Human Genetics, Technical University of Munich, Munich, Germany.,Lehrstuhl für Neurogenetik, Technische Universität München, Munich, Germany.,Munich Cluster for Systems Neurology, Munich, Germany
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15
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Poulen G, Chan Seng E, Menjot De Champfleur N, Cif L, Cyprien F, Perez J, Coubes P. Comparison between 1.5- and 3-T Magnetic Resonance Acquisitions for Direct Targeting Stereotactic Procedures for Deep Brain Stimulation: A Phantom Study. Stereotact Funct Neurosurg 2020; 98:337-344. [DOI: 10.1159/000509303] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 06/09/2020] [Indexed: 11/19/2022]
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16
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Nicholson CL, Coubes P, Poulen G. Dentate nucleus as target for deep brain stimulation in dystono-dyskinetic syndromes. Neurochirurgie 2020; 66:258-265. [PMID: 32623056 DOI: 10.1016/j.neuchi.2020.04.132] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 02/21/2020] [Accepted: 04/13/2020] [Indexed: 02/05/2023]
Abstract
PURPOSE To discuss the potential of deep brain stimulation (DBS) of the dentate nucleus as a treatment for dystono-dyskinetic syndromes. METHODS An extensive literature review covered the anatomy and physiology of the dentate nucleus and the experimental evidence for its involvement in the pathophysiology of dystonia and dyskinesia. RESULTS Evidence from animal models and from functional imaging in humans is strongly in favor of involvement of the dentate nucleus in dystono-dyskinetic syndromes. Results from previous surgical series of dentate nucleus stimulation were promising but precise description of movement disorders being treated were lacking and outcome measures were generally not well defined. CONCLUSIONS In the light of new evidence regarding the involvement of the dentate nucleus in dystono-dyskinetic syndromes, we present a review of the current literature and discuss why the question of dentate nucleus stimulation deserves to be revisited.
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Affiliation(s)
- C L Nicholson
- Service de neurochirurgie, CHRU Montpellier, 34295 Montpellier, France; Department of Neurosurgery, Newcastle General Hospital, Newcastle, UK
| | - P Coubes
- Service de neurochirurgie, CHRU Montpellier, 34295 Montpellier, France; IGF, 34094 Montpellier, France; CNRS UMR5203, 34094 Montpellier, France; Inserm, U661, 34094 Montpellier, France; Université Montpellier I, 34094 Montpellier, France
| | - G Poulen
- Service de neurochirurgie, CHRU Montpellier, 34295 Montpellier, France; IGF, 34094 Montpellier, France; CNRS UMR5203, 34094 Montpellier, France; Inserm, U661, 34094 Montpellier, France; Université Montpellier I, 34094 Montpellier, France.
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17
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Tsuboi T, Cif L, Coubes P, Ostrem JL, Romero DA, Miyagi Y, Lozano AM, De Vloo P, Haq I, Meng F, Sharma N, Ozelius LJ, Wagle Shukla A, Cauraugh JH, Foote KD, Okun MS. Secondary Worsening Following DYT1 Dystonia Deep Brain Stimulation: A Multi-country Cohort. Front Hum Neurosci 2020; 14:242. [PMID: 32670041 PMCID: PMC7330126 DOI: 10.3389/fnhum.2020.00242] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 06/02/2020] [Indexed: 12/16/2022] Open
Abstract
Objective: To reveal clinical characteristics of suboptimal responses to deep brain stimulation (DBS) in a multi-country DYT1 dystonia cohort. Methods: In this multi-country multi-center retrospective study, we analyzed the clinical data of DYT1 patients who experienced suboptimal responses to DBS defined as <30% improvement in dystonia scales at the last follow-up compared with baseline. We used a literature-driven historical cohort of 112 DYT1 patients for comparison. Results: Approximately 8% of our study cohort (11 out of 132) experienced suboptimal responses to DBS. Compared with the historical cohort, the multi-country cohort with suboptimal responses had a significantly younger age at onset (mean, 7.0 vs. 8.4 years; p = 0.025) and younger age at DBS (mean, 12.0 vs. 18.6 years; p = 0.019). Additionally, cranial involvement was more common in the multi-country cohort (before DBS, 64% vs. 45%, p = 0.074; before or after DBS, 91% vs. 47%, p = 0.001). Mean motor improvement at the last follow-up from baseline were 0% and 66% for the multi-country and historical cohorts, respectively. All 11 patients of the multi-country cohort had generalization of dystonia within 2.5 years after disease onset. All patients experienced dystonia improvement of >30% postoperatively; however, secondary worsening of dystonia commenced between 6 months and 3 years following DBS. The improvement at the last follow-up was less than 30% despite optimally-placed leads, a trial of multiple programming settings, and additional DBS surgeries in all patients. The on-/off-stimulation comparison at the long-term follow-up demonstrated beneficial effects of DBS despite missing the threshold of 30% improvement over baseline. Conclusion: Approximately 8% of patients represent a more aggressive phenotype of DYT1 dystonia characterized by younger age at onset, faster disease progression, and cranial involvement, which seems to be associated with long-term suboptimal responses to DBS (e.g., secondary worsening). This information could be useful for both clinicians and patients in clinical decision making and patient counseling before and following DBS implantations. Patients with this phenotype may have different neuroplasticity, neurogenetics, or possibly distinct neurophysiology.
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Affiliation(s)
- Takashi Tsuboi
- Department of Neurology, Norman Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL, United States.,Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Laura Cif
- Department of Neurology, University Hospital Montpellier, Montpellier, France
| | - Philippe Coubes
- Department of Neurosurgery, University Hospital Montpellier, Montpellier, France
| | - Jill L Ostrem
- Department of Neurology, University of California, San Francisco, San Francisco, CA, United States
| | - Danilo A Romero
- Department of Neurology, University of California, San Francisco, San Francisco, CA, United States
| | - Yasushi Miyagi
- Department of Stereotactic and Functional Neurosurgery, Fukuoka Mirai Hospital, Fukuoka, Japan
| | - Andres M Lozano
- Division of Neurosurgery, Toronto Western Hospital Krembil Neuroscience Center, Toronto, ON, Canada.,Department of Neurosurgery, University of Toronto, Toronto, ON, Canada
| | - Philippe De Vloo
- Department of Neurosurgery, University of Toronto, Toronto, ON, Canada.,Department of Neurosurgery, KU Leuven, Leuven, Belgium
| | - Ihtsham Haq
- Department of Neurology, Wake Forest School of Medicine, Winston-Salem, NC, United States
| | - Fangang Meng
- Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Nutan Sharma
- Department of Neurology, Massachusetts General Hospital, Charlestown, MA, United States
| | - Laurie J Ozelius
- Department of Neurology, Massachusetts General Hospital, Charlestown, MA, United States
| | - Aparna Wagle Shukla
- Department of Neurology, Norman Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL, United States
| | - James H Cauraugh
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, United States
| | - Kelly D Foote
- Department of Neurosurgery, Norman Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL, United States
| | - Michael S Okun
- Department of Neurology, Norman Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL, United States
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18
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Charroud C, Menjot de Champfleur N, Sanrey E, Pfeuffer J, Deverdun J, Le Bars E, Coubes P. Differential effects of hunger on cerebral blood flow in healthy adolescents. Behav Brain Res 2020; 383:112505. [DOI: 10.1016/j.bbr.2020.112505] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 01/21/2020] [Accepted: 01/22/2020] [Indexed: 02/06/2023]
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19
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Danielsson A, Carecchio M, Cif L, Koy A, Lin JP, Solders G, Romito L, Lohmann K, Garavaglia B, Reale C, Zorzi G, Nardocci N, Coubes P, Gonzalez V, Roubertie A, Collod-Beroud G, Lind G, Tedroff K. Pallidal Deep Brain Stimulation in DYT6 Dystonia: Clinical Outcome and Predictive Factors for Motor Improvement. J Clin Med 2019; 8:jcm8122163. [PMID: 31817799 PMCID: PMC6947218 DOI: 10.3390/jcm8122163] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 12/02/2019] [Accepted: 12/03/2019] [Indexed: 12/14/2022] Open
Abstract
Pallidal deep brain stimulation is an established treatment in dystonia. Available data on the effect in DYT-THAP1 dystonia (also known as DYT6 dystonia) are scarce and long-term follow-up studies are lacking. In this retrospective, multicenter follow-up case series of medical records of such patients, the clinical outcome of pallidal deep brain stimulation in DYT-THAP1 dystonia, was evaluated. The Burke Fahn Marsden Dystonia Rating Scale served as an outcome measure. Nine females and 5 males were enrolled, with a median follow-up of 4 years and 10 months after implant. All benefited from surgery: dystonia severity was reduced by a median of 58% (IQR 31-62, p = 0.001) at last follow-up, as assessed by the Burke Fahn Marsden movement subscale. In the majority of individuals, there was no improvement of speech or swallowing, and overall, the effect was greater in the trunk and limbs as compared to the cranio-cervical and orolaryngeal regions. No correlation was found between disease duration before surgery, age at surgery, or preoperative disease burden and the outcome of deep brain stimulation. Device- and therapy-related side-effects were few. Accordingly, pallidal deep brain stimulation should be considered in clinically impairing and pharmaco-resistant DYT-THAP1 dystonia. The method is safe and effective, both short- and long-term.
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Affiliation(s)
- Annika Danielsson
- Department of Women’s and Children’s Health, Karolinska Institutet, 17176 Stockholm, Sweden;
- Sachs’ Children and Youth Hospital, Stockholm South General Hospital, 11883 Stockholm, Sweden
- Correspondence: ; Tel.: +46-708-182785
| | - Miryam Carecchio
- Department of Pediatric Neuroscience, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20131 Milan, Italy; (M.C.); (G.Z.); (N.N.)
- Neurogenetics Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20126 Milan, Italy
- Department of Neuroscience, University of Padua, 35128 Padua, Italy
| | - Laura Cif
- Département de Neurochirurgie, Unité de Recherche sur les Comportements et Mouvements Anormaux, (URCMA), Centre hospitalier universitaire de Montpellier, 34090 Montpellier, France; (L.C.); (P.C.); (V.G.)
| | - Anne Koy
- Faculty of Medicine, University of Cologne and Deparment of Pediatrics, University Hospital Cologne, 50924 Cologne, Germany;
| | - Jean-Pierre Lin
- Complex Motor Disorders Services, Evelina London Children’s Hospital, Children’s Neuromodulation, Children and Women’s Health Institute, King’s Health Partners, London SE1 7EH, UK;
| | - Göran Solders
- Department of Clinical Neuroscience, Karolinska Institutet, 17177 Stockholm, Sweden; (G.S.); (G.L.)
- Department of Neurology, Karolinska University Hospital, 14186 Stockholm, Sweden
| | - Luigi Romito
- Department of Movement Disorders, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milan, Italy;
| | - Katja Lohmann
- Institute of Neurogenetics, University of Luebeck, 23562 Luebeck, Germany;
| | - Barbara Garavaglia
- Medical Genetics and Neurogenetics Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20126 Milan, Italy; (B.G.); (C.R.)
| | - Chiara Reale
- Medical Genetics and Neurogenetics Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20126 Milan, Italy; (B.G.); (C.R.)
| | - Giovanna Zorzi
- Department of Pediatric Neuroscience, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20131 Milan, Italy; (M.C.); (G.Z.); (N.N.)
| | - Nardo Nardocci
- Department of Pediatric Neuroscience, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20131 Milan, Italy; (M.C.); (G.Z.); (N.N.)
| | - Philippe Coubes
- Département de Neurochirurgie, Unité de Recherche sur les Comportements et Mouvements Anormaux, (URCMA), Centre hospitalier universitaire de Montpellier, 34090 Montpellier, France; (L.C.); (P.C.); (V.G.)
| | - Victoria Gonzalez
- Département de Neurochirurgie, Unité de Recherche sur les Comportements et Mouvements Anormaux, (URCMA), Centre hospitalier universitaire de Montpellier, 34090 Montpellier, France; (L.C.); (P.C.); (V.G.)
| | - Agathe Roubertie
- Département de Neuropédiatrie, Centre hospitalier universitaire de Montpellier, 34295 Montpellier, France;
- INSERM U 1051, Institut des Neuroscience de Montpellier, 34091 Montpellier, France
| | | | - Göran Lind
- Department of Clinical Neuroscience, Karolinska Institutet, 17177 Stockholm, Sweden; (G.S.); (G.L.)
| | - Kristina Tedroff
- Department of Women’s and Children’s Health, Karolinska Institutet, 17176 Stockholm, Sweden;
- Astrid Lindgren Children’s Hospital, Karolinska University Hospital, 17176 Stockholm, Sweden
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20
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Demailly D, Vianey-Saban C, Acquaviva C, Gonzalez V, Rubio IDA, Cyprien F, Roujeau T, Masoliver A, Leboucq N, Coubes P, Cif L. Atypical Glutaric Aciduria Type I with Hemidystonia and Asymmetric Radiological Findings Misdiagnosed as an Ischemic Stroke. Mov Disord Clin Pract 2019; 5:436-438. [PMID: 30838298 DOI: 10.1002/mdc3.12633] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Revised: 03/06/2018] [Accepted: 04/04/2018] [Indexed: 11/06/2022] Open
Affiliation(s)
- Diane Demailly
- Department of Neurosurgery Gui de Chauliac University Hospital Montpellier France.,Unité de Recherche sur les Comportements et Mouvements Anormaux (URCMA) Montpellier France
| | - Christine Vianey-Saban
- Department of Inborn Errors of Metabolism and Neonatal Screening, Center of Biology and Pathology Est CHU Lyon Bron France
| | - Cécile Acquaviva
- Department of Inborn Errors of Metabolism and Neonatal Screening, Center of Biology and Pathology Est CHU Lyon Bron France
| | - Victoria Gonzalez
- Department of Neurosurgery Gui de Chauliac University Hospital Montpellier France.,Unité de Recherche sur les Comportements et Mouvements Anormaux (URCMA) Montpellier France
| | - Isabel De Antonio Rubio
- Department of Neurosurgery Gui de Chauliac University Hospital Montpellier France.,Unité de Recherche sur les Comportements et Mouvements Anormaux (URCMA) Montpellier France
| | - Fabienne Cyprien
- Department of Neurosurgery Gui de Chauliac University Hospital Montpellier France.,Unité de Recherche sur les Comportements et Mouvements Anormaux (URCMA) Montpellier France
| | - Thomas Roujeau
- Department of Neurosurgery Gui de Chauliac University Hospital Montpellier France
| | - Adria Masoliver
- Department of Neurosurgery Gui de Chauliac University Hospital Montpellier France
| | - Nicolas Leboucq
- Department of Neuroradiology Gui de Chauliac University Hospital Montpellier France
| | - Philippe Coubes
- Department of Neurosurgery Gui de Chauliac University Hospital Montpellier France.,Unité de Recherche sur les Comportements et Mouvements Anormaux (URCMA) Montpellier France
| | - Laura Cif
- Department of Neurosurgery Gui de Chauliac University Hospital Montpellier France.,Unité de Recherche sur les Comportements et Mouvements Anormaux (URCMA) Montpellier France
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21
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Koy A, Cirak S, Gonzalez V, Becker K, Roujeau T, Milesi C, Baleine J, Cambonie G, Boularan A, Greco F, Perrigault PF, Cances C, Dorison N, Doummar D, Roubertie A, Beroud C, Körber F, Stüve B, Waltz S, Mignot C, Nava C, Maarouf M, Coubes P, Cif L. Deep brain stimulation is effective in pediatric patients with GNAO1 associated severe hyperkinesia. J Neurol Sci 2018; 391:31-39. [DOI: 10.1016/j.jns.2018.05.018] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Accepted: 05/21/2018] [Indexed: 12/27/2022]
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22
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Nerrant E, Gonzalez V, Milesi C, Vasques X, Ruge D, Roujeau T, De Antonio Rubio I, Cyprien F, Seng EC, Demailly D, Roubertie A, Boularan A, Greco F, Perrigault PF, Cambonie G, Coubes P, Cif L. Deep brain stimulation treated dystonia-trajectory via status dystonicus. Mov Disord 2018; 33:1168-1173. [PMID: 29786895 DOI: 10.1002/mds.27357] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Revised: 12/30/2017] [Accepted: 01/11/2018] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Status dystonicus (SD) is a life-threatening condition. OBJECTIVE AND METHODS In a dystonia cohort who developed status dystonicus, we analyzed demographics, background dystonia phenomenology and complexity, trajectory previous to-, via status dystonicus episodes, and evolution following them. RESULTS Over 20 years, 40 of 328 dystonia patients who were receiving DBS developed 58 status dystonicus episodes. Dystonia was of pediatric onset (95%), frequently complex, and had additional cognitive and pyramidal impairment (62%) and MRI alterations (82.5%); 40% of episodes occured in adults. Mean disease duration preceding status dystonicus was 10.3 ± 8 years. Evolution time to status dystonicus varied from days to weeks; however, 37.5% of patients exhibited progressive worsening over years. Overall, DBS was efficient in resolving 90% of episodes. CONCLUSION Status dystonicus is potentially reversible and a result of heterogeneous conditions with nonuniform underlying physiology. Recognition of the complex phenomenology, morphological alterations, and distinct patterns of evolution, before and after status dystonicus, will help our understanding of these conditions. © 2018 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Elodie Nerrant
- Département de Neurochirurgie, Centre Hospitalier Régional Montpellier, France.,Unité de Recherche sur les Comportements et Mouvements Anormaux (URCMA), Montpellier, France.,Université Montpellier, 34000, Montpellier, France
| | - Victoria Gonzalez
- Département de Neurochirurgie, Centre Hospitalier Régional Montpellier, France.,Unité de Recherche sur les Comportements et Mouvements Anormaux (URCMA), Montpellier, France.,Université Montpellier, 34000, Montpellier, France
| | - Christophe Milesi
- Université Montpellier, 34000, Montpellier, France.,Département Pédiatrie néonatale et réanimations; Centre Hospitalier Régional Montpellier, Montpellier, France
| | - Xavier Vasques
- Laboratoire de Recherche en Neurosciences Cliniques (LRENC), Montpellier, France.,IBM Systems, IBM, Montpellier, France
| | - Diane Ruge
- Department of Psychology and Neurosciences. Leibniz Research Centre for Working Environment and Human Factors, Technical University Dortmund, Dortmund, Germany
| | - Thomas Roujeau
- Département de Neurochirurgie, Centre Hospitalier Régional Montpellier, France.,Université Montpellier, 34000, Montpellier, France
| | - Isabel De Antonio Rubio
- Département de Neurochirurgie, Centre Hospitalier Régional Montpellier, France.,Unité de Recherche sur les Comportements et Mouvements Anormaux (URCMA), Montpellier, France.,Université Montpellier, 34000, Montpellier, France
| | - Fabienne Cyprien
- Département de Neurochirurgie, Centre Hospitalier Régional Montpellier, France.,Unité de Recherche sur les Comportements et Mouvements Anormaux (URCMA), Montpellier, France.,Inserm U1061, Hôpital La Colombière, Montpellier, France
| | - Emilie Chan Seng
- Département de Neurochirurgie, Centre Hospitalier Régional Montpellier, France.,Université Montpellier, 34000, Montpellier, France.,INSERM U 1051, Institut des Neurosciences Montpellier, Montpellier, France
| | - Diane Demailly
- Département de Neurochirurgie, Centre Hospitalier Régional Montpellier, France.,Université Montpellier, 34000, Montpellier, France
| | - Agathe Roubertie
- Université Montpellier, 34000, Montpellier, France.,Département de Neuropédiatrie, Centre Hospitalier Régional Montpellier, Montpellier, France
| | - Alain Boularan
- Université Montpellier, 34000, Montpellier, France.,Anesthésie-Réanimation Gui de Chauliac, Centre Hospitalier Régional Montpellier, Montpellier, France
| | - Fréderic Greco
- Université Montpellier, 34000, Montpellier, France.,Anesthésie-Réanimation Gui de Chauliac, Centre Hospitalier Régional Montpellier, Montpellier, France
| | - Pierre-François Perrigault
- Université Montpellier, 34000, Montpellier, France.,Anesthésie-Réanimation Gui de Chauliac, Centre Hospitalier Régional Montpellier, Montpellier, France
| | - Gilles Cambonie
- Université Montpellier, 34000, Montpellier, France.,Département Pédiatrie néonatale et réanimations; Centre Hospitalier Régional Montpellier, Montpellier, France
| | - Philippe Coubes
- Département de Neurochirurgie, Centre Hospitalier Régional Montpellier, France.,Unité de Recherche sur les Comportements et Mouvements Anormaux (URCMA), Montpellier, France.,Université Montpellier, 34000, Montpellier, France
| | - Laura Cif
- Département de Neurochirurgie, Centre Hospitalier Régional Montpellier, France.,Unité de Recherche sur les Comportements et Mouvements Anormaux (URCMA), Montpellier, France.,Université Montpellier, 34000, Montpellier, France
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23
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Perez J, Gonzalez V, Cif L, Cyprien F, Chan-Seng E, Coubes P. Rechargeable or Nonrechargeable Deep Brain Stimulation in Dystonia: A Cost Analysis. Neuromodulation 2017; 20:243-247. [PMID: 28083888 DOI: 10.1111/ner.12550] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 10/12/2016] [Accepted: 10/18/2016] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Deep brain stimulation of the internal Globus Pallidus (GPi DBS) delivered by an implantable neurostimulator (INS) is an established, effective, and safe treatment option for patients with medically refractory primary dystonia. Compared to other DBS targets, the battery life of the INS is substantially shorter due to the higher energy demands required to penetrate the GPi resulting in faster battery depletion and more frequent hospitalizations for INS replacement. We, therefore, performed a cost analysis to compare a rechargeable DBS system, Activa®RC, with nonrechargeable systems, from the perspective of the French public health insurer. MATERIALS AND METHODS To estimate the cost of INS replacement in the nonrechargeable cohort, and costs potentially avoided in the hypothetical Activa® RC cohort, the medical records of patients who had undergone GPi DBS with a nonrechargeable INS between 1996 and 2010 at a center in France were accessed. Replacement rates were estimated for up to nine years. RESULTS With Activa® RC, a total of 315 hospitalizations for replacement procedures would have been avoided over nine years compared with a nonrechargeable INS, resulting in a discounted mean direct medical cost per patient over nine years of €50,119 with a nonrechargeable INS and €33,306 with Activa® RC, a reduction of 34%. CONCLUSIONS The adoption of a rechargeable instead of a nonrechargeable INS for eligible patients with dystonia may provide substantial savings to the public health insurer in France.
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Affiliation(s)
- Jerome Perez
- Unité de Recherche sur les Comportements et Mouvements Anormaux, CHU Montpellier, France.,Université de Montpellier, France.,Institut de Génomique Fonctionnelle, Montpellier, France.,CNRS UMR5203, Montpellier, France.,INSERM U661, Montpellier, France
| | - Victoria Gonzalez
- Unité de Recherche sur les Comportements et Mouvements Anormaux, CHU Montpellier, France.,Université de Montpellier, France.,Institut de Génomique Fonctionnelle, Montpellier, France.,CNRS UMR5203, Montpellier, France.,INSERM U661, Montpellier, France.,Unité Médico-Chirurgicale de Neurochirurgie Fonctionnelle et Stéréotaxique, CHU Montpellier, France
| | - Laura Cif
- Unité de Recherche sur les Comportements et Mouvements Anormaux, CHU Montpellier, France.,Université de Montpellier, France.,Institut de Génomique Fonctionnelle, Montpellier, France.,CNRS UMR5203, Montpellier, France.,INSERM U661, Montpellier, France.,Unité Médico-Chirurgicale de Neurochirurgie Fonctionnelle et Stéréotaxique, CHU Montpellier, France
| | - Fabienne Cyprien
- Unité de Recherche sur les Comportements et Mouvements Anormaux, CHU Montpellier, France.,Université de Montpellier, France.,Institut de Génomique Fonctionnelle, Montpellier, France.,CNRS UMR5203, Montpellier, France.,INSERM U661, Montpellier, France.,Unité Médico-Chirurgicale de Neurochirurgie Fonctionnelle et Stéréotaxique, CHU Montpellier, France
| | - Emilie Chan-Seng
- Unité de Recherche sur les Comportements et Mouvements Anormaux, CHU Montpellier, France.,Université de Montpellier, France.,Institut de Génomique Fonctionnelle, Montpellier, France.,CNRS UMR5203, Montpellier, France.,INSERM U661, Montpellier, France.,Unité Médico-Chirurgicale de Neurochirurgie Fonctionnelle et Stéréotaxique, CHU Montpellier, France
| | - Philippe Coubes
- Unité de Recherche sur les Comportements et Mouvements Anormaux, CHU Montpellier, France.,Université de Montpellier, France.,Institut de Génomique Fonctionnelle, Montpellier, France.,CNRS UMR5203, Montpellier, France.,INSERM U661, Montpellier, France.,Unité Médico-Chirurgicale de Neurochirurgie Fonctionnelle et Stéréotaxique, CHU Montpellier, France
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24
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Hauseux PA, Cyprien F, Cif L, Gonzalez V, Boulenger JP, Coubes P, Capdevielle D. Long-term follow-up of pallidal Deep Brain Stimulation in teenagers with refractory Tourette syndrome and comorbid psychiatric disorders: About three cases. Eur J Paediatr Neurol 2017; 21:214-217. [PMID: 27436698 DOI: 10.1016/j.ejpn.2016.06.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2016] [Revised: 06/29/2016] [Accepted: 06/30/2016] [Indexed: 12/01/2022]
Abstract
OBJECTIVES Tourette syndrome (TS) is a complex neuropsychiatric disorder associated with comorbid psychiatric disorders. Peak of tic severity typically occurs in early adolescence and impacts quality of life. Since 1999, promising therapeutic effects of Deep Brain Stimulation (DBS) have been reported in tic reduction for adults with refractory TS. The aim of the study was to assess the long-term risk-benefit ratio of pallidal DBS for young patients with refractory TS and severe comorbid psychiatric disorders. METHODS We retrospectively assessed the long-term clinical outcomes of three adolescents who underwent pallidal DBS for the treatment of refractory TS. RESULTS The mean duration of follow-up was 52 months in our case series. We observed that motor tics decreased with posteroventral GPi DBS in all patients, without reaching a continuous significance over the long-term follow-up. Self-reported social inclusion was globally improved, despite lack of efficacy of DBS on comorbid conditions. CONCLUSIONS These findings suggest a long-term therapeutic benefit of early DBS intervention for highly socially impaired young patients suffering from intractable TS with severe comorbid psychiatric conditions. Further studies are needed to determine the most effective targets of DBS on both tics and comorbid psychiatric profile of TS.
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Affiliation(s)
- P-A Hauseux
- University Department of Adult Psychiatry, Hôpital La Colombière, University Hospital of Montpellier, Montpellier, France; University of Montpellier, France.
| | - F Cyprien
- Functional Neurosurgery Unit, Department of Neurosurgery, Hôpital Gui de Chauliac, University Hospital of Montpellier, France; Inserm, Unit 1061, Neuropsychiatry, Epidemiological and Clinical Research, Montpellier, France
| | - L Cif
- Functional Neurosurgery Unit, Department of Neurosurgery, Hôpital Gui de Chauliac, University Hospital of Montpellier, France
| | - V Gonzalez
- Functional Neurosurgery Unit, Department of Neurosurgery, Hôpital Gui de Chauliac, University Hospital of Montpellier, France
| | - J-P Boulenger
- University Department of Adult Psychiatry, Hôpital La Colombière, University Hospital of Montpellier, Montpellier, France; University of Montpellier, France
| | - P Coubes
- University of Montpellier, France; Functional Neurosurgery Unit, Department of Neurosurgery, Hôpital Gui de Chauliac, University Hospital of Montpellier, France
| | - D Capdevielle
- University Department of Adult Psychiatry, Hôpital La Colombière, University Hospital of Montpellier, Montpellier, France; University of Montpellier, France; Inserm, Unit 1061, Neuropsychiatry, Epidemiological and Clinical Research, Montpellier, France
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25
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Abstract
BACKGROUND Heterogeneous by the underlying pathobiology and clinical presentation, childhood onset dystonia is most frequently progressive, with related disability and limitations in functions of daily living. Consequently, there is an obvious need for efficient symptomatic therapies. METHODS AND RESULTS Following lesional surgery to basal ganglia (BG) and thalamus, deep brain stimulation (DBS) is a more conservative and adjustable intervention to and validated for internal segment of the globus pallidus (GPi), highly efficient in treating isolated "primary" dystonia and associated symptoms such as subcortical myoclonus. The role of DBS in acquired, neurometabolic and degenerative disorders with dystonia deserves further exploration to confirm as an efficient and lasting therapy. However, the pathobiological background with distribution of the sequellae over the central nervous system and related clinical features, will limit DBS efficacy in these conditions. Cumulative arguments propose DBS in severe life threatening dystonic conditions called status dystonicus as first line therapy, irrespective of the underlying cause. There are no currently available validated selection criteria for DBS in pediatric dystonia. Concurrent targets such as subthalamic nucleus (STN) and several motor nuclei of the thalamus are under exploration and only little information is available in children. DBS programming in paediatric population was adopted from experience in adults. The choice of neuromodulatory DBS parameters could influence not only the initial therapeutic outcome of dystonic symptoms but also its maintenance over time and potentially the occurrence of DBS related side effects. CONCLUSION DBS allows efficient symptomatic treatment of severe dystonia in children and advances pathophysiological knowledge about local and distributed abnormal neural activity over the motor cortical-subcortical networks in dystonia and other movement disorders.
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Affiliation(s)
- Laura Cif
- Unités de Neurochirurgie Fonctionnelle et Pédiatrique, Département de Neurochirurgie, Centre Hospitalier Universitaire Montpellier, France; Unité de Recherche sur les Comportements et Mouvements Anormaux (URCMA), France; Institut de Génomique Fonctionnelle, Centre National de la Recherche Scientifique, Unité Mixte de la Recherche 5203, France; Université Montpellier, 34000, Montpellier, France; Laboratoire de Recherche en Neurosciences Cliniques (LRENC), France.
| | - Philippe Coubes
- Unités de Neurochirurgie Fonctionnelle et Pédiatrique, Département de Neurochirurgie, Centre Hospitalier Universitaire Montpellier, France; Unité de Recherche sur les Comportements et Mouvements Anormaux (URCMA), France; Institut de Génomique Fonctionnelle, Centre National de la Recherche Scientifique, Unité Mixte de la Recherche 5203, France; Université Montpellier, 34000, Montpellier, France
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26
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Kominami S, Liu Y, Alvarez H, Rodesch G, Coubes P, Lasjaunias P. A Case of Vertebrovertebral Arteriovenous Fistula Presenting with Subarachnoid Haemorrhage. Interv Neuroradiol 2016; 2:229-33. [DOI: 10.1177/159101999600200309] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/1996] [Accepted: 07/25/1996] [Indexed: 11/15/2022] Open
Abstract
A rare paediatric case of vertebrovertebral arteriovenous fistula presented with a subarachnoid haemorrhage. A 12 year-old boy, who fell on his back at school, presented with a one week history of headache, vomiting, and double vision. Computed tomography (CT) scan revealed subarachnoid haemorrhage. Magnetic resonance imaging (MRI) demonstrated a tortuous vessel on the anterior surface of the spinal cord. Selective angiography showed an arteriovenous fistula of the left vertebral artery at the level of C1. The venous drainage of the fistula refluxed into the medullary vein at the level of C6-7, and drained upwards into the posterior fossa veins. An endovascular detachable balloon technique was employed and complete occlusion of the fistula was achieved.
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Affiliation(s)
| | | | | | | | - P. Coubes
- Neurochirurgie B, C.H.U. de Montpellier; Montpellier Cédex, France
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27
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Landais A, Crespel A, Moulis JL, Coubes P, Gelisse P. Psychiatric comorbidity in temporal DNET and improvement after surgery. Neurochirurgie 2016; 62:165-70. [PMID: 27237726 DOI: 10.1016/j.neuchi.2016.02.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2015] [Revised: 12/22/2015] [Accepted: 02/26/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND "Alien tissue" may be responsible for a higher frequency of psychiatric disorders in patients with temporal lobe epilepsy (TLE). Also, ganglioglioma and dysembryoplastic neuroepithelial tumors (DNET) could represent a risk-factor for the development of post-surgical psychoses. Classically, severe psychiatric disorders contra-indicate epilepsy surgery. OBJECTIVES Assessment of inter-ictal psychiatric disorders in 10 consecutive patients with temporal DNET, before and after epilepsy surgery with a minimum of a 2-year follow-up evaluation. METHODS DNETs were confirmed on histological examination. Psychiatric disorders were classified according to the DSM-IV-TR. RESULTS Five patients presented inter-ictal psychiatric disorders with, according to the DSM-IV-TR, undifferentiated schizophrenia (one case), "borderline" personality (two cases), intermittent explosive disorder with slight mental retardation (one case), and personality disorders not otherwise specified but with some traits of dependent personality and with mythomania (one case). The condition of these five patients dramatically improved after surgery. No psychiatric behavior or "de novo" psychosis was observed after surgery in any of the patients. CONCLUSION The prevalence of inter-ictal psychiatric disorders appears to be high in epileptic patients with a temporal lobe DNET primarily in relation to personality and behavioral problems with some degree of impulsivity and verbal aggressiveness. The improvements after surgery suggest that this therapy could be performed in these patients and severe psychiatric disorders do not contra-indicate this procedure.
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Affiliation(s)
- A Landais
- Neurology Department, University Hospital of Pointe-à-Pitre, 97139 Abymes, Guadeloupe.
| | - A Crespel
- Epilepsy Unit, Gui-de-Chauliac University Hospital, route de Chauvel, Montpellier, France
| | - J-L Moulis
- Department of Psychiatry (Pavillon 41), Colombière University Hospital, 34090 Montpellier, France
| | - P Coubes
- Epilepsy Unit, Gui-de-Chauliac University Hospital, route de Chauvel, Montpellier, France
| | - P Gelisse
- Epilepsy Unit, Gui-de-Chauliac University Hospital, route de Chauvel, Montpellier, France
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28
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Gélisse P, Genton P, Coubes P, Tang NPL, Crespel A. Can emotional stress trigger the onset of epilepsy? Epilepsy Behav 2015; 48:15-20. [PMID: 26037844 DOI: 10.1016/j.yebeh.2015.05.010] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Revised: 05/05/2015] [Accepted: 05/05/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the potential role of an acute adverse stress as "trigger" for the onset of epilepsy. METHODS Among 4618 consecutive patients, twenty-two reported a major life event within three months before the onset of epilepsy. RESULTS All patients had focal epilepsy except one with idiopathic generalized epilepsy. The temporal lobe was involved in 90% of patients with focal epilepsy. More precisely, 13 patients (62% of patients with focal epilepsy) had medial temporal lobe epilepsy (MTLE), two had lateral temporal lobe epilepsy, four had temporoparietooccipital junction epilepsy, and two patients had central lobe epilepsy. The mean age and the median age at onset of epilepsy for patients with MTLE were both 38 years (range: 9.5-65 years). Ten patients had right and three had left MTLE. Among patients with focal epilepsy, MRI was abnormal in 7 (33%) with hippocampal sclerosis in four, periventricular nodular heterotopia in two, and complex cortical dysgenesis in one. The mean age at onset of epilepsy for patients with brain lesions was 26 years (range: 9.5-49). Twelve patients (54%) reported a death as a triggering factor for the onset of their epilepsy. Seven patients (32%) reported that a relationship of trust had been broken. Three patients (14%) had been subjects of violence. No patient reported sexual abuse as a triggering factor. CONCLUSION This study provides evidence that some patients (5/1000 patients) began their seizures in the wake of significant life events. The average age at onset of epilepsy is quite late, around age 30, even in the presence of brain lesions. These patients are emotionally and affectively more prone to have consequences of a stressful life event. The recognition and management of such situations may bring significant relief with improvement of the control of epilepsy.
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Affiliation(s)
- Philippe Gélisse
- Epilepsy Unit, Hôpital Gui de Chauliac, Montpellier, France; Research Unit (URCMA: Unité de Recherche sur les Comportements et Mouvements Anormaux), INSERM U661, Montpellier, France.
| | | | - Philippe Coubes
- Epilepsy Unit, Hôpital Gui de Chauliac, Montpellier, France; Research Unit (URCMA: Unité de Recherche sur les Comportements et Mouvements Anormaux), INSERM U661, Montpellier, France
| | - Ngoc Phuong Loc Tang
- Epilepsy Unit, Hôpital Gui de Chauliac, Montpellier, France; Research Unit (URCMA: Unité de Recherche sur les Comportements et Mouvements Anormaux), INSERM U661, Montpellier, France
| | - Arielle Crespel
- Epilepsy Unit, Hôpital Gui de Chauliac, Montpellier, France; Research Unit (URCMA: Unité de Recherche sur les Comportements et Mouvements Anormaux), INSERM U661, Montpellier, France
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29
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Cif L, Kurian MA, Gonzalez V, Garcia‐Ptacek S, Roujeau T, Gelisse P, Moura de Ribeiro AM, Crespel A, MacPherson L, Coubes P. Atypical PLA2G6-Associated Neurodegeneration: Social Communication Impairment, Dystonia and Response to Deep Brain Stimulation. Mov Disord Clin Pract 2014; 1:128-131. [PMID: 30363890 PMCID: PMC6183017 DOI: 10.1002/mdc3.12030] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2014] [Revised: 03/21/2014] [Accepted: 03/28/2014] [Indexed: 11/10/2022] Open
Affiliation(s)
- Laura Cif
- Département de NeurochirurgieCHRU MontpellierHôpital Gui de ChauliacMontpellierFrance
- INSERM, U661MontpellierFrance
- Université de Montpellier 1MontpellierFrance
- CNRS UMR5203Institut de Génomique FonctionnelleMontpellierFrance
- Département des Neurosciences CliniquesLaboratoire de Recherche en NeuroimagerieCentre Hospitalier Universitaire VaudoisUniversité de LausanneLausanneSwitzerland
| | - Manju A. Kurian
- Neurosciences UnitInstitute of Child Health, LondonUnited Kingdom
- Department of NeurologyGreat Ormond Street HospitalLondonUnited Kingdom
| | - Victoria Gonzalez
- Département de NeurochirurgieCHRU MontpellierHôpital Gui de ChauliacMontpellierFrance
- INSERM, U661MontpellierFrance
- Université de Montpellier 1MontpellierFrance
- CNRS UMR5203Institut de Génomique FonctionnelleMontpellierFrance
| | - Sara Garcia‐Ptacek
- Department of NeurobiologyCare Sciences and SocietyKarolinska InstitutetStockholmSweden
| | - Thomas Roujeau
- Département de NeurochirurgieCHRU MontpellierHôpital Gui de ChauliacMontpellierFrance
| | - Philippe Gelisse
- Epilepsy UnitUniversity Hospital of MontpellierMontpellierFrance
| | | | - Arielle Crespel
- Epilepsy UnitUniversity Hospital of MontpellierMontpellierFrance
| | - Lesley MacPherson
- Department of RadiologyBirmingham Children's HospitalBirminghamUnited Kingdom
| | - Philippe Coubes
- Département de NeurochirurgieCHRU MontpellierHôpital Gui de ChauliacMontpellierFrance
- INSERM, U661MontpellierFrance
- Université de Montpellier 1MontpellierFrance
- CNRS UMR5203Institut de Génomique FonctionnelleMontpellierFrance
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Ruge D, Cif L, Limousin P, Gonzalez V, Vasques X, Coubes P, Rothwell JC. Longterm deep brain stimulation withdrawal: clinical stability despite electrophysiological instability. J Neurol Sci 2014; 342:197-9. [PMID: 24857354 DOI: 10.1016/j.jns.2014.05.011] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2014] [Revised: 05/03/2014] [Accepted: 05/06/2014] [Indexed: 11/26/2022]
Abstract
Deep brain stimulation (DBS) is a powerful treatment option for movement disorders, including severe generalised dystonia. After several years of treatment, cases have been reported in which DBS has been stopped without any deterioration in clinical benefit. This might indicate that DBS can restore function in some cases. The mechanism of DBS induced clinical retention effects has been addressed before. Here, the question we asked was if such clinical stability is reflected at the underlying physiology level or whether there is indication to believe that a stand-still of symptoms might be at risk because of neurophysiological instability. We recorded patients with pre-intervention life-threatening or severe genetic dystonia with long lasting clinical benefit when turned off DBS. Despite clinical stability, our physiological studies revealed large changes in the excitability of excitatory and inhibitory motor circuits in the cortex, which exceed normal fluctuation. This discrepancy between instability in the motor network physiology caused by removal of DBS and clinical stability alerts as it potentially indicates a risk to fail and cause symptoms to return.
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Affiliation(s)
- Diane Ruge
- Sobell Department of Motor Neuroscience and Movement Disorders, UCL-Institute of Neurology, University College London, 33 Queen Square, London WC1N3BG, United Kingdom.
| | - Laura Cif
- CHRU Montpellier, Hôpital Gui de Chauliac, Département de Neurochirurgie, Montpellier F-34000 France; Unité de Recherche sur les Mouvements Anormaux, URMA, France; INSERM, U661, Montpellier F-34000, France; Université de Montpellier 1, Montpellier F-34000, France; CNRS UMR5203, Institut de Génomique Fonctionnelle, Montpellier F-34000, France
| | - Patricia Limousin
- Sobell Department of Motor Neuroscience and Movement Disorders, UCL-Institute of Neurology, University College London, 33 Queen Square, London WC1N3BG, United Kingdom
| | - Victoria Gonzalez
- CHRU Montpellier, Hôpital Gui de Chauliac, Département de Neurochirurgie, Montpellier F-34000 France; Unité de Recherche sur les Mouvements Anormaux, URMA, France; INSERM, U661, Montpellier F-34000, France; Université de Montpellier 1, Montpellier F-34000, France; CNRS UMR5203, Institut de Génomique Fonctionnelle, Montpellier F-34000, France
| | | | - Philippe Coubes
- CHRU Montpellier, Hôpital Gui de Chauliac, Département de Neurochirurgie, Montpellier F-34000 France; Unité de Recherche sur les Mouvements Anormaux, URMA, France; INSERM, U661, Montpellier F-34000, France; Université de Montpellier 1, Montpellier F-34000, France; CNRS UMR5203, Institut de Génomique Fonctionnelle, Montpellier F-34000, France
| | - John C Rothwell
- Sobell Department of Motor Neuroscience and Movement Disorders, UCL-Institute of Neurology, University College London, 33 Queen Square, London WC1N3BG, United Kingdom
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Gonzalez V, Cif L, Biolsi B, Garcia-Ptacek S, Seychelles A, Sanrey E, Descours I, Coubes C, de Moura AMR, Corlobe A, James S, Roujeau T, Coubes P. Deep brain stimulation for Huntington's disease: long-term results of a prospective open-label study. J Neurosurg 2014; 121:114-22. [PMID: 24702329 DOI: 10.3171/2014.2.jns131722] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
UNLABELLED OBJECT.: To date, experience of globus pallidus internus (GPi) deep brain stimulation (DBS) in the treatment of Huntington's disease (HD) has been limited to a small number of case reports. The aim of this study was to analyze long-term motor outcome of a cohort of HD patients treated with GPi DBS. METHODS Seven patients with pharmacologically resistant chorea and functional impairment were included in a prospective open-label study from 2008 to 2011. The main outcome measure was the motor section of the Unified Huntington's Disease Rating Scale. The primary end point was reduction of chorea. RESULTS Patients underwent MRI-guided bilateral GPi implantation. The median duration of follow-up was 3 years. A significant reduction of chorea was observed in all patients, with sustained therapeutic effect; the mean improvement on the chorea subscore was 58.34% at the 12-month follow-up visit (p = 0.018) and 59.8% at the 3-year visit (p = 0.040). Bradykinesia and dystonia showed a nonsignificant trend toward progressive worsening related to disease evolution and partly to DBS. The frequency of stimulation was 130 Hz for all patients. DBS-induced bradykinesia was managed by pulse-width reduction or bipolar settings. Levodopa mildly improved bradykinesia in 4 patients. Regular off-stimulation tests confirmed a persistent therapeutic effect of DBS on chorea. CONCLUSIONS GPi DBS may provide sustained chorea improvement in selected HD patients with pharmacologically resistant chorea, with transient benefit in physical aspects of quality of life before progression of behavioral and cognitive disorders. DBS therapy did not improve dystonia or bradykinesia. Further studies including quality of life measures are needed to evaluate the impact of DBS in the long-term outcome of HD.
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Cochereau J, Leboucq N, James S, Coubes P, Bonafe A, Roujeau T. Intérêts de l’IRM dans le suivi des ventriculocisternostomies. Neurochirurgie 2013. [DOI: 10.1016/j.neuchi.2013.10.081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Cif L, Gonzalez V, Garcia-Ptacek S, James S, Boetto J, Seychelles A, Roujeau T, Moura De Ribeiro AM, Sillon M, Mondain M, Coubes P. Progressive Dystonia in Mohr-Tranebjaerg Syndrome With Cochlear Implant and Deep Brain Stimulation. Mov Disord 2013; 28:737-8. [DOI: 10.1002/mds.25519] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2012] [Revised: 04/10/2013] [Accepted: 04/17/2013] [Indexed: 11/06/2022] Open
Affiliation(s)
- Laura Cif
- Functional Neurosurgery Unit, Neurosurgery Department; University Hospital of Montpellier; Montpellier France
- University of Montpellier; 1 Montpellier France
- National Institute of Health and Medical Research (INSERM) Unit 661; Montpellier France
- Functional Genomics Institute; Montpellier France
| | - Victoria Gonzalez
- Functional Neurosurgery Unit, Neurosurgery Department; University Hospital of Montpellier; Montpellier France
- University of Montpellier; 1 Montpellier France
- National Institute of Health and Medical Research (INSERM) Unit 661; Montpellier France
- Functional Genomics Institute; Montpellier France
| | - Sara Garcia-Ptacek
- Functional Neurosurgery Unit, Neurosurgery Department; University Hospital of Montpellier; Montpellier France
| | - Syril James
- Functional Neurosurgery Unit, Neurosurgery Department; University Hospital of Montpellier; Montpellier France
- University of Montpellier; 1 Montpellier France
- National Institute of Health and Medical Research (INSERM) Unit 661; Montpellier France
- Functional Genomics Institute; Montpellier France
| | - Julien Boetto
- Functional Neurosurgery Unit, Neurosurgery Department; University Hospital of Montpellier; Montpellier France
| | - Anne Seychelles
- Functional Neurosurgery Unit, Neurosurgery Department; University Hospital of Montpellier; Montpellier France
| | - Thomas Roujeau
- Functional Neurosurgery Unit, Neurosurgery Department; University Hospital of Montpellier; Montpellier France
- University of Montpellier; 1 Montpellier France
- National Institute of Health and Medical Research (INSERM) Unit 661; Montpellier France
- Functional Genomics Institute; Montpellier France
| | - Ana Maria Moura De Ribeiro
- Functional Neurosurgery Unit, Neurosurgery Department; University Hospital of Montpellier; Montpellier France
- University of Montpellier; 1 Montpellier France
- National Institute of Health and Medical Research (INSERM) Unit 661; Montpellier France
- Functional Genomics Institute; Montpellier France
| | - Martine Sillon
- University of Montpellier; 1 Montpellier France
- Otolaryngology Department; University Hospital of Montpellier; Montpellier France
| | - Michel Mondain
- University of Montpellier; 1 Montpellier France
- Otolaryngology Department; University Hospital of Montpellier; Montpellier France
| | - Philippe Coubes
- Functional Neurosurgery Unit, Neurosurgery Department; University Hospital of Montpellier; Montpellier France
- University of Montpellier; 1 Montpellier France
- National Institute of Health and Medical Research (INSERM) Unit 661; Montpellier France
- Functional Genomics Institute; Montpellier France
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Boetto J, Seychelles A, James S, Gonzalez V, Roujeau T, Cif L, Coubes P. Stimulation cérébrale profonde dans le traitement du syndrome de Gilles de la Tourette : expérience clinique à propos de six cas et revue de la littérature. Neurochirurgie 2012. [DOI: 10.1016/j.neuchi.2012.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Cif L, Ruge D, Gonzalez V, Limousin P, Vasques X, Hariz MI, Rothwell J, Coubes P. The influence of deep brain stimulation intensity and duration on symptoms evolution in an OFF stimulation dystonia study. Brain Stimul 2012; 6:500-5. [PMID: 23088851 DOI: 10.1016/j.brs.2012.09.005] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2012] [Revised: 09/01/2012] [Accepted: 09/17/2012] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND Deep brain stimulation (DBS) of the internal globus pallidus (GPi) is an established therapy for primary generalized dystonia. However, the evolution of dystonia symptoms after DBS discontinuation after years of therapy has only rarely been reported. We therefore longitudinally studied the main physiological measurements known to be impaired in dystonia, with DBS ON and then again after termination of DBS, after at least five years of continuous DBS. OBJECTIVE We studied whether dystonia evolution after DBS discontinuation in patients benefiting from long-term GPi DBS is different from that observed in earlier stages of the therapy. METHODS In eleven DYT1 patients treated with bilateral GPi DBS for at least 5 years, dystonia was assessed ON-DBS, immediately after switch-off (OFF-DBS1) and 48 h after DBS termination (OFF-DBS2). We studied the influence of DBS intensity on dystonia when DBS was discontinued. RESULTS On average a significant difference in symptoms was measured only between ON-DBS and OFF-DBS1 conditions. Importantly, none of the patients returned to their preoperative dystonia severity, even 48 h after discontinuation. The amount of clinical deterioration in the OFF conditions positively correlated with higher stimulation current in the chronic ON-DBS condition. CONCLUSIONS The duration of DBS application influences symptom evolution after DBS termination. DBS intensity seems to have a prominent role on evolution of dystonic symptoms when DBS is discontinued. In conclusion, DBS induces changing modulation of the motor network with less worsening of symptoms after long term stimulation, when DBS is stopped.
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Affiliation(s)
- Laura Cif
- CHRU Montpellier, Hôpital Gui de Chauliac, Service de Neurochirurgie, Montpellier F-34000, France.
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Hemm S, Vayssiere N, Mennessier G, Cif L, Zanca M, Ravel P, Frerebeau P, Coubes P. Evolution of brain impedance in dystonic patients treated by GPI electrical stimulation. Neuromodulation 2012; 7:67-75. [PMID: 22151186 DOI: 10.1111/j.1094-7159.2004.04009.x] [Citation(s) in RCA: 37] [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: 11/28/2022]
Abstract
Deep Brain Stimulation is an effective treatment of generalized dystonia. Optimal stimulation parameters vary between patients. This article investigates the influence of electrical brain impedance and delivered current on the brain response to stimulation. Twenty-four patients were bilaterally stimulated in the globus pallidus internus through two implanted four-contact electrodes. The variation of brain impedance and current measurements was correlated with stimulation parameters, time course, and clinical outcome. When a contact was activated, a statistically significant and reversible decrease of brain impedance was found. Impedance and current values and their variations with time significantly differed between patients. The absolute impedance did not significantly correlate with the final outcome. We conclude that the reversible decrease of impedance reflects an adaptive long-term mechanism, which could be due to a plasticity phenomenon, but has no prognostic value. Impedance and current measurements give new complementary information for parameter adjustment and trouble shooting and should therefore be included in all patients' follow-up.
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Affiliation(s)
- Simone Hemm
- Departments of Pediatric Neurosurgery (Research Group on Movement Disorders) and Nuclear Medicine, University Hospital, Montpellier; Laboratory of Mathematical and Theoretical Physics, University of Science, Montpellier II; Laboratory of Industrial Physics and Information Processing, University of Montpellier I, France
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Bouyer B, Bachy M, Vermesch AI, Doummar D, Coubes P, Vialle R. The use of harmonic scalpel in spinal surgery with contraindication to the use of monopolar electrocautery: a case report in a 14-year-old girl with a primary generalized dystonia and a 100° thoracic scoliosis. Childs Nerv Syst 2012; 28:1251-5. [PMID: 22543430 DOI: 10.1007/s00381-012-1757-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2011] [Accepted: 04/03/2012] [Indexed: 11/29/2022]
Affiliation(s)
- Benjamin Bouyer
- Université Pierre et Marie Curie Paris 6, Department of Pediatric Orthopaedics, Armand Trousseau Hospital, 26 Avenue du Dr Arnold Netter, 75571 Paris Cedex 12, France
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Cif L, Gonzalez-Martinez V, Vasques X, Corlobé A, Moura AM, Bonafé A, Coubes P. Staged implantation of multiple electrodes in the internal globus pallidus in the treatment of primary generalized dystonia. J Neurosurg 2012; 116:1144-52. [DOI: 10.3171/2012.1.jns102045] [Citation(s) in RCA: 28] [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: 11/06/2022]
Abstract
Object
Deep brain stimulation (DBS) is used for treating various types of dystonia. Multiple electrodes could be proposed to improve the therapeutic outcome enabling the targeting of specific neuronal populations not reached by the electrical field generated by the initially implanted electrode. The authors address the question of the feasibility and safety of staged multiple lead implantations in the sensorimotor internal globus pallidus (GPi) in primary generalized dystonia (PGD). Criteria for patient selection, surgical technique, target selection, electrical settings management, and clinical outcome are presented.
Methods
Sixteen patients (8 harbored the DYT1 gene mutation) presented with PGD and were enrolled in this study. Patients underwent clinical assessment using the Burke-Fahn-Marsden Dystonia Rating Scale preoperatively and during follow-up with DBS. Prior to the addition of electrodes, the authors confirmed, by turning off stimulation, that the patient was still benefiting from DBS and that DBS settings adjustment did not provide further improvement. The second target was defined according to the position of the first electrode, to the residual volume within the sensorimotor GPi, and according to residual symptoms. The second surgery followed the same protocol as the first and the new electrode were inserted using the same bur hole as the first electrode.
Results
The addition of a new pair of electrodes was followed by significant improvement in the whole population (p = 0.005), as well as in the DYT1-negative subgroup (p = 0.012) but not in the DYT1 subgroup (p = not significant). Nevertheless, some patients did not exhibit significant additional benefit. Seven hardware-related complications occurred during the entire follow-up, 3 prior to it, and 4 after the addition of the second pair of electrodes.
Conclusions
The addition of a second pair of electrodes in the GPi in patients with PGD with suboptimal or decaying benefit following the first surgery seems to be a safe procedure and is not followed by an increase in surgery-related complications. This staged procedure may provide further clinical improvement in patients with PGD in whom DBS effect is initially incomplete or when disease progression occurs over time. The position of the additional electrode within the GPi is determined by the available volume within the posteroventral GPi and by the distribution of the dystonic symptoms that need to be controlled.
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Affiliation(s)
- Laura Cif
- 1Département de Neurochirurgie,
- 2Institut National de la Santé et de la Recherche Médicale Unité 661
- 3Université de Montpellier 1
- 4Institut de Génomique Fonctionnelle, Unité Mixte de Recherche 5203, Centre National de la Recherche Scientifique; and
| | - Victoria Gonzalez-Martinez
- 1Département de Neurochirurgie,
- 2Institut National de la Santé et de la Recherche Médicale Unité 661
- 3Université de Montpellier 1
- 4Institut de Génomique Fonctionnelle, Unité Mixte de Recherche 5203, Centre National de la Recherche Scientifique; and
| | - Xavier Vasques
- 1Département de Neurochirurgie,
- 2Institut National de la Santé et de la Recherche Médicale Unité 661
- 3Université de Montpellier 1
- 4Institut de Génomique Fonctionnelle, Unité Mixte de Recherche 5203, Centre National de la Recherche Scientifique; and
- 5Product and Solution Support Center, Centre for Advanced Studies, IBM, Montpellier, France
| | - Astrid Corlobé
- 1Département de Neurochirurgie,
- 6Service de Neurologie, and
| | | | - Alain Bonafé
- 7Département de Neuroradiologie, Hôpital Gui de Chauliac, Centre Hospitalier Régional Universitaire Montpellier
| | - Philippe Coubes
- 1Département de Neurochirurgie,
- 2Institut National de la Santé et de la Recherche Médicale Unité 661
- 3Université de Montpellier 1
- 4Institut de Génomique Fonctionnelle, Unité Mixte de Recherche 5203, Centre National de la Recherche Scientifique; and
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Serafini A, Kuate C, Gelisse P, Velizarova R, Gigli GL, Coubes P, Crespel A. Sleep before and after temporal lobe epilepsy surgery. Seizure 2012; 21:260-5. [DOI: 10.1016/j.seizure.2012.01.007] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2011] [Revised: 01/16/2012] [Accepted: 01/18/2012] [Indexed: 11/28/2022] Open
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Saleh C, Gonzalez V, Cif L, Coubes P. Deep brain stimulation of the globus pallidus internus and Gilles de la Tourette syndrome: Toward multiple networks modulation. Surg Neurol Int 2012; 3:S127-42. [PMID: 22826816 PMCID: PMC3400493 DOI: 10.4103/2152-7806.95424] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2012] [Accepted: 03/28/2012] [Indexed: 11/09/2022] Open
Abstract
Background: Gilles de la Tourette's syndrome (GTS) is a complex neuropsychiatric disorder characterized by disabling motor and vocal tics. The pathophysiology of GTS remains poorly understood. Conventional treatment consists in pharmacological and behavioral treatment. For patients suffering severe adverse effects or not responding to pharmacological treatment, deep brain stimulation (DBS) presents an alternative treatment. However, the optimal target choice in DBS for GTS remains a divisive issue. Methods: A PubMed search from 1999 to 2012 was conducted. Thirty-three research articles reporting on DBS in patients with GTS were selected and analyzed. Results: Eighty-eight patients with Tourette's syndrome were treated since 1999 with DBS. The majority of patients received thalamic stimulation. Significantly fewer patients were treated with globus pallidus internus stimulation. Occasionally, the anterior limb of the internal capsule and the nucleus accumbens were implanted. The subthalamic nucleus was selected once. All targets were reported with positive results, but of variable extent. Only 14 patients exhibited level 1 evidence. Conclusion: In light of the wide spectrum of associated behavioral co-morbidities in GTS, multiple networks modulation may result in the most efficacious treatment strategy. The optimal locations for DBS within the cortico-basal ganglia-thalamocortical circuits remain to be established. However, at the current stage, comparison between targets should be done with great caution. Significant disparity between number of patients treated per target, methodological variability, and quality of reporting renders a meaningful comparison between targets difficult. Randomized controlled trials with larger cohorts and standardization of procedures are urgently needed.
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Affiliation(s)
- Christian Saleh
- Department of Neurosurgery, CHRU Montpellier, Montpellier, France
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Velizarova R, Crespel A, Juntas-Morales R, Coubes P, Gélisse P. Teaching NeuroImages: benediction sign as a result of cervical astrocytoma with syringomyelia. Neurology 2011; 77:e50. [PMID: 21876192 DOI: 10.1212/wnl.0b013e31822c619d] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- R Velizarova
- Departments of Neurology, Gui de Chauliac Hospital, Montpellier, France
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Ruge D, Cif L, Limousin P, Gonzalez V, Vasques X, Hariz MI, Coubes P, Rothwell JC. Shaping reversibility? Long-term deep brain stimulation in dystonia: the relationship between effects on electrophysiology and clinical symptoms. Brain 2011; 134:2106-15. [PMID: 21705425 DOI: 10.1093/brain/awr122] [Citation(s) in RCA: 101] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Long-term results show that benefits from chronic deep brain stimulation in dystonia are maintained for many years. Despite this, the neurophysiological long-term consequences of treatment and their relationship to clinical effects are not well understood. Previous studies have shown that transcranial magnetic stimulation measures of abnormal long-term potentiation-like plasticity (paired associative stimulation) and GABAa-ergic inhibition (short-interval intracortical inhibition), which are seen in dystonia, normalize after several months of deep brain stimulation. In the present study, we examine the same measures in a homogenous group of 10 DYT1 gene-positive patients after long-term deep brain stimulation treatment for at least 4.5 years. Recordings were made 'on' deep brain stimulation and after stopping deep brain stimulation for 2 days. The results show that: (i) on average, prior to discontinuing deep brain stimulation, the paired associative stimulation response was almost absent and short-interval intracortical inhibition was reduced compared with normal. This pattern differs from that in both healthy volunteers and from the typical pattern of enhanced plasticity and reduced inhibition seen in deep brain stimulation-naïve dystonia. It is similar to that seen in untreated Parkinson's disease and may relate to thus far unexplained clinical phenomena like parkinsonian symptoms that have sometimes been observed in patients treated with deep brain stimulation. (ii) Overall, there was no change in average physiological or clinical status when deep brain stimulation was turned off for 2 days, suggesting that deep brain stimulation had produced long-term neural reorganization in the motor system. (iii) However, there was considerable variation between patients. Those who had higher levels of plasticity when deep brain stimulation was 'on', had the best retention of clinical benefit when deep brain stimulation was stopped and vice versa. This may indicate that better plasticity is required for longer term retention of normal movement when deep brain stimulation is off. (iv) Patients with the highest plasticity 'on' deep brain stimulation were those who had been receiving stimulation with the least current drain. This suggests that it might be possible to 'shape' deep brain stimulation of an individual patient to maximize beneficial neurophysiological patterns that have an impact on clinical status. The results are relevant for understanding long-term consequences and management of deep brain stimulation in dystonia.
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Affiliation(s)
- Diane Ruge
- Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, University College London, 33 Queen Square, London WC1N3BG, UK.
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Blanchard A, Roubertie A, Simonetta-Moreau M, Ea V, Coquart C, Frederic MY, Gallouedec G, Adenis JP, Benatru I, Borg M, Burbaud P, Calvas P, Cif L, Damier P, Destee A, Faivre L, Guyant-Marechal L, Janik P, Janoura S, Kreisler A, Lusakowska A, Odent S, Potulska-Chromik A, Rudzińska M, Thobois S, Vuillaume I, Tranchant C, Tuffery-Giraud S, Coubes P, Sablonnière B, Claustres M, Collod-Béroud G. Singular DYT6 phenotypes in association with new THAP1 frameshift mutations. Mov Disord 2011; 26:1775-7. [PMID: 21520283 DOI: 10.1002/mds.23641] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Vasques X, Cif L, Mennessier G, Coubes P. A target-specific electrode and lead design for internal globus pallidus deep brain stimulation. Stereotact Funct Neurosurg 2010; 88:129-37. [PMID: 20357520 DOI: 10.1159/000303524] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2008] [Accepted: 11/29/2009] [Indexed: 11/19/2022]
Abstract
In nearly all deep brain stimulation (DBS) applications, the same quadripolar electrode design is used for different anatomical targets even if shape and volume differences exist between nuclei. Taking into account the electrode location within the internal globus pallidus (GPi) and the size of the GPi, 2 electrodes were designed in order to improve the therapeutic benefit, to minimize side effects from DBS and to obtain a more homogeneous electric field distribution. The electrodes were evaluated numerically by using a stereotactic model measuring the correlation between the electric field and the GPi. The model was applied to 26 dystonodyskinetic patients who underwent surgery for a bilateral lead implantation into the posteroventral part of the GPi. The designed electrodes produced a more homogeneous distribution of the electric field than the quadripolar electrode.
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Affiliation(s)
- Xavier Vasques
- Service de Neurochirurgie, CHRU Montpellier, Montpellier, France
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Cif L, Vasques X, Gonzalez V, Ravel P, Biolsi B, Collod-Beroud G, Tuffery-Giraud S, Elfertit H, Claustres M, Coubes P. Long-term follow-up of DYT1 dystonia patients treated by deep brain stimulation: An open-label study. Mov Disord 2010; 25:289-99. [DOI: 10.1002/mds.22802] [Citation(s) in RCA: 120] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Vasques X, Cif L, Gonzalez V, Nicholson C, Coubes P. Factors predicting improvement in primary generalized dystonia treated by pallidal deep brain stimulation. Mov Disord 2009; 24:846-53. [PMID: 19199337 DOI: 10.1002/mds.22433] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.9] [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: 11/07/2022] Open
Abstract
Despite the beneficial effects of Globus Pallidus internus (GPi) deep brain stimulation (DBS) in patients with primary generalized dystonia (PGD), the degree of improvement varies from one patient to another. The objective of this study was to examine the effects of clinical, anatomical (volume of the GPi), and electrical variables on the postoperative Burke-Fahn-Marsden Dystonia rating scale (BFMDRS) motor score to identify which factors may be predictive of the degree of improvement. We reviewed retrospectively the clinical records of 40 steady-state patients with PGD who had been treated by bilateral GPi lead implantation. The follow-up period was 2 to 8 years. The correlation between the electrical parameters (voltage, impedance, and current) and the clinical outcome was studied. An analysis of covariance was performed to identify factors predictive of the magnitude of improvement. The most influential factors according to the model are as follows: the preoperative BFMDRS score (P < 0.0001); age at surgery (P < 0.0001); the right GPi volume (P = 0.002); the left stimulated GPi volume (P = 0.005). No significant correlation was found between the electrical parameters used and the mean motor scores in steady state.
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Affiliation(s)
- Xavier Vasques
- CHRU Montpellier, Service de Neurochirurgie, Montpellier, France
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Palenzuela G, El-Fertit H, Coubes P, Mallié M, Rigau V, Margueritte G. Cryptococcose neuroméningée pseudotumorale chez une enfant immunodéprimée traitée pour un gliome infiltrant du tronc cérébral. À propos d’un cas et revue de la littérature. Neurochirurgie 2009; 55:329-32. [DOI: 10.1016/j.neuchi.2008.05.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2007] [Accepted: 05/19/2008] [Indexed: 01/30/2023]
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Crespel A, Genton P, Coubes P, Gélisse P. Épilepsie myoclonique juvénile chez une patiente atteinte d’hémiplégie infantile. Rev Neurol (Paris) 2009; 165:189-93. [DOI: 10.1016/j.neurol.2008.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2008] [Revised: 04/15/2008] [Accepted: 06/06/2008] [Indexed: 11/28/2022]
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Vasques X, Cif L, Hess O, Gavarini S, Mennessier G, Coubes P. Prognostic value of globus pallidus internus volume in primary dystonia treated by deep brain stimulation. J Neurosurg 2009; 110:220-8. [DOI: 10.3171/2008.3.17433] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Object
Given that improvement is variable from one patient to another, the authors analyzed the impact of globus pallidus internus (GPi) volume on the result of deep brain stimulation (DBS) by comparing highly and less improved patients with primary dystonodyskinetic syndromes.
Methods
A stereotactic model was developed to visualize and quantify the relationship between the isofield lines generated by the DBS lead and GPi target. The model was used in 30 right-handed selected patients with primary dystonodyskinetic syndromes who had been treated using bilateral stimulation of the sensorimotor GPi. Ten healthy control individuals were also included in the study. First, the authors compared the GPi volumes between patients and healthy controls. Second, the stimulated GPi volumes, that is, the intersection between the volume of each isofield value and the GPi volumes, were compared between less improved and highly improved patients.
Results
Improvement in the Burke-Fahn-Marsden Dystonia Rating Scale's motor score was rated > 90% in 20 patients (97 ± 4.6%) and < 60% in 10 patients (56.9 ± 6%). The mean volume of the right (461.8 ± 81.8 mm3) and left (406.6 ± 113.2 mm3) GPi in patients showing less response to DBS was significantly smaller than the GPi volume of patients who responded well (right 539.9 ± 86.6 mm3, left 510.6 ± 88.7 mm3) and healthy controls (right 557.8 ± 109.1 mm3, left 525.1 ± 40.8 mm3).
Conclusions
On the left side, the mean stimulated volumes (isofield line range 0.2–1 V/mm) were significantly larger in highly improved than in less improved patients. In this model, the threshold for functional effect was calculated at 0.2 V/mm.
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Affiliation(s)
- Xavier Vasques
- 1Service de Neurochirurgie, Centre Hospitalier Régional Universitaire Montpellier
- 2Institut de Génomique Fonctionnele
- 3Centre National de la Recherche Scientifique Unité Mixte de la Recherche 5203
- 4U661, Institut National de la Santé et de la Recherche Médicale
- 5Université Montpellier I
| | - Laura Cif
- 1Service de Neurochirurgie, Centre Hospitalier Régional Universitaire Montpellier
- 2Institut de Génomique Fonctionnele
- 3Centre National de la Recherche Scientifique Unité Mixte de la Recherche 5203
- 4U661, Institut National de la Santé et de la Recherche Médicale
- 5Université Montpellier I
| | - Olivier Hess
- 7Deep Computing Europe, International Business Machines Montpellier, France
| | - Sophie Gavarini
- 1Service de Neurochirurgie, Centre Hospitalier Régional Universitaire Montpellier
- 2Institut de Génomique Fonctionnele
- 3Centre National de la Recherche Scientifique Unité Mixte de la Recherche 5203
- 4U661, Institut National de la Santé et de la Recherche Médicale
- 5Université Montpellier I
| | - Gerard Mennessier
- 6Laboratoire de Physique Théorique et Astroparticules, Unité Mixte de la Recherche 5207, Centre National de la Recherche Scientifique, Université Montpellier II; and
| | - Philippe Coubes
- 1Service de Neurochirurgie, Centre Hospitalier Régional Universitaire Montpellier
- 2Institut de Génomique Fonctionnele
- 3Centre National de la Recherche Scientifique Unité Mixte de la Recherche 5203
- 4U661, Institut National de la Santé et de la Recherche Médicale
- 5Université Montpellier I
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Robles SG, Gelisse P, El Fertit H, Tancu C, Duffau H, Crespel A, Coubes P. Parasagittal Transinsular Electrodes for Stereo-EEG in Temporal and Insular Lobe Epilepsies. Stereotact Funct Neurosurg 2009; 87:368-78. [PMID: 19844136 DOI: 10.1159/000249818] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2008] [Accepted: 03/17/2009] [Indexed: 11/19/2022]
Affiliation(s)
- Santiago Gil Robles
- Epilepsy Unit, Department of Neurosurgery, IGF-UMR CNRS 5203, INSERM U661, Montpellier, France
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