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Benis D, Voruz P, Chiuve SC, Garibotto V, Assal F, Krack P, Péron J, Fleury V. Electroencephalographic Abnormalities in a Patient Suffering from Long-Term Neuropsychological Complications following SARS-CoV-2 Infection. Case Rep Neurol 2024; 16:6-17. [PMID: 38179211 PMCID: PMC10764086 DOI: 10.1159/000535241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 11/07/2023] [Indexed: 01/06/2024] Open
Abstract
Introduction Emotional apathy has recently been identified as a common symptom of long COVID. While recent meta-analyses have demonstrated generalized EEG slowing with the emergence of delta rhythms in patients hospitalized for severe SARS-CoV-2 infection, no EEG study or dopamine transporter scintigraphy (DaTSCAN) has been performed in patients with long COVID presenting with apathy. The objective of this case report was to explore the pathophysiology of neuropsychological symptoms in long COVID. Case Presentation A 47-year-old patient who developed a long COVID with prominent apathy following an initially clinically mild SARS-CoV-2 infection underwent neuropsychological assessment, cerebral MRI, DaTSCAN, and resting-state high-density EEG 7 months after SARS-CoV-2 infection. The EEG data were compared to those of 21 healthy participants. The patient presented with apathy, cognitive difficulties with dysexecutive syndrome, moderate attentional and verbal episodic memory disturbances, and resolution of premorbid mild gaming disorder, mild mood disturbances, and sleep disturbances. His MRI and DaTSCAN were unremarkable. EEG revealed a complex pattern of oscillatory abnormalities compared to the control group, with a strong increase in whole-scalp delta and beta band activity, as well as a decrease in alpha band activity. Overall, these effects were more prominent in the frontal-central-temporal region. Conclusion These results suggest widespread changes in EEG oscillatory patterns in a patient with long COVID characterized by neuropsychological complications with prominent apathy. Despite the inherent limitations of a case report, these results suggest dysfunction in the cortical networks involved in motivation and emotion.
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Affiliation(s)
- Damien Benis
- Neurology Department, University Hospitals of Geneva, Geneva, Switzerland
- Department of Psychology and Educational Sciences, Clinical and Experimental Neuropsychology Laboratory, University of Geneva, Geneva, Switzerland
- Department of Psychology and Educational Sciences and Swiss Centre for Affective Sciences, Neuroscience of Emotion and Affective Dynamics (NEAD) Laboratory, University of Geneva, Geneva, Switzerland
| | - Philippe Voruz
- Neurology Department, University Hospitals of Geneva, Geneva, Switzerland
- Department of Psychology and Educational Sciences, Clinical and Experimental Neuropsychology Laboratory, University of Geneva, Geneva, Switzerland
- Department of Psychology and Educational Sciences and Swiss Centre for Affective Sciences, Neuroscience of Emotion and Affective Dynamics (NEAD) Laboratory, University of Geneva, Geneva, Switzerland
| | | | - Valentina Garibotto
- Nuclear Medicine and Molecular Division, University Hospitals of Geneva, Geneva, Switzerland
| | - Frédéric Assal
- Neurology Department, University Hospitals of Geneva, Geneva, Switzerland
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Paul Krack
- Neurology Department, University Bern, Bern, Switzerland
| | - Julie Péron
- Neurology Department, University Hospitals of Geneva, Geneva, Switzerland
- Department of Psychology and Educational Sciences, Clinical and Experimental Neuropsychology Laboratory, University of Geneva, Geneva, Switzerland
| | - Vanessa Fleury
- Neurology Department, University Hospitals of Geneva, Geneva, Switzerland
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
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Fleury V, Romascano D, Schneider D, Tuleasca C, Lorton O, Tomkova E, Catalano Chiuve S, Chytas V, Lüscher C, Burkhard PR, Salomir R, Levivier M, Momjian S. Successful MRI-Guided Focused Ultrasound Thalamotomy after Ipsilateral Gamma Knife Radiosurgery for Essential Tremor: A Case Report with Video. Stereotact Funct Neurosurg 2023; 101:380-386. [PMID: 37918368 DOI: 10.1159/000534014] [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: 03/24/2023] [Accepted: 09/03/2023] [Indexed: 11/04/2023]
Abstract
We report the case of a 67-year-old left-handed female patient with disabling medically refractory essential tremor who underwent successful right-sided magnetic resonance-guided focused ultrasound (MRgFUS) of the ventral intermediate nucleus after ipsilateral gamma knife radiosurgery (GKRS) thalamotomy performed 3 years earlier. The GKRS had a partial effect on her postural tremor without side effects, but there was no reduction of her kinetic tremor or improvement in her quality of life (QoL). The patient subsequently underwent a MRgFUS thalamotomy, which induced an immediate and marked reduction in both the postural and kinetic tremor components, with minor complications (left upper lip hypesthesia, dysmetria in her left hand, and slight gait ataxia). The MRgFUS-induced lesion was centered more medially than the GKRS-induced lesion and extended more posteriorly and inferiorly. The MRgFUS-induced lesion interrupted remaining fibers of the dentatorubrothalamic tract (DRTT). The functional improvement 1-year post-MRgFUS was significant due to a marked reduction of the patient's kinetic tremor. The QoL score (Quality of Life in Essential Tremor) improved by 88% and her Clinical Rating Scale for Tremor left hand score by 62%. The side effects persisted but were minor, with no impact on her QoL. The explanation for the superior efficacy of MRgFUS compared to GKRS in our patient could be due to either a poor response to the GKRS or to a better localization of the MRgFUS lesion with a more extensive interruption of DRTT fibers. In conclusion, MRgFUS can be a valuable therapeutic option after unsatisfactory GKRS, especially because MRgFUS has immediate clinical effectiveness, allowing intra-procedural test lesions and possible readjustment of the target if necessary.
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Affiliation(s)
- Vanessa Fleury
- Department of Neurology, Geneva University Hospital, Geneva, Switzerland
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - David Romascano
- Medical Image Processing Laboratory, Neuro-X Institute, Ecole Polytechnique Fédérale de Lausanne (EPFL), Geneva, Switzerland
| | - Damien Schneider
- Department of Neurology, Geneva University Hospital, Geneva, Switzerland
| | - Constantin Tuleasca
- Neurosurgery Service and Gamma Knife Center, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
- Faculty of Biology and Medicine (FBM), University of Lausanne, Lausanne, Switzerland
| | - Orane Lorton
- Image Guided Interventions Laboratory, University of Geneva, Geneva, Switzerland
- Division of Radiology, Geneva University Hospitals, Geneva, Switzerland
| | - Emilie Tomkova
- Department of Neurology, Geneva University Hospital, Geneva, Switzerland
| | | | - Vasileios Chytas
- Department of Psychiatry, Geneva University Hospital, Geneva, Switzerland
| | - Christian Lüscher
- Department of Neurology, Geneva University Hospital, Geneva, Switzerland
- Department of Basic Neurosciences, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Pierre R Burkhard
- Department of Neurology, Geneva University Hospital, Geneva, Switzerland
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Rares Salomir
- Image Guided Interventions Laboratory, University of Geneva, Geneva, Switzerland
- Division of Radiology, Geneva University Hospitals, Geneva, Switzerland
| | - Marc Levivier
- Neurosurgery Service and Gamma Knife Center, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
- Faculty of Biology and Medicine (FBM), University of Lausanne, Lausanne, Switzerland
| | - Shahan Momjian
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Department of Neurosurgery, Geneva University Hospital, Geneva, Switzerland
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Berthouzoz E, Lazarevic V, Zekeridou A, Castro M, Debove I, Aybek S, Schrenzel J, Burkhard PR, Fleury V. Oral and intestinal dysbiosis in Parkinson's disease. Rev Neurol (Paris) 2023; 179:937-946. [PMID: 36934020 DOI: 10.1016/j.neurol.2022.12.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 10/29/2022] [Accepted: 12/10/2022] [Indexed: 03/18/2023]
Abstract
The suspicion of an origin of Parkinson's disease (PD) at the periphery of the body and the involvement of environmental risk factors in the pathogenesis of PD have directed the attention of the scientific community towards the microbiota. The microbiota represents all the microorganisms residing both in and on a host. It plays an essential role in the physiological functioning of the host. In this article, we review the dysbiosis repeatedly demonstrated in PD and how it influences PD symptoms. Dysbiosis is associated with both motor and non-motor PD symptoms. In animal models, dysbiosis only promotes symptoms in individuals genetically susceptible to Parkinson's disease, suggesting that dysbiosis is a risk factor but not a cause of Parkinson's disease. We also review how dysbiosis contributes to the pathophysiology of PD. Dysbiosis induces numerous and complex metabolic changes, resulting in increased intestinal permeability, local and systemic inflammation, production of bacterial amyloid proteins that promote α-synuclein aggregation, as well as a decrease in short-chain fatty acid-producing bacteria that have anti-inflammatory and neuroprotective potential. In addition, we review how dysbiosis decreases the efficacy of dopaminergic treatments. We then discuss the interest of dysbiosis analysis as a biomarker of Parkinson's disease. Finally, we give an overview of how interventions modulating the gut microbiota such as dietary interventions, pro-biotics, intestinal decontamination and fecal microbiota transplantation could influence the course of PD.
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Affiliation(s)
- E Berthouzoz
- Faculty of Medicine, University of Geneva, Centre Médical Universitaire, 1211 Geneva 4, Switzerland
| | - V Lazarevic
- Faculty of Medicine, University of Geneva, Centre Médical Universitaire, 1211 Geneva 4, Switzerland; Genomic Research Laboratory, Department of Infectious Diseases, University Hospital of Geneva, 1211 Geneva 14, Switzerland
| | - A Zekeridou
- Division of Regenerative Dentistry and Periodontology, University Clinic of Dental Medicine, University of Geneva, 1211 Geneva 4, Switzerland
| | - M Castro
- Movement disorders Unit, Department of Neurology, University Hospital of Lausanne, 1011 Lausanne, Switzerland
| | - I Debove
- Movement disorders Unit, Department of Neurology, Inselspital, 3010 Bern, Switzerland
| | - S Aybek
- Psychosomatic Medicine Unit, Department of Neurology, Inselspital, 3010 Bern, Switzerland
| | - J Schrenzel
- Faculty of Medicine, University of Geneva, Centre Médical Universitaire, 1211 Geneva 4, Switzerland; Genomic Research Laboratory, Department of Infectious Diseases, University Hospital of Geneva, 1211 Geneva 14, Switzerland
| | - P R Burkhard
- Faculty of Medicine, University of Geneva, Centre Médical Universitaire, 1211 Geneva 4, Switzerland; Movement disorders Unit, Division of Neurology, Department of Clinical Neurosciences, University Hospital of Geneva, 1211 Geneva 14, Switzerland
| | - V Fleury
- Faculty of Medicine, University of Geneva, Centre Médical Universitaire, 1211 Geneva 4, Switzerland; Movement disorders Unit, Division of Neurology, Department of Clinical Neurosciences, University Hospital of Geneva, 1211 Geneva 14, Switzerland.
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Boëx C, Awadhi AA, Tyrand R, Corniola MV, Kibleur A, Fleury V, Burkhard PR, Momjian S. Validation of Lead-DBS β-Oscillation Localization with Directional Electrodes. Bioengineering (Basel) 2023; 10:898. [PMID: 37627782 PMCID: PMC10451384 DOI: 10.3390/bioengineering10080898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 07/17/2023] [Accepted: 07/21/2023] [Indexed: 08/27/2023] Open
Abstract
In deep brain stimulation (DBS) studies in patients with Parkinson's disease, the Lead-DBS toolbox allows the reconstruction of the location of β-oscillations in the subthalamic nucleus (STN) using Vercise Cartesia directional electrodes (Boston Scientific). The objective was to compare these probabilistic locations with those of intraoperative monopolar β-oscillations computed from local field potentials (0.5-3 kHz) recorded by using shielded single wires and an extracranial shielded reference electrode. For each electrode contact, power spectral densities of the β-band (13-31 Hz) were compared with those of all eight electrode contacts on the directional electrodes. The DBS Intrinsic Template AtLas (DISTAL), electrophysiological, and DBS target atlases of the Lead-DBS toolbox were applied to the reconstructed electrodes from preoperative MRI and postoperative CT. Thirty-six electrodes (20 patients: 7 females, 13 males; both STN electrodes for 16 of 20 patients; one single STN electrode for 4 of 20 patients) were analyzed. Stimulation sites both dorsal and/or lateral to the sensorimotor STN were the most efficient. In 33 out of 36 electrodes, at least one contact was measured with stronger β-oscillations, including 23 electrodes running through or touching the ventral subpart of the β-oscillations' probabilistic volume, while 10 did not touch it but were adjacent to this volume; in 3 out of 36 electrodes, no contact was found with β-oscillations and all 3 were distant from this volume. Monopolar local field potentials confirmed the ventral subpart of the probabilistic β-oscillations.
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Affiliation(s)
- Colette Boëx
- Department of Neurosurgery, University Hospitals of Geneva, CH-1205 Geneva, Switzerland (S.M.)
- Faculty of Medicine, University of Geneva, 1206 Geneva, Switzerland (P.R.B.)
| | - Abdullah Al Awadhi
- Department of Neurosurgery, University Hospitals of Geneva, CH-1205 Geneva, Switzerland (S.M.)
| | - Rémi Tyrand
- Department of Neurosurgery, University Hospitals of Geneva, CH-1205 Geneva, Switzerland (S.M.)
- Faculty of Medicine, University of Geneva, 1206 Geneva, Switzerland (P.R.B.)
| | - Marco V. Corniola
- Department of Neurosurgery, Pontchaillou Hospitals, CEDEX 9, F-35033 Rennes, France
| | - Astrid Kibleur
- Centre Hospitalier Universitaire Caen Normandie, F-14000 Caen, France
| | - Vanessa Fleury
- Faculty of Medicine, University of Geneva, 1206 Geneva, Switzerland (P.R.B.)
- Department of Neurosurgery, Pontchaillou Hospitals, CEDEX 9, F-35033 Rennes, France
| | - Pierre R. Burkhard
- Faculty of Medicine, University of Geneva, 1206 Geneva, Switzerland (P.R.B.)
| | - Shahan Momjian
- Department of Neurosurgery, University Hospitals of Geneva, CH-1205 Geneva, Switzerland (S.M.)
- Faculty of Medicine, University of Geneva, 1206 Geneva, Switzerland (P.R.B.)
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Stancu P, Catalano Chiuvé S, Sveikata L, Assal F, Fleury V. [Dementia with Lewy bodies: state of the art and perspectives for the clinician]. Rev Med Suisse 2023; 19:810-813. [PMID: 37133941 DOI: 10.53738/revmed.2023.19.824.810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Dementia with Lewy bodies (DLB) is one of the most common causes of dementia, after Alzheimer's disease (AD) and vascular dementia. Its diagnosis remains a challenge for the clinician because of the variety of clinical presentations and comorbidities. The diagnosis is based on clinical criteria such as cognitive fluctuations, visual hallucinations, progressive cognitive impairment, Parkinsonian signs and REM sleep behavioral disorder. Although not specific, biomarkers are helpful for increasing the likelihood of LBD diagnosis and for differentiating LBD from other differential diagnoses such as Parkinson's disease with dementia and Alzheimer's disease. Clinicians should be aware of LBD clinical features and actively look for them in patients with cognitive symptoms, take into consideration the often-associated co-pathologies and to optimize patient's management.
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Affiliation(s)
- Patrick Stancu
- Service de neurologie, Département de neurosciences cliniques, Hôpitaux universitaires de Genève et Faculté de médecine, Université de Genève, 1211 Genève 4
| | - Sabina Catalano Chiuvé
- Service de neurologie, Département de neurosciences cliniques, Hôpitaux universitaires de Genève et Faculté de médecine, Université de Genève, 1211 Genève 4
| | - Lukas Sveikata
- Service de neurologie, Département de neurosciences cliniques, Hôpitaux universitaires de Genève et Faculté de médecine, Université de Genève, 1211 Genève 4
| | - Frédéric Assal
- Service de neurologie, Département de neurosciences cliniques, Hôpitaux universitaires de Genève et Faculté de médecine, Université de Genève, 1211 Genève 4
| | - Vanessa Fleury
- Service de neurologie, Département de neurosciences cliniques, Hôpitaux universitaires de Genève et Faculté de médecine, Université de Genève, 1211 Genève 4
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Cailleteau A, Ferrer L, Movassaghi R, Geffroy D, Rousseau C, Doré M, Fleury V. Diagnostic différentiel entre radionécrose cérébrale et rechute locale après radiothérapie intracrânienne : intérêt de la TEP-IRM FDG ? Médecine Nucléaire 2023. [DOI: 10.1016/j.mednuc.2023.01.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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Fleury V. Microbiote et Parkinson. Rev Neurol (Paris) 2022. [DOI: 10.1016/j.neurol.2022.02.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Rousseau C, Le Thiec M, Maucherat B, Frindel M, Fleury V. [Place of molecular imaging in the management of prostate cancer]. Cancer Radiother 2021; 25:663-666. [PMID: 34404605 DOI: 10.1016/j.canrad.2021.07.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 07/01/2021] [Indexed: 11/19/2022]
Abstract
In the management of prostate cancer in recent years, innovative therapies have appeared requiring precise and reliable disease detection. In 2021, new generation imaging (PET/CT, multiparametric MRI, PET/MRI) have their place at all stages of the prostate cancer natural history to help target the lesion(s) and guide therapy and improve the results obtained. PSMA PET/CT is currently the leader in this type of imaging with a complete offer during the disease: both from diagnosis, to recurrence or in the oligo-metastatic and metastatic stage resistant to castration with a pivotal role in the PSMA theranostic approach. However, multiparametric MRI also has many detection advantages when the prostate is left in place, which suggests the potential major benefit of hybrid PSMA PET/MRI imaging.
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Affiliation(s)
- C Rousseau
- Département de médecine nucléaire, institut de cancérologie de l'Ouest, centre René-Gauducheau, boulevard Jacques-Monod, 44805 Saint-Herblain cedex, France; Université de Nantes, 44000 Nantes, France; Inserm, CNRS, CRCINA, 44000 Nantes, France.
| | - M Le Thiec
- Département de médecine nucléaire, institut de cancérologie de l'Ouest, centre René-Gauducheau, boulevard Jacques-Monod, 44805 Saint-Herblain cedex, France
| | - B Maucherat
- Département de médecine nucléaire, institut de cancérologie de l'Ouest, centre René-Gauducheau, boulevard Jacques-Monod, 44805 Saint-Herblain cedex, France
| | - M Frindel
- Département de pharmacie, institut de cancérologie de l'Ouest, centre René-Gauducheau, boulevard Jacques-Monod, 44805 Saint-Herblain cedex, France
| | - V Fleury
- Département de médecine nucléaire, institut de cancérologie de l'Ouest, centre René-Gauducheau, boulevard Jacques-Monod, 44805 Saint-Herblain cedex, France
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Fleury V, Zekeridou A, Lazarevic V, Gaïa N, Giannopoulou C, Genton L, Cancela J, Girard M, Goldstein R, Bally JF, Mombelli A, Schrenzel J, Burkhard PR. Oral Dysbiosis and Inflammation in Parkinson's Disease. J Parkinsons Dis 2021; 11:619-631. [PMID: 33646178 PMCID: PMC8150470 DOI: 10.3233/jpd-202459] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Background: Oral microbiota has largely escaped attention in Parkinson’s disease (PD), despite its pivotal role in maintaining oral and systemic health. Objective: The aim of our study was to examine the composition of the oral microbiota and the degree of oral inflammation in PD. Methods: Twenty PD patients were compared to 20 healthy controls. Neurological, periodontal and dental examinations were performed as well as dental scaling and gingival crevicular fluid sampling for cytokines measurement (interleukine (IL)-1β, IL-6, IL-1 receptor antagonist (RA), interferon-γ and tumor necrosis factor (TNF)-α). Two months later, oral microbiota was sampled from saliva and subgingival dental plaque. A 16S rRNA gene amplicon sequencing was used to assess bacterial communities. Results: PD patients were in the early and mid-stage phases of their disease (Hoehn & Yahr 2–2.5). Dental and periodontal parameters did not differ between groups. The levels of IL-1β and IL-1RA were significantly increased in patients compared to controls with a trend for an increased level of TNF-α in patients. Both saliva and subgingival dental plaque microbiota differed between patients and controls. Streptococcus mutans, Kingella oralis, Actinomyces AFQC_s, Veillonella AFUJ_s, Scardovia, Lactobacillaceae, Negativicutes and Firmicutes were more abundant in patients, whereas Treponema KE332528_s, Lachnospiraceae AM420052_s, and phylum SR1 were less abundant. Conclusion: Our findings show that the oral microbiome is altered in early and mid-stage PD. Although PD patients had good dental and periodontal status, local inflammation was already present in the oral cavity. The relationship between oral dysbiosis, inflammation and the pathogenesis of PD requires further study.
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Affiliation(s)
- Vanessa Fleury
- Faculty of Medicine, University of Geneva, CMU, Geneva, Switzerland.,Division of Neurology, Geneva University Hospitals, Geneva, Switzerland
| | - Alkisti Zekeridou
- University Clinic of Dental Medicine, Division of Periodontology, University of Geneva, Geneva, Switzerland
| | - Vladimir Lazarevic
- Genomic Research Laboratory, Service of Infectious Diseases, Geneva University Hospitals, Geneva, Switzerland
| | - Nadia Gaïa
- Genomic Research Laboratory, Service of Infectious Diseases, Geneva University Hospitals, Geneva, Switzerland
| | - Catherine Giannopoulou
- University Clinic of Dental Medicine, Division of Periodontology, University of Geneva, Geneva, Switzerland
| | - Laurence Genton
- Clinical Nutrition, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - José Cancela
- University Clinic of Dental Medicine, Division of Periodontology, University of Geneva, Geneva, Switzerland
| | - Myriam Girard
- Genomic Research Laboratory, Service of Infectious Diseases, Geneva University Hospitals, Geneva, Switzerland
| | - Rachel Goldstein
- Division of Neurology, Geneva University Hospitals, Geneva, Switzerland
| | - Julien F Bally
- Division of Neurology, Geneva University Hospitals, Geneva, Switzerland
| | - Andrea Mombelli
- University Clinic of Dental Medicine, Division of Periodontology, University of Geneva, Geneva, Switzerland
| | - Jacques Schrenzel
- Faculty of Medicine, University of Geneva, CMU, Geneva, Switzerland.,Genomic Research Laboratory, Service of Infectious Diseases, Geneva University Hospitals, Geneva, Switzerland
| | - Pierre R Burkhard
- Faculty of Medicine, University of Geneva, CMU, Geneva, Switzerland.,Division of Neurology, Geneva University Hospitals, Geneva, Switzerland
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Fleury V, Himsl R, Joost S, Nicastro N, Bereau M, Guessous I, Burkhard PR. Geospatial analysis of individual-based Parkinson's disease data supports a link with air pollution: A case-control study. Parkinsonism Relat Disord 2021; 83:41-48. [PMID: 33476876 DOI: 10.1016/j.parkreldis.2020.12.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 09/02/2020] [Revised: 12/18/2020] [Accepted: 12/18/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND The etiology of Parkinson's disease (PD) remains unknown. To approach the issue of PD's risk factors from a new perspective, we hypothesized that coupling the geographic distribution of PD with spatial statistics may provide new insights into environmental epidemiology research. The aim of this case-control study was to examine the spatial dependence of PD prevalence in the Canton of Geneva, Switzerland (population = 474,211). METHODS PD cases were identified through Geneva University Hospitals, private neurologists and nursing homes medical records (n = 1115). Controls derived from a population-based study (n = 12,614) and a comprehensive population census dataset (n = 237,771). All individuals were geographically localized based on their place of residence. Spatial Getis-Ord Gi* statistics were used to identify clusters of high versus low disease prevalence. Confounder-adjustment was performed for age, sex, nationality and income. Tukey's honestly significant difference was used to determine whether nitrogen dioxide and particulate matters PM10 concentrations were different within PD hotspots, coldspots or neutral areas. RESULTS Confounder-adjustment greatly reduced greatly the spatial association. Characteristics of the geographic space influenced PD prevalence in 6% of patients. PD hotspots were concentrated in the urban centre. There was a significant difference in mean annual nitrogen dioxide and PM10 levels (+3.6 μg/m3 [p < 0.001] and +0.63 μg/m3 [p < 0.001] respectively) between PD hotspots and coldspots. CONCLUSION PD prevalence exhibited a spatial dependence for a small but significant proportion of patients. A positive association was detected between PD clusters and air pollution. Our data emphasize the multifactorial nature of PD and support a link between PD and air pollution.
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Affiliation(s)
- Vanessa Fleury
- Division of Neurology, Geneva University Hospitals, 1211, Geneva 14, Switzerland; Faculty of Medicine, University of Geneva, CMU, 1211, Geneva 4, Switzerland.
| | - Rebecca Himsl
- Unit of Population Epidemiology, Division of Primary Care Medicine, Department of Primary Care Medicine, Geneva University Hospitals, 1211, Geneva 14, Switzerland; Geographic Information Research and Analysis in Population Health (GIRAPH) Group, Geneva University Hospitals, Geneva and Ecole Polytechnique Fédérale de Lausanne (EPFL), 1015, Lausanne, Switzerland; Laboratory of Geographical Information Systems (LASIG), School of Architecture, Civil and Environmental Engineering (ENAC), Ecole Polytechnique Fédérale de Lausanne (EPFL), 1015, Lausanne, Switzerland
| | - Stéphane Joost
- Geographic Information Research and Analysis in Population Health (GIRAPH) Group, Geneva University Hospitals, Geneva and Ecole Polytechnique Fédérale de Lausanne (EPFL), 1015, Lausanne, Switzerland; Laboratory of Geographical Information Systems (LASIG), School of Architecture, Civil and Environmental Engineering (ENAC), Ecole Polytechnique Fédérale de Lausanne (EPFL), 1015, Lausanne, Switzerland; La Source, School of Nursing, University of Applied Sciences and Arts Western Switzerland (HES-SO), Lausanne, Switzerland
| | - Nicolas Nicastro
- Division of Neurology, Geneva University Hospitals, 1211, Geneva 14, Switzerland; Department of Psychiatry, University of Cambridge, UK
| | - Matthieu Bereau
- Division of Neurology, Geneva University Hospitals, 1211, Geneva 14, Switzerland
| | - Idris Guessous
- Faculty of Medicine, University of Geneva, CMU, 1211, Geneva 4, Switzerland; Unit of Population Epidemiology, Division of Primary Care Medicine, Department of Primary Care Medicine, Geneva University Hospitals, 1211, Geneva 14, Switzerland; Geographic Information Research and Analysis in Population Health (GIRAPH) Group, Geneva University Hospitals, Geneva and Ecole Polytechnique Fédérale de Lausanne (EPFL), 1015, Lausanne, Switzerland
| | - Pierre R Burkhard
- Division of Neurology, Geneva University Hospitals, 1211, Geneva 14, Switzerland; Faculty of Medicine, University of Geneva, CMU, 1211, Geneva 4, Switzerland
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Nicastro N, Fleury V, Broc N, Burkhard PR, Garibotto V. Extrastriatal 123I-FP-CIT SPECT impairment in degenerative parkinsonisms. Parkinsonism Relat Disord 2020; 78:38-43. [DOI: 10.1016/j.parkreldis.2020.07.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 07/06/2020] [Accepted: 07/07/2020] [Indexed: 10/23/2022]
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12
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Fleury V, Catalano Chiuvé S, Forjaz MJ, Di Marco M, Messe M, Debove I, Angulo J, Hariz GM, Burkhard PR, Martinez-Martin P, Rodriguez-Blazquez C, Krack P. Embarrassment and Shame in People With Parkinson's Disease: A New Tool for Self-Assessment. Front Neurol 2020; 11:779. [PMID: 32849230 PMCID: PMC7411180 DOI: 10.3389/fneur.2020.00779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 06/24/2020] [Indexed: 11/13/2022] Open
Abstract
Shame and embarrassment related to Parkinson's disease (PD) are rarely addressed in clinical practice nor studied in neuroscience research, partly because no specific tool exists to detect them in PD. Objective: To develop a self-applied assessment tool of shame and embarrassment specifically related to PD or its treatment, to promptly identify the presence and severity of these two emotions in PD. Methods: Identification and selection of relevant items were obtained from the collection of PD patients' opinions during support groups and interviews. Several further items were added following a literature review. Subsequently, a two-phase pilot study was performed for identification of ambiguous items and omissions, and to obtain preliminary data on acceptability, reliability, validity and relevance of the new scale (SPARK). Results: A total of 105 PD patients were enrolled in the study. Embarrassment was reported in 85% of patients, while shame was present in 26%. Fifteen percent of patients did not describe any shame or embarrassment. On average, the intensity of these two emotions was low with a marked floor effect in SPARK items and subscales. However, SPARK total score inter-individual variability was important (range 1-84 out of 99). Acceptability and quality of data were satisfactory with no floor or ceiling effects (2.9% each) or missing data. Internal consistency (Cronbach's alpha) was 0.94 for total score and 0.73-0.87 for subscales. The scale correlated ≥0.60 with instruments measuring related constructs. Content validity was satisfactory. SPARK total score strongly correlated with impaired health-related quality of life (rS = 0.81), the propensity to feel embarrassed or ashamed (rS = 0.68 and 0.66, respectively), and anxiety (rS = 0.72) and depression (rS = 0.63) levels. Moderate to high correlations were observed between SPARK total score and apathy (rS = 0.46) and a more pronounced personality trait directed toward harm avoidance (rS = 0.46). No significant differences in SPARK scores were found by sex, education level, PD duration, Hoehn and Yahr stages or PD phenotype. Conclusion: Preliminary analysis of psychometric properties suggests that SPARK could be an acceptable and reliable instrument for assessing shame and embarrassment in PD. SPARK could help healthcare professionals to identify and characterize PD-induced shame and embarrassment.
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Affiliation(s)
- Vanessa Fleury
- Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Division of Neurology, Geneva University Hospitals, Geneva, Switzerland
| | | | - Maria João Forjaz
- National Centre of Epidemiology, Carlos III Institute of Health, REDISSEC, Madrid, Spain.,Center for Networked Biomedical Research in Neurodegenerative Diseases (CIBERNED), Carlos III Institute of Health, Madrid, Spain
| | | | - Maria Messe
- Division of Neurology, Geneva University Hospitals, Geneva, Switzerland
| | - Ines Debove
- Department of Neurology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland
| | - Julio Angulo
- Morningview Place, Lake Oswego, OR, United States.,Member, Persons With Parkinson's Advisory Council, Parkinson Foundation, Miami, FL, United States.,Member, Program Design Committee 2019 World Parkinson's Congress, World Parkinson's Coalition, New York, NY, United States
| | - Gun-Marie Hariz
- Department of Clinical Science, Neuroscience, Umeå University, Umeå, Sweden
| | - Pierre R Burkhard
- Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Division of Neurology, Geneva University Hospitals, Geneva, Switzerland
| | - Pablo Martinez-Martin
- Center for Networked Biomedical Research in Neurodegenerative Diseases (CIBERNED), Carlos III Institute of Health, Madrid, Spain
| | - Carmen Rodriguez-Blazquez
- National Centre of Epidemiology, Carlos III Institute of Health, REDISSEC, Madrid, Spain.,Center for Networked Biomedical Research in Neurodegenerative Diseases (CIBERNED), Carlos III Institute of Health, Madrid, Spain
| | - Paul Krack
- Department of Neurology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland
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13
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Béreau M, Kibleur A, Bouthour W, Tomkova Chaoui E, Maling N, Nguyen TAK, Momjian S, Vargas Gomez MI, Zacharia A, Bally JF, Fleury V, Tatu L, Burkhard PR, Krack P. Modeling of Electric Fields in Individual Imaging Atlas for Capsular Threshold Prediction of Deep Brain Stimulation in Parkinson's Disease: A Pilot Study. Front Neurol 2020; 11:532. [PMID: 32714264 PMCID: PMC7343907 DOI: 10.3389/fneur.2020.00532] [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: 02/16/2020] [Accepted: 05/13/2020] [Indexed: 12/30/2022] Open
Abstract
Background: Modeling of deep brain stimulation electric fields and anatomy-based software might improve post-operative management of patients with Parkinson's disease (PD) who have benefitted from subthalamic nucleus deep brain stimulation (STN-DBS). Objective: We compared clinical and software-guided determination of the thresholds for current diffusion to the pyramidal tract, the most frequent limiting side effect in post-operative management of STN-DBS PD patients. Methods: We assessed monopolar reviews in 16 consecutive STN-DBS PD patients and retrospectively compared clinical capsular thresholds, which had been assessed according to standard clinical practice, to those predicted by volume of tissue activated (VTA) model software. All the modeling steps were performed blinded from patients' clinical evaluations. Results: At the group level, we found a significant correlation (p = 0.0001) when performing statistical analysis on the z-scored capsular thresholds, but with a low regression coefficient (r = 0.2445). When considering intra-patient analysis, we found significant correlations (p < 0.05) between capsular threshold as modeled with the software and capsular threshold as determined clinically in five patients (31.2%). Conclusions: In this pilot study, the VTA model software was of limited assistance in identifying capsular thresholds for the whole cohort due to a large inter-patient variability. Clinical testing remains the gold standard in selecting stimulation parameters for STN-DBS in PD.
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Affiliation(s)
- Matthieu Béreau
- Department of Neurology, Besançon University Hospital, Besançon, France.,Department of Neurology, Geneva University Hospital, Geneva, Switzerland
| | - Astrid Kibleur
- Department of Neurology, Geneva University Hospital, Geneva, Switzerland
| | - Walid Bouthour
- Department of Neurology, Geneva University Hospital, Geneva, Switzerland
| | | | | | - T A Khoa Nguyen
- Department of Neurology, Bern University Hospital, Bern, Switzerland
| | - Shahan Momjian
- Department of Neurosurgery, Geneva University Hospital, Geneva, Switzerland
| | | | - André Zacharia
- Department of Neurology, Geneva University Hospital, Geneva, Switzerland
| | - Julien F Bally
- Department of Neurology, Geneva University Hospital, Geneva, Switzerland
| | - Vanessa Fleury
- Department of Neurology, Geneva University Hospital, Geneva, Switzerland
| | - Laurent Tatu
- Department of Neurology, Besançon University Hospital, Besançon, France
| | - Pierre R Burkhard
- Department of Neurology, Geneva University Hospital, Geneva, Switzerland
| | - Paul Krack
- Department of Neurology, Geneva University Hospital, Geneva, Switzerland.,Department of Neurology, Bern University Hospital, Bern, Switzerland
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14
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Dissaux G, Visvikis D, Pradier O, Chajon É, Barillot I, Duverge L, Masson I, Abgral R, Santiago Ribeiro MJ, Devillers A, Pallardy A, Fleury V, Mahé MA, de Crevoisier R, Hatt M, Schick U. Prédiction de la récidive locale par l’analyse de texture dérivée de l’imagerie tomographique par émission de positon (TEP/TDM) des cancers pulmonaires non à petites cellules localisés traités par irradiation stéréotaxique. Cancer Radiother 2019. [DOI: 10.1016/j.canrad.2019.07.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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15
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Bouthour W, Béreau M, Kibleur A, Zacharia A, Tomkova Chaoui E, Fleury V, Benis D, Momjian S, Bally J, Lüscher C, Krack P, Burkhard PR. Dyskinesia‐inducing lead contacts optimize outcome of subthalamic stimulation in Parkinson's disease. Mov Disord 2019; 34:1728-1734. [DOI: 10.1002/mds.27853] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 07/25/2019] [Accepted: 08/14/2019] [Indexed: 11/06/2022] Open
Affiliation(s)
- Walid Bouthour
- Department of Neurology Geneva University Hospital Geneva Switzerland
- Department of Basic Neuroscience University of Geneva Geneva Switzerland
| | - Matthieu Béreau
- Department of Neurology Geneva University Hospital Geneva Switzerland
| | - Astrid Kibleur
- Department of Neurology Geneva University Hospital Geneva Switzerland
| | - André Zacharia
- Department of Neurology Geneva University Hospital Geneva Switzerland
| | | | - Vanessa Fleury
- Department of Neurology Geneva University Hospital Geneva Switzerland
| | - Damien Benis
- Department of Neurology Geneva University Hospital Geneva Switzerland
| | - Shahan Momjian
- Department of Neurosurgery Geneva University Hospital Geneva Switzerland
| | - Julien Bally
- Department of Neurology Geneva University Hospital Geneva Switzerland
| | - Christian Lüscher
- Department of Neurology Geneva University Hospital Geneva Switzerland
- Department of Basic Neuroscience University of Geneva Geneva Switzerland
| | - Paul Krack
- Department of Neurology Geneva University Hospital Geneva Switzerland
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16
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Abstract
Shame is a self-conscious emotion marked by an intensely negative self-evaluation. It is exhibited by an individual upon realizing that she/he has violated an important (usually social) norm. Shame can be a source of emotional distress leading to social withdrawal and depression, with a significant negative impact on quality of life. In Parkinson’s disease (PD), shame is rarely addressed. Based on reports of persons affected with Parkinson’s disease (PwP) as well as a literature review, this article describes PD-related shame. PD-related shame may emerge from motor and non-motor symptoms, from self-perception of inadequacy due to loss of autonomy and need for help, or from perceived deterioration of body image. The neurobiology of shame delineates neuronal networks involved in cognitive and emotions regulation, self-representation and representation of the others mental states. Although this hypothesis remains to be demonstrated, these substrates could be modulated, at least partially, by dopaminergic depletion related to PD, which may open a window for pharmacotherapy. Owing to the negative impact that shame can produce, shame should be actively explored and addressed in the individual PwP. Teaching PwP how to develop resilience to shame may be a useful strategy in preventing the vicious circle of shame. The paucity of existing data on prevalence and management of PD-specific shame contrasts with the manifold reported situations inducing suffering from shame. There is a crucial need for further investigations of shame in PD and the development of interventions to reduce its impact on PwP’s quality of life.
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Affiliation(s)
- Julio Angulo
- Morningview Place, Lake Oswego, OR, USA.,Persons with Parkinson's Advisory Council, Parkinson Foundation, Miami-New York, USA.,Program Design Committee 2019 World Parkinson's Congress, World Parkinson's Coalition, NY, USA
| | - Vanessa Fleury
- Department of Neurology, Geneva University Hospital, Geneva, Switzerland.,Faculty of Medicine, University of Geneva, CMU, Geneva, Switzerland
| | - Julie Anne Péron
- Department of Psychology and Swiss Center for Affective Sciences, Neuroscience of Emotion and Affective Dynamics laboratory, University of Geneva, Geneva, Switzerland.,Department of Neurology, Neuropsychology Unit, University Hospitals of Geneva, Geneva, Switzerland
| | | | - Daniele Zullino
- Department of Psychiatry, Geneva University Hospital, Geneva, Switzerland
| | - Paul Krack
- Department of Neurology, Geneva University Hospital, Geneva, Switzerland.,Faculty of Medicine, University of Geneva, CMU, Geneva, Switzerland
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17
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Rousseau C, Le Thiec M, Ferrer L, Rusu D, Rauscher A, Maucherat B, Frindel M, Baumgartner P, Fleury V, Denis A, Debeaupuis E, Campion L, Kraeber-Bodéré F. Résultats préliminaires d’une étude prospective tep/tdm 68ga-psma chez des patients atteints de récidive occulte d’un cancer de la prostate : performances diagnostiques et impact sur la prise en charge thérapeutique. Prog Urol 2018. [DOI: 10.1016/j.purol.2018.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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18
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Béreau M, Fleury V, Bouthour W, Castrioto A, Lhommée E, Krack P. Hyperdopaminergic behavioral spectrum in Parkinson's disease: A review. Rev Neurol (Paris) 2018; 174:653-663. [DOI: 10.1016/j.neurol.2018.07.005] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 07/22/2018] [Accepted: 07/24/2018] [Indexed: 02/08/2023]
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19
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Fleury V, Brindel P, Nicastro N, Burkhard PR. Descriptive epidemiology of parkinsonism in the Canton of Geneva, Switzerland. Parkinsonism Relat Disord 2018; 54:30-39. [DOI: 10.1016/j.parkreldis.2018.03.030] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Revised: 02/12/2018] [Accepted: 03/29/2018] [Indexed: 01/01/2023]
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20
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Béreau M, Tomkova E, Zacharia A, Bouthour W, Fleury V, Bally JF, Horvath J, Momjian S, Lüscher C, Burkhard P, Krack P. [Advanced Parkinson's disease : indication for complex treatments]. Rev Med Suisse 2018; 14:875-878. [PMID: 29701432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Advanced Parkinson's disease (PD) is characterized by severe motor and non-motor complications that negatively impact on patients' autonomy and health-related quality of life. In early disease, the therapeutic strategy consists of gradual increase in dopaminergic treatment and levodopa dose fragmentation. In more advanced stages, this approach becomes insufficient and three therapeutic options can be considered: deep brain stimulation (DBS), continuous subcutaneous apomorphine infusion, and continuous levodopa/carbidopa intestinal gel infusion.
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Affiliation(s)
- Matthieu Béreau
- Service de neurologie, Département des neurosciences cliniques, HUG, 1211 Genève 14
| | - Emilie Tomkova
- Infirmière d'éducation thérapeutique, Service de neurologie, Département des neurosciences cliniques, HUG, 1211 Genève 14
| | - André Zacharia
- Service de neurologie, Département des neurosciences cliniques, HUG, 1211 Genève 14
| | - Walid Bouthour
- Service de neurologie, Département des neurosciences cliniques, HUG, 1211 Genève 14
| | - Vanessa Fleury
- Service de neurologie, Département des neurosciences cliniques, HUG, 1211 Genève 14
| | | | - Judit Horvath
- Service de neurologie, Département des neurosciences cliniques, HUG, 1211 Genève 14
| | - Shahan Momjian
- Service de neurologie, Département des neurosciences cliniques, HUG, 1211 Genève 14
| | - Christian Lüscher
- Service de neurologie, Département des neurosciences cliniques, HUG, 1211 Genève 14
| | - Pierre Burkhard
- Service de neurologie, Département des neurosciences cliniques, HUG, 1211 Genève 14
| | - Paul Krack
- Service de neurologie, Département des neurosciences cliniques, HUG, 1211 Genève 14
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21
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Burkhard PR, Horvath J, Fleury V, Zacharia A, Bally JF, Bereau M, Bouthour W, Lüscher C, Krack P. [Movement disorders emergencies]. Rev Med Suisse 2018; 14:888-891. [PMID: 29701435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Unlike most basal ganglia disorders, which usually progress slowly and relentlessly, a number of movement disorders may develop as acute or subacute conditions. Their occurrence commonly prompts patients to rush into the emergency room. A proper diagnosis is not always straightforward and requires a detailed analysis of the movement disorder phenomenology and a thorough medication screening, as many of these acute situations may be iatrogenic and drug-related. An accurate identification of the problem may enable an effective management and an appropriate therapy. This article is an overview of three distinct movement disorder emergencies, namely acute dystonia, acute chorea, and acute complications that can be observed in Parkinson's disease. Each topic is illustrated with a case report.
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Affiliation(s)
- Pierre R Burkhard
- Service de neurologie, Département des neurosciences cliniques, HUG, 1211 Genève 14
- Faculté de médecine, Université de Genève, 1211 Genève
| | - Judit Horvath
- Service de neurologie, Département des neurosciences cliniques, HUG, 1211 Genève 14
- Faculté de médecine, Université de Genève, 1211 Genève
| | - Vanessa Fleury
- Service de neurologie, Département des neurosciences cliniques, HUG, 1211 Genève 14
| | - André Zacharia
- Service de neurologie, Département des neurosciences cliniques, HUG, 1211 Genève 14
| | - Julien F Bally
- Service de neurologie, Département des neurosciences cliniques, HUG, 1211 Genève 14
| | - Matthieu Bereau
- Service de neurologie, Département des neurosciences cliniques, HUG, 1211 Genève 14
| | - Walid Bouthour
- Service de neurologie, Département des neurosciences cliniques, HUG, 1211 Genève 14
| | - Christian Lüscher
- Service de neurologie, Département des neurosciences cliniques, HUG, 1211 Genève 14
- Faculté de médecine, Université de Genève, 1211 Genève
| | - Paul Krack
- Service de neurologie, Département des neurosciences cliniques, HUG, 1211 Genève 14
- Faculté de médecine, Université de Genève, 1211 Genève
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22
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Frasca Polara G, Fleury V, Stone J, Barbey A, Burkhard PR, Vingerhoets F, Aybek S. Prevalence of functional (psychogenic) parkinsonism in two Swiss movement disorders clinics and review of the literature. J Neurol Sci 2018; 387:37-45. [PMID: 29571869 DOI: 10.1016/j.jns.2018.01.022] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Revised: 01/04/2018] [Accepted: 01/17/2018] [Indexed: 12/29/2022]
Abstract
BACKGROUND Functional parkinsonism (FP) is considered rare but no studies have looked at its frequency. Case series have described high rates of comorbidity with Parkinson's disease (PD), suggesting a possible association between these conditions. OBJECTIVES To study the prevalence, epidemiology and clinical features of FP and its association with PD. METHODS We conducted a cross-sectional population-based prevalence study as well as a chart review of cases who received a diagnosis of FP over a 10-year-period in two movement disorder clinics in Switzerland. Epidemiological data regarding FP features were collected. The co-occurrence of PD, psychiatric disorders and other functional disorders were recorded. Clinical differences between FP and FP+PD groups are presented and discussed in light of a literature review. RESULTS The crude prevalence of FP was 0.64 per 100,000 in our population. FP represented 0.24% of patients with parkinsonism. Among 12 FP cases, female gender predominance (87%), mean age of onset of 45.5(±13.3 Standard deviation SD) years and prolonged diagnostic delay (mean 59±75 SD months) was found. Six patients had an additional diagnosis of PD, 83% of depression and 66% of other functional neurological disorder. In four patients with FP+PD, FP preceded PD by 6 to 56months. CONCLUSIONS These results suggest that FP should be considered in the differential diagnosis of patients presenting with parkinsonism. The high rate of co-occurrence with PD emphasizes the importance of long-term follow up of these patients. The observation that FP often precedes PD should be verified in prospective studies.
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Affiliation(s)
- Giulia Frasca Polara
- Movement Disorder Unit, Hôpitaux Universitaires Genevois (HUG), Geneva, Switzerland.
| | - Vanessa Fleury
- Movement Disorder Unit, Hôpitaux Universitaires Genevois (HUG), Geneva, Switzerland
| | - Jon Stone
- Dpt Clinical Neurosciences, Western General Hospital, Edinburgh, United Kingdom
| | - Anita Barbey
- Movement Disorder Unit, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland; Universitätsklinik für Neurologie, InselSpital, Bern, Switzerland
| | - Pierre R Burkhard
- Movement Disorder Unit, Hôpitaux Universitaires Genevois (HUG), Geneva, Switzerland
| | - François Vingerhoets
- Movement Disorder Unit, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - Selma Aybek
- Movement Disorder Unit, Hôpitaux Universitaires Genevois (HUG), Geneva, Switzerland; Universitätsklinik für Neurologie, InselSpital, Bern, Switzerland.
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23
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Bouthour W, Wegrzyk J, Momjian S, Péron J, Fleury V, Tomkova Chaoui E, Horvath J, Boëx C, Lüscher C, Burkhard PR, Krack P, Zacharia A. Short pulse width in subthalamic stimulation in Parkinson's disease: a randomized, double-blind study. Mov Disord 2017; 33:169-173. [DOI: 10.1002/mds.27265] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Revised: 10/21/2017] [Accepted: 11/05/2017] [Indexed: 11/12/2022] Open
Affiliation(s)
- Walid Bouthour
- Department of Neurology; Geneva University Hospital; Geneva Switzerland
- Department of Basic Neuroscience; University of Geneva; Geneva Switzerland
| | - Jennifer Wegrzyk
- Department of Neurology; Geneva University Hospital; Geneva Switzerland
| | - Shahan Momjian
- Department of Neurosurgery; Geneva University Hospital; Geneva Switzerland
| | - Julie Péron
- Department of Neurology; Geneva University Hospital; Geneva Switzerland
| | - Vanessa Fleury
- Department of Neurology; Geneva University Hospital; Geneva Switzerland
| | | | - Judit Horvath
- Department of Neurology; Geneva University Hospital; Geneva Switzerland
| | - Colette Boëx
- Department of Neurology; Geneva University Hospital; Geneva Switzerland
| | - Christian Lüscher
- Department of Neurology; Geneva University Hospital; Geneva Switzerland
- Department of Basic Neuroscience; University of Geneva; Geneva Switzerland
| | | | - Paul Krack
- Department of Neurology; Geneva University Hospital; Geneva Switzerland
| | - André Zacharia
- Department of Neurology; Geneva University Hospital; Geneva Switzerland
- Sobell Department of Motor Neuroscience; UCL Institute of Neurology, National Hospital for Neurology and Neurosurgery; London UK
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24
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Bally JF, Vargas MI, Horvath J, Fleury V, Burkhard P, Momjian S, Pollak P, Boex C. Localization of Deep Brain Stimulation Contacts Using Corticospinal/Corticobulbar Tracts Stimulation. Front Neurol 2017; 8:239. [PMID: 28620349 PMCID: PMC5450375 DOI: 10.3389/fneur.2017.00239] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Accepted: 05/16/2017] [Indexed: 11/21/2022] Open
Abstract
Background Successful deep brain stimulation (DBS) in Parkinson’s disease (PD) requires optimal electrode placement. One technique of intraoperative electrode testing is determination of stimulation thresholds inducing corticospinal/corticobulbar tracts (CSBT) motor contractions. Objective This study aims to analyze correlations between DBS electrode distance to CSBT and contraction thresholds, with either visual or electromyography (EMG) detection, to establish an intraoperative tool devoted to ensure safe distance of the electrode to the CSBT. Methods Twelve PD patients with subthalamic nucleus DBS participated. Thresholds of muscular contractions were assessed clinically and with EMG, for three different sets of stimulation parameters, all monopolar: 130 Hz high-frequency stimulation (HFS); 2 Hz low-frequency stimulation with either 60 or 210 µs (LFS-60, LFS-210). The anatomical distance of electrode contacts to CSBT was measured from fused CT-MRI. Results The best linear correlation was found for thresholds of visually detected contractions with HFS (r2 = 0.63, p < 0.0001) when estimated stimulation currents rather than voltages were used. This correlation was found in agreement with an accepted model of electrical spatial extent of activation (r2 = 0.50). When using LFS, the correlation found remained lower than for HFS but increased when EMG was used. Indeed, the detection of contraction thresholds with EMG versus visual inspection did allow more frequent detection of face contractions, contributing to improve that correlation. Conclusion The correlation between electrode distance to the CSBT and contraction thresholds was found better when estimated with currents rather than voltage, eliminating the variance due to electrode impedance. Using LFS did not improve the precision of that evaluation, but EMG did. This technique provides a prediction band to ensure minimum distance of the electrode contacts to the CSBT, integrating the variance that can be encountered between prediction of models and practice.
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Affiliation(s)
- Julien F Bally
- Department of Neurology, University Hospitals of Geneva (HUG), Geneva, Switzerland.,Department of Neurology, Movement Disorders Research Center, Toronto Western Hospital, University of Toronto, Toronto, ON, Canada
| | - Maria-Isabel Vargas
- Department of Neuroradiology, University Hospitals of Geneva (HUG), Geneva, Switzerland
| | - Judit Horvath
- Department of Neurology, University Hospitals of Geneva (HUG), Geneva, Switzerland
| | - Vanessa Fleury
- Department of Neurology, University Hospitals of Geneva (HUG), Geneva, Switzerland
| | - Pierre Burkhard
- Department of Neurology, University Hospitals of Geneva (HUG), Geneva, Switzerland
| | - Shahan Momjian
- Department Neurosurgery, University Hospitals of Geneva (HUG), Geneva, Switzerland
| | - Pierre Pollak
- Department of Neurology, University Hospitals of Geneva (HUG), Geneva, Switzerland
| | - Colette Boex
- Department of Neurology, University Hospitals of Geneva (HUG), Geneva, Switzerland
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25
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Chevalier N, Gazguez E, Bidault L, Guilbert T, Vias C, Vian E, Watanabe Y, Muller L, Germain S, Bondurand N, Dufour S, Fleury V. How Tissue Mechanical Properties Affect Enteric Neural Crest Cell Migration. Sci Rep 2016; 6:20927. [PMID: 26887292 PMCID: PMC4757826 DOI: 10.1038/srep20927] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Accepted: 01/13/2016] [Indexed: 12/19/2022] Open
Abstract
Neural crest cells (NCCs) are a population of multipotent cells that migrate extensively during vertebrate development. Alterations to neural crest ontogenesis cause several diseases, including cancers and congenital defects, such as Hirschprung disease, which results from incomplete colonization of the colon by enteric NCCs (ENCCs). We investigated the influence of the stiffness and structure of the environment on ENCC migration in vitro and during colonization of the gastrointestinal tract in chicken and mouse embryos. We showed using tensile stretching and atomic force microscopy (AFM) that the mesenchyme of the gut was initially soft but gradually stiffened during the period of ENCC colonization. Second-harmonic generation (SHG) microscopy revealed that this stiffening was associated with a gradual organization and enrichment of collagen fibers in the developing gut. Ex-vivo 2D cell migration assays showed that ENCCs migrated on substrates with very low levels of stiffness. In 3D collagen gels, the speed of the ENCC migratory front decreased with increasing gel stiffness, whereas no correlation was found between porosity and ENCC migration behavior. Metalloprotease inhibition experiments showed that ENCCs actively degraded collagen in order to progress. These results shed light on the role of the mechanical properties of tissues in ENCC migration during development.
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Affiliation(s)
- N.R. Chevalier
- Laboratoire Matière et Systèmes Complexes, Université Paris-Diderot/CNRS UMR 7057, 10 rue Alice Domon et Léonie Duquet, 75013 Paris, France
| | - E. Gazguez
- UMR144, CNRS-Institut Curie, 26, rue d’Ulm, 75248 Paris cedex 05, France
| | - L. Bidault
- Collège de France, Center for Interdisciplinary Research in Biology (CIRB), Paris, F-75005, France
- INSERM, U1050, Paris, F-75005, France
- CNRS, UMR 7241, Paris, F-75005, France
| | - T. Guilbert
- INSERM, U1016, Institut Cochin, Paris, France
- CNRS, UMR8104, Paris, France
- Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - C. Vias
- Laboratoire Matière et Systèmes Complexes, Université Paris-Diderot/CNRS UMR 7057, 10 rue Alice Domon et Léonie Duquet, 75013 Paris, France
| | - E. Vian
- Laboratoire Matière et Systèmes Complexes, Université Paris-Diderot/CNRS UMR 7057, 10 rue Alice Domon et Léonie Duquet, 75013 Paris, France
| | - Y. Watanabe
- INSERM U955, Equipe 11, F-94000 Créteil, France
| | - L. Muller
- Collège de France, Center for Interdisciplinary Research in Biology (CIRB), Paris, F-75005, France
- INSERM, U1050, Paris, F-75005, France
- CNRS, UMR 7241, Paris, F-75005, France
| | - S. Germain
- Collège de France, Center for Interdisciplinary Research in Biology (CIRB), Paris, F-75005, France
- INSERM, U1050, Paris, F-75005, France
- CNRS, UMR 7241, Paris, F-75005, France
| | | | - S. Dufour
- UMR144, CNRS-Institut Curie, 26, rue d’Ulm, 75248 Paris cedex 05, France
| | - V. Fleury
- Laboratoire Matière et Systèmes Complexes, Université Paris-Diderot/CNRS UMR 7057, 10 rue Alice Domon et Léonie Duquet, 75013 Paris, France
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Fleury V, Pollak P, Gere J, Tommasi G, Romito L, Combescure C, Bardinet E, Chabardes S, Momjian S, Krainik A, Burkhard P, Yelnik J, Krack P. Subthalamic stimulation may inhibit the beneficial effects of levodopa on akinesia and gait. Mov Disord 2016; 31:1389-97. [PMID: 26887333 DOI: 10.1002/mds.26545] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Revised: 12/15/2015] [Accepted: 12/16/2015] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Gait and akinesia deterioration in PD patients during the immediate postoperative period of DBS has been directly related to stimulation in the subthalamic region. The underlying mechanisms remain poorly understood. The aim of the present study was to clinically and anatomically describe this side effect. METHODS PD patients presenting with a worsening of gait and/or akinesia following STN-DBS, that was reversible on stimulation arrest were included. The evaluation included (1) a Stand Walk Sit Test during a monopolar survey of each electrode in the on-drug condition; (2) a 5-condition test with the following conditions: off-drug/off-DBS, off-drug/on-best-compromise-DBS, on-drug/off-DBS, on-drug/on-best-compromise-DBS, and on-drug/on-worsening-DBS, which utilized the contact inducing the most prominent gait deterioration. The following scales were performed: UPDRSIII subscores, Stand Walk Sit Test, and dyskinesia and freezing of gait scales. Localization of contacts was performed using a coregistration method. RESULTS Twelve of 17 patients underwent the complete evaluation. Stimulation of the most proximal contacts significantly slowed down the Stand Walk Sit Test. The on-drug/on-worsening-DBS condition compared with the on-drug/off-DBS condition worsened akinesia (P = 0.02), Stand Walk Sit Test (P = 0.001), freezing of gait (P = 0.02), and improved dyskinesias (P = 0.003). Compared with the off-drug/off-DBS condition, the on-drug/on-worsening-DBS condition improved rigidity (P = 0.007) and tremor (P = 0.007). Worsening contact sites were predominantly dorsal and anterior to the STN in the anterior zona incerta and Forel fields H2. CONCLUSIONS A paradoxical deterioration of gait and akinesia is a rare side effect following STN-DBS. We propose that this may be related to misplaced contacts, and we discuss the pathophysiology and strategies to identify and manage this complication. © 2016 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Vanessa Fleury
- Department of Neurology, Geneva University Hospital, Geneva, Switzerland. .,Movement Disorder Unit, Department of Psychiatry and Neurology, Grenoble University Hospital, Grenoble, France.
| | - Pierre Pollak
- Department of Neurology, Geneva University Hospital, Geneva, Switzerland.,Movement Disorder Unit, Department of Psychiatry and Neurology, Grenoble University Hospital, Grenoble, France
| | - Julien Gere
- Movement Disorder Unit, Department of Psychiatry and Neurology, Grenoble University Hospital, Grenoble, France.,Department of Neurology, Savoie Hospital, Chambery, France
| | - Giorgio Tommasi
- Movement Disorder Unit, Department of Psychiatry and Neurology, Grenoble University Hospital, Grenoble, France.,Department of Neurology, University Hospital of Verona, Verona, Italy
| | - Luigi Romito
- Movement Disorder Unit, Department of Psychiatry and Neurology, Grenoble University Hospital, Grenoble, France.,Department of Neurology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
| | - Christophe Combescure
- Department of Health and Community Medicine, Geneva University Hospital, Geneva, Switzerland
| | - Eric Bardinet
- Sorbonne Université, UPMC Univ Paris, Inserm U975, CNRS UMR 7225, Centre de Neuroimagerie de Recherche, Institut du Cerveau et de la Moelle Épinière, Paris, France
| | - Stephan Chabardes
- Department of Neurosurgery, Grenoble University Hospital, Grenoble, France
| | - Shahan Momjian
- Department of Neurosurgery, Geneva University Hospital, Geneva, Switzerland
| | - Alexandre Krainik
- US 017, INSERM, UMS 3552, CNRS, Grenoble University Hospital, Neuroradiology and MRI, Grenoble, France
| | - Pierre Burkhard
- Department of Neurology, Geneva University Hospital, Geneva, Switzerland
| | - Jérôme Yelnik
- Sorbonne Université, UPMC Univ Paris, Inserm U975, CNRS UMR 7225, Centre de Neuroimagerie de Recherche, Institut du Cerveau et de la Moelle Épinière, Paris, France
| | - Paul Krack
- Movement Disorder Unit, Department of Psychiatry and Neurology, Grenoble University Hospital, Grenoble, France.,INSERM U836, University Grenoble Alpes, Grenoble Neuroscience Institute, Grenoble, France
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Chevalier NR, Dantan P, Gazquez E, Cornelissen AJM, Fleury V. Water jet indentation for local elasticity measurements of soft materials. Eur Phys J E Soft Matter 2016; 39:10. [PMID: 26830759 DOI: 10.1140/epje/i2016-16010-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Accepted: 10/07/2015] [Indexed: 06/05/2023]
Abstract
We present a novel elastography method for soft materials (100Pa-100kPa) based on indentation by a μm-sized water jet. We show that the jet creates a localized deformation ("cavity") of the material that can be easily visualized. We study experimentally how cavity width and depth depend on jet speed, height, incidence angle and sample elasticity. We describe how to calibrate the indenter using gels of known stiffness. We then demonstrate that the indenter yields quantitative elasticity values within 10% of those measured by shear rheometry. We corroborate our experimental findings with fluid-solid finite-element simulations that quantitatively predict the cavity profile and fluid flow lines. The water jet indenter permits in situ local stiffness measurements of 2D or 3D gels used for cell culture in physiological buffer, is able to assess stiffness heterogeneities with a lateral resolution in the range 50-500μm (at the tissue scale) and can be assembled at low cost with standard material from a biology laboratory. We therefore believe it will become a valuable method to measure the stiffness of a wide range of soft, synthetic or biological materials.
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Affiliation(s)
- N R Chevalier
- Laboratoire Matière et Systèmes Complexes, Université Paris Diderot/CNRS UMR 7057, 10 rue Alice Domon et Léonie Duquet, 75013, Paris, France.
| | - Ph Dantan
- Laboratoire Matière et Systèmes Complexes, Université Paris Diderot/CNRS UMR 7057, 10 rue Alice Domon et Léonie Duquet, 75013, Paris, France
| | - E Gazquez
- CNRS-Institut Curie, UMR144, 26, rue d'Ulm, 75248, Paris cedex 05, France
- Present address: INSERM U955, Equipe 6, F-94000, Créteil, France
| | - A J M Cornelissen
- Laboratoire Matière et Systèmes Complexes, Université Paris Diderot/CNRS UMR 7057, 10 rue Alice Domon et Léonie Duquet, 75013, Paris, France
| | - V Fleury
- Laboratoire Matière et Systèmes Complexes, Université Paris Diderot/CNRS UMR 7057, 10 rue Alice Domon et Léonie Duquet, 75013, Paris, France
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Horvath J, Chiuvé SC, Gronchi-Perrin A, Zacharia A, Wider C, Fleury V. [Trajectory of a patient with deep brain stimulation (DBS)]. Rev Med Suisse 2015; 11:968-971. [PMID: 26062222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
An eligibility assessment for deep brain stimulation is performed in order to select patients who are likely to benefit from it. Parkinson's patients have to stop dopaminergic drugs the day before surgery. During the operation, the patient must remain awake for recording of neuronal activity and for test stimulations to optimize the position of the electrodes. Postoperatively, the stimulation is increased progressively in parallel with a decrease of dopaminergic treatments. After about ten days, the patient can return to home and controls continue as an outpatient. Three months postoperatively, a complete testing of the neurostimulator is performed and at the one year follow-up visit, the effectiveness of the DBS is assessed.
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Fleury V, Vingerhoets F, Horvath J, Pollak P, Burkhard P. [Deep brain stimulation for movement disorders: indications, results and complications]. Rev Med Suisse 2015; 11:962-967. [PMID: 26062221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Movement disorders such as Parkinson's disease (PD), essential tremor (ET) and dystonia can benefit from deep brain stimulation (DBS). DBS is considered when symptoms are disabling despite optimal medical therapy. Contraindications include dementia, uncontrolled psychiatric disease and/or comorbid conditions with potential for evolution. Targets are the subthalamic nucleus for PD, the ventral intermediate nucleus for ET and the globus pallidus internus for dystonia. The beneficial effet of DBS has been well documented for symptom control. Optimal target localization of the electrodes reduces the occurrence of side-effects. Stimulation-induced adverse effects can usually be abolished by turning the stimulation off, changing the active contact or other stimulation parameters.
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Troussier I, Fleury V, Bernadeau S, Bolan G, Garcia A, Bensadoun R, Guérif S. Cancer de la prostate localisé, à risque intermédiaire ou élevé, dont le traitement a été une radiothérapie externe et incluant une curiethérapie de haut débit de dose : expérience du pôle régional de cancérologie de Poitou-Charentes. Cancer Radiother 2014. [DOI: 10.1016/j.canrad.2014.07.102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Fleury V, Spielberger S, Wolf E, Yelnik J, Fraix V, Poewe W, Pollak P. Vertical supranuclear gaze palsy induced by deep brain stimulation: report of two cases. Parkinsonism Relat Disord 2014; 20:1295-7. [PMID: 25172124 DOI: 10.1016/j.parkreldis.2014.07.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2014] [Revised: 07/04/2014] [Accepted: 07/12/2014] [Indexed: 11/30/2022]
Affiliation(s)
- Vanessa Fleury
- Department of Neurology, Geneva University Hospital, Site Cluse-Roseraie, Rue Micheli-du-Crest 24, 1211 Geneva 14, Switzerland.
| | - Sabine Spielberger
- Department of Neurology, Medical University Innsbruck, Innsbruck, Austria
| | - Elisabeth Wolf
- Department of Neurology, Medical University Innsbruck, Innsbruck, Austria
| | - Jérôme Yelnik
- Pierre and Marie Curie University-Paris 6, Centre de Recherche de l'Institut du cerveau et de la Moelle épinière, Paris, France
| | - Valérie Fraix
- Department of Neurology, Grenoble University Hospital, Grenoble, France
| | - Werner Poewe
- Department of Neurology, Medical University Innsbruck, Innsbruck, Austria
| | - Pierre Pollak
- Department of Neurology, Geneva University Hospital, Geneva, Switzerland
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Fleury V, Cousin E, Czernecki V, Schmitt E, Lhommée E, Poncet A, Fraix V, Troprès I, Pollak P, Krainik A, Krack P. Dopaminergic modulation of emotional conflict in Parkinson's disease. Front Aging Neurosci 2014; 6:164. [PMID: 25100991 PMCID: PMC4107849 DOI: 10.3389/fnagi.2014.00164] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Accepted: 06/29/2014] [Indexed: 12/13/2022] Open
Abstract
Neuropsychiatric fluctuations in Parkinson's disease (PD) are frequent and disabling. One way to investigate them is to assess the ability to inhibit distractive emotional information by a modified emotional Stroop (ES) task. We compared non-depressed, non-demented PD patients with healthy controls. During an acute levodopa challenge, patients performed a modified ES task during functional MRI and a neuropsychological assessment including Visual Analog Mood (VAMS) and Apathy scales. Ten patients and 12 controls completed the study. The VAMS scores were significantly improved by the acute intake of levodopa (p = 0.02), as was the apathy score (p = 0.03). Negative ES task (i.e. fearful facial expressions with the words "happy" or "fear" written across them), induced a lengthening of the mean reaction time during the incongruent trials compared with the congruent trials in controls (relative difference = 2.7%, p < 0.001) and in ON patients (relative difference = 5.9%, p < 0.001), but not in OFF patients (relative difference = 1.7%, p = 0.28). Controls and ON patients displayed greater activation than OFF patients within the right pregenual anterior cingulate cortex (pACC), an area specifically involved in emotional conflict resolution (p < 0.001 and p < 0.008 respectively, k > 5 uncorrected). No difference in the activation of the pACC was found between controls and ON patients, suggesting a normalization of the activation following levodopa administration. These results suggest that emotional conflict processes could be dopamine-dependent. Pregenual ACC hypoactivation could be directly due to the degeneration of dopaminergic mesocorticolimbic pathway. Our results propose that neuropsychiatric fluctuations in PD patients could be partially explained by pACC hypoactivation and that adjustments of dopaminergic medication might be helpful for their treatment.
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Affiliation(s)
- Vanessa Fleury
- Department of Neurology, Geneva University Hospital Geneva, Switzerland ; Movement Disorder Unit, Department of Psychiatry and Neurology, Grenoble University Hospital Grenoble, France
| | - Emilie Cousin
- Psychology and Neurocognition Laboratory, UMR CNRS 5105, Pierre Mendès-France University Grenoble, France
| | - Virginie Czernecki
- Unit 610, Federation of Nervous System Disease, National Institute of Health and Medical Research (INSERM), Pitié-Salpêtrière Hospital Paris, France
| | - Emmanuelle Schmitt
- Movement Disorder Unit, Department of Psychiatry and Neurology, Grenoble University Hospital Grenoble, France
| | - Eugénie Lhommée
- Movement Disorder Unit, Department of Psychiatry and Neurology, Grenoble University Hospital Grenoble, France
| | - Antoine Poncet
- Department of Health and Community Medicine, Geneva University Hospital Geneva, Switzerland
| | - Valérie Fraix
- Movement Disorder Unit, Department of Psychiatry and Neurology, Grenoble University Hospital Grenoble, France ; Joseph Fourier University - Grenoble I Grenoble, France ; Grenoble Neuroscience Institute, INSERM-UJF-CEA-CHU U836 Grenoble, France
| | - Irène Troprès
- IRMaGe, Université Grenoble Alpes Grenoble, France ; US 017, INSERM Grenoble, France ; UMS 3552, CNRS Grenoble, France
| | - Pierre Pollak
- Department of Neurology, Geneva University Hospital Geneva, Switzerland ; Movement Disorder Unit, Department of Psychiatry and Neurology, Grenoble University Hospital Grenoble, France
| | - Alexandre Krainik
- US 017, INSERM Grenoble, France ; UMS 3552, CNRS Grenoble, France ; Neuroradiology and MRI, Grenoble University Hospital Grenoble, France
| | - Paul Krack
- Movement Disorder Unit, Department of Psychiatry and Neurology, Grenoble University Hospital Grenoble, France ; Joseph Fourier University - Grenoble I Grenoble, France ; Grenoble Neuroscience Institute, INSERM-UJF-CEA-CHU U836 Grenoble, France
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Abstract
Recent technical advances including digital imaging and particle image velocimetry can be used to extract the full range of embryonic movements that constitute the instantaneous 'morphogenetic fields' of a developing animal. The final shape of the animal results from the sum over time (integral) of the movements that make up the velocity fields of all the tissue constituents. In vivo microscopy can be used to capture the details of vertebrate development at the earliest embryonic stages. The movements thus observed can be quantitatively compared to physical models that provide velocity fields based on simple hypotheses about the nature of living matter (a visco-elastic gel). This approach has cast new light on the interpretation of embryonic movement, folding, and organisation. It has established that several major discontinuities in development are simple physical changes in boundary conditions. In other words, with no change in biology, the physical consequences of collisions between folds largely explain the morphogenesis of the major structures (such as the head). Other discontinuities result from changes in physical conditions, such as bifurcations (changes in physical behaviour beyond specific yield points). For instance, beyond a certain level of stress, a tissue folds, without any new gene being involved. An understanding of the physical features of movement provides insights into the levers that drive evolution; the origin of animals is seen more clearly when viewed under the light of the fundamental physical laws (Newton's principle, action-reaction law, changes in symmetry breaking scale). This article describes the genesis of a vertebrate embryo from the shapeless stage (round mass of tissue) to the development of a small, elongated, bilaterally symmetric structure containing vertebral precursors, hip and shoulder enlarges, and a head.
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Affiliation(s)
- V Fleury
- Laboratoire matière et systèmes complexes, université Paris-Diderot, 10, rue Alice-Domon-et-Léonie-Duquet, 75013 Paris, France.
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Krainik A, Maillet A, Fleury V, Sahin M, Troprès I, Lamalle L, Thobois S, Fraix V, Villien M, Warnking J, Pollak P, Pinto S, Krack P. Levodopa does not change cerebral vasoreactivity in Parkinson's disease. Mov Disord 2012; 28:469-75. [DOI: 10.1002/mds.25267] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2012] [Revised: 09/27/2012] [Accepted: 09/30/2012] [Indexed: 11/09/2022] Open
Affiliation(s)
| | | | | | - Mehmet Sahin
- Department of Neuroradiology and MRI; University Hospital of Grenoble; Grenoble; France
| | | | | | - Stephane Thobois
- Hospices Civils de Lyon; Hôpital Neurologique; Université Lyon I; Faculté de Médecine Lyon Sud; CNRS; UMR 5229; Lyon; France
| | | | | | | | - Pierre Pollak
- Department of Neurology; University Hospitals of Geneva; Geneva; Switzerland
| | - Serge Pinto
- Laboratoire Parole et Langage; UMR 7309 CNRS/Aix-Marseille University; Aix-en-Provence; France
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Abstract
Electrochemical deposition (ECD) of metals is a very old subject[l], which has considerable applications in the context of electroshaping or electroplating. Electrochemists and chemical engineers have long known the different growth conditions of these metal aggregates and the different parameters which drive morphological changes, at least empirically [2-4]. However, in the recent years, after the introduction of the concept of fractal aggregation[5,6], in the field of non-linear pattern formation[7,8], a lot of work has been devoted to the specific problem of growth of electrodeposits from binary electrolytes [9-51] (i.e. without supporting electrolyte). These studies aimed at understanding the morphology, on the large scale (∼1cm) of the deposits and, more specifically, the transitions between morphologies. It is the aim of this paper to review the progress which has been achieved in the past five years on this question.
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Fleury V, Sabourdy C, Minotti L, Kahane P, Vercueil L. Effet de la pointe centrotemporale sur l’EMG dans une population d’enfants atteints d’épilepsie à paroxysmes rolandiques. Rev Neurol (Paris) 2012. [DOI: 10.1016/j.neurol.2012.01.320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Fleury V. A change in boundary conditions induces a discontinuity of tissue flow in chicken embryos and the formation of the cephalic fold. Eur Phys J E Soft Matter 2011; 34:73. [PMID: 21792746 DOI: 10.1140/epje/i2011-11073-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2010] [Revised: 03/15/2011] [Accepted: 07/01/2011] [Indexed: 05/31/2023]
Abstract
The morphogenesis of vertebrate body parts remains an open question. It is not clear whether the existence of different structures, such as a head, can be addressed by fundamental laws of tissue movement and deformation, or whether they are only a sequence of stop-and-go genetic instructions. I have filmed by time-lapse microscopy the formation of the presumptive head territory in chicken embryos. I show that the early lateral evagination of the eye cups and of the mesencephalic plate is a consequence of a sudden change in boundary conditions of the initial cell flow occurring in these embryos. Due to tissue flow, and collision of the two halves of the embryo, the tissue sheet movement is first dipolar, and next quadrupolar. In vivo air puff tonometry reveals a simple visco-elastic behaviour of the living material. The jump from a dipolar to a quadrupolar flow changes the topology of the early morphogenetic field which is observed towards a complex vortex winding with a trail (the eye cups and brain folds). The hydrodynamical model accounts for the discontinuity of the vector field at the moment of collision of the left and right halves of the embryo, at a quantitative level. This suggests a possible mechanism for the morphogenesis of the head of amniotes, as compared to cephalochordates and anamniotes.
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Affiliation(s)
- V Fleury
- Laboratoire Matière et Systèmes Complexes, Université Paris Diderot, 10 rue Alice Domon et Léonie Duquet, 75013 Paris, France.
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Thobois S, Ardouin C, Schmitt E, Lhommée E, Klinger H, Xie J, Lagrange C, Kistner A, Aya Kombo M, Fleury V, Poisson A, Fraix V, Broussolle E, Pollak P, Krack P. [Behavioral disorders in Parkinson's disease: from pathophysiology to the mastery of dopaminergic treatment]. Rev Neurol (Paris) 2010; 166:816-21. [PMID: 20739041 DOI: 10.1016/j.neurol.2010.07.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2010] [Accepted: 07/07/2010] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Behavioral changes in Parkinson's disease are complex and their pathophysiology is not yet fully understood. The dopaminergic system seems to play a major role and most of the behavioral disorders in Parkinson's disease can be classified into either hypodopaminergic if related to the disease itself or hyperdopaminergic if related to dopaminergic treatment. STATE OF THE ART Subthalamic stimulation, which enables withdrawal of dopaminergic medication at an advanced stage in the disease, provides a model for the study of certain nonmotor, dopamine-sensitive symptoms. Such a study has shown that apathy, which is the most frequent behavioral problem in Parkinson's disease, is part of a much broader hypodopaminergic behavioral syndrome which also includes anxiety and depression. Nonmotor fluctuations--essential fluctuations in the patient's psychological state--are an expression of mesolimbic denervation, as shown in positron emission tomography. Drug-induced sensitization of the denervated mesolimbic system accounts for hyperdopaminergic behavioral problems that encompass impulse control disorders that can be alternatively classified as behavioral addictions. The association of impulse control disorders and addiction to the dopaminergic medication has been called dopamine dysregulation syndrome. While L-dopa is the most effective treatment for motor symptoms, dopamine agonists are more effective in improving the nonmotor levodopa-sensitive symptoms. On the other hand, L-dopa induces more motor complications and dopamine agonist more behavioral side effects. There is increasing data and awareness that patients' quality of life appears to be dictated by hypo- and hyperdopaminergic psychological symptoms stemming from mesolimbic denervation and dopaminergic treatment rather than by motor symptoms and motor complications related to nigrostriatal denervation and dopaminergic treatment. PERSPECTIVES Better management requires knowledge of the clinical syndromes of hyper- and hypodopaminergic behaviors and nonmotor fluctuations, a better understanding of their underlying mechanisms and the development of new evaluation tools for these nonmotor symptoms. CONCLUSIONS The neurologist who strives to gain mastery of dopaminergic treatment needs to fine tune the dosage of levodopa and dopamine agonists on an individual basis, depending on the presence of motor and nonmotor signs respectively.
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Affiliation(s)
- S Thobois
- Service de Neurologie C, Université Lyon-I, Hospices Civils, Hôpital Neurologique Pierre-Wertheimer, 69500 Bron, France
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Fleury V, Aqallal A, Lagrange E, Besson G, Caudie C. Acute bilateral mydriasis associated with anti-GQ1b antibody. J Clin Neurosci 2010; 17:514-5. [PMID: 20093031 DOI: 10.1016/j.jocn.2009.06.030] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2009] [Accepted: 06/20/2009] [Indexed: 10/19/2022]
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Abstract
A 48-year-old woman with temporal lobe epilepsy and no prior history of psychiatric illness was started on topiramate (TPM). The dose was titrated up to 150 mg twice daily over 14 weeks and led to a significant reduction in seizure frequency. Upon reaching this dose, she developed intense pruritus and the firm belief that her skin was infected by parasites. She was diagnosed with delusional parasitosis (DP). Consequently, her TPM was weaned off and her DP settled completely without the use of antipsychotic medication. DP is characterized by the unshakeable conviction that small organisms infest the body despite the absence of confirmatory medical evidence. DP can occur in a wide variety of organic and psychiatric disorders or as an isolated delusional disorder. Rarely DP can be drug-induced. While psychiatric symptoms are a well recognized side-effect of TPM, this is, to our knowledge, the first reported case of TPM-induced DP.
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Affiliation(s)
- V Fleury
- Neurology Department, Royal Adelaide Hospital, North Terrace, Adelaide, South Australia 5000, Australia
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Fleury V, Kleinig TJ, Thompson PD, Ravindran J. Cardio-embolic cerebellar stroke secondary to mitral valve chordae rupture as a delayed complication of a high-voltage electrical injury. J Clin Neurosci 2008; 15:210-2. [DOI: 10.1016/j.jocn.2006.09.008] [Citation(s) in RCA: 4] [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: 08/12/2006] [Accepted: 09/04/2006] [Indexed: 11/26/2022]
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le Noble F, Fleury V, Pries A, Corvol P, Eichmann A, Reneman RS. Control of arterial branching morphogenesis in embryogenesis: go with the flow. Cardiovasc Res 2005; 65:619-28. [PMID: 15664388 DOI: 10.1016/j.cardiores.2004.09.018] [Citation(s) in RCA: 118] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2004] [Revised: 09/16/2004] [Accepted: 09/20/2004] [Indexed: 11/26/2022] Open
Abstract
Formation of a properly branched vascular system during embryogenesis is crucial for embryo survival. Here we review the regulation of the morphogenesis of the arterial and venous system during embryogenesis. We show that in addition to deterministic patterning mechanisms and plasticity of endothelial cells, arterial-venous differentiation and branching morphogenesis involves a prominent role for blood flow. Based on in vivo observations of developing arteries, we identified a novel morphological event crucial for the morphogenesis of the arterial tree, disconnection of small side branches. This disconnection of side branches occurs exactly at the point of bifurcation. The rate of disconnection of side branches depends on flow velocity and branching angle. The balance between disconnection and maintenance of arterial side branches determines the number of side branches connected to a large artery. Based on these observations, we postulate that the number of pre-existing collaterals connected to a large artery is a function of the disconnection process and can be regulated by hemodynamics. We furthermore show that embryonic arteries already adapt their lumen diameter to the amount of flow carried. Taken together, we suggest that hemodynamics plays a pivotal role in shaping the arterial system. We suggest that flow-evoked remodeling processes determine the number of preexisting collaterals during critical periods of embryo-fetal development. Insight into these basic principles of arterial growth and branching during embryogenesis may aid to understanding the observed variability in the capacity to establish a collateral circulation in patients with ischemic diseases and finding new strategies for therapeutic arteriogenesis.
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Affiliation(s)
- F le Noble
- Collège de France, Laboratoire de Médecine Expérimentale, Inserm U36, 11 Place Marcelin Berthelot, Paris 75231, France.
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Abstract
It is generally difficult to find any relationship between the morphogenesis of an organ and its final function. A priori, such a relationship has no reason to exist, since organs do not actually function during their formation. I will show in this article that, for a very large class of organs--the branched organs--there exists a hidden relationship between their morphogenesis and their function. This class of organs comprises: the lungs, the salivary mammary and lacrymal glands, the kidneys, the pancreas, and possibly other organs, such as testes. For all these organs, a fundamental fact that comes from recent developments in physics explains at the same time how they form, and why they work. This suggests, first, that complex organs are not the result of gradual and long selection processes, and, second, that this specific structure for the organs is imposed by the laws of physics. The growth process, as described here, is possibly the only one that allows both to build a fluid-secreting organ, and make it work.
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Affiliation(s)
- V Fleury
- Laboratoire de physique de la matière condensée, Ecole Polytechnique/CNRS, 91128 Palaiseau, France.
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Fleury V. Branching morphogenesis in a reaction-diffusion model. Phys Rev E Stat Phys Plasmas Fluids Relat Interdiscip Topics 2000; 61:4156-4160. [PMID: 11088210 DOI: 10.1103/physreve.61.4156] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/1999] [Revised: 12/20/1999] [Indexed: 05/23/2023]
Abstract
I show that a class of reaction-diffusion models of vasculature growth developed in the mid 1970s is in fact a class of dendritic growth models. I then comment on the relevance of these models.
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Affiliation(s)
- V Fleury
- Laboratoire de Physique de la Matiere Condensee, Ecole Polytechnique, 91128 Palaiseau cedex, France
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Jagerschmidt A, Fleury V, Anger-Leroy M, Thomas C, Agnel M, O'brien DP. Human thrombopoietin structure-function relationships: identification of functionally important residues. Biochem J 1998; 333 ( Pt 3):729-34. [PMID: 9677334 PMCID: PMC1219638 DOI: 10.1042/bj3330729] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [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: 11/17/2022]
Abstract
Thrombopoietin (TPO) is a haematopoietic growth factor responsible for megakaryocyte progenitor proliferation and differentiation. It belongs to the four-helix-bundle cytokine family and exerts its biological effects through binding to a specific receptor, c-Mpl. With the use of site-directed mutagenesis we have generated 20 TPO mutants. Each of the TPO mutants was produced in a eukaryotic expression system and the mutants' ability to induce the proliferation of factor-dependent c-Mpl-expressing megakaryoblastic M-O7e cells was compared with that of wild-type TPO. Among the mutations studied, 10 lead to a significant decrease in TPO bioactivity. Of these ten residues, three are located in helix A of the protein (Arg10, Lys14 and Arg17) and four in helix D (His133, Gln132, Lys138 and Phe141), indicating that in TPO, as in other cytokines, these two helices are important for functional cytokine/receptor interactions. Surprisingly, mutant Arg10-->Ala (R10A) lacked any proliferative activity, despite the fact that this mutation was recently reported to have no effect on TPO/c-Mpl binding in a TPO phage ELISA [Pearce, Potts, Presta, Bald, Fendly and Wells (1997) J. Biol. Chem. 272, 20595-20602]. The lack of M-O7e proliferation is probably due to an inability of R10A mutant to promote receptor dimerization and thus receptor activation. Moreover we found that the Arg10 and Arg17 residues of TPO seem to be specific determinants for TPO/c-Mpl recognition. We also demonstrate that the O-glycosylation site located at position 110 of TPO is not necessary for the bioactivity of the cytokine.
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Affiliation(s)
- A Jagerschmidt
- Synthélabo Recherche, Department of Genomic Biology, 10 rue des Carrières, 92500 Rueil-Malmaison, France
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Chazalviel J, Fleury V. Comment on "Modeling of metal electrodeposits: Analytical solutions". Phys Rev E Stat Phys Plasmas Fluids Relat Interdiscip Topics 1996; 54:4480-4481. [PMID: 9965610 DOI: 10.1103/physreve.54.4480] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
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Balazs L, Fleury V, Duclos F. Fractal growth of silicon-rich domains during annealing of aluminum thin films deposited on silica. Phys Rev E Stat Phys Plasmas Fluids Relat Interdiscip Topics 1996; 54:599-604. [PMID: 9965104 DOI: 10.1103/physreve.54.599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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Fleury V, Kaufman J, Hibbert B. Evolution of the space-charge layer during electrochemical deposition with convection. Phys Rev E Stat Phys Plasmas Fluids Relat Interdiscip Topics 1993; 48:3831-3840. [PMID: 9961040 DOI: 10.1103/physreve.48.3831] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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