首页 > 最新文献

Revue neurologique最新文献

英文 中文
Discriminating factors in access to video-EEG for epilepsy surgery in a French tertiary epilepsy center 法国一家三级癫痫中心在癫痫手术中使用视频脑电图的鉴别因素。
IF 2.8 4区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-10-01 DOI: 10.1016/j.neurol.2024.04.003
Equitable access to care and management is a priority for patients with epilepsy and may vary depending on each country's healthcare system. As this issue has not been specifically addressed in France, we conducted a retrospective study to identify discriminating factors in access to surgery at a French tertiary epilepsy center. Initially, we examined factors previously identified in other countries as influential in surgery access, including age at diagnosis, affected side, gender, years of education, socio-professional categories, and density of general practitioners in the residential area, in 293 consecutive French-native patients with refractory medial temporal lobe epilepsy and hippocampal sclerosis (MTLE-HS). Subsequently, we conducted a case-control study comparing patients born in France with 22 patients born abroad to specifically explore migratory status. The analysis revealed that the only three factors statistically influencing the delay between the onset of epilepsy and entry into video-EEG were early age at onset (associated with a longer delay), pensioner status (associated with a longer delay), and student status (associated with a shorter delay). Migratory status, gender, and socio-economic level (indirectly reflected by the level of education and socio-professional category) were not found to be discriminatory factors in access to video-EEG. Discrepancies between our study and foreign studies may be attributed to differences in healthcare systems and medical coverage among countries. Efforts in France to improve access to surgery should focus on enhancing communication among practitioners to promptly refer any MTLE-HS patient to an epilepsy surgery center, regardless of their age.
公平地获得护理和管理是癫痫患者的首要任务,而每个国家的医疗体系可能会有所不同。由于这一问题在法国尚未得到专门解决,因此我们进行了一项回顾性研究,以确定在法国一家三级癫痫中心接受手术的歧视性因素。首先,我们对 293 名连续就诊的法国本土难治性颞叶内侧癫痫和海马硬化症(MTLE-HS)患者进行了检查,这些因素包括诊断时的年龄、患侧、性别、受教育年限、社会职业类别以及居住区全科医生的密度。随后,我们进行了一项病例对照研究,将出生在法国的患者与 22 名出生在国外的患者进行了比较,以具体探讨移民状况。分析结果显示,在统计学上影响癫痫发病与视频脑电图检查之间延迟时间的因素只有三个,即发病年龄早(与延迟时间较长有关)、领取养老金者身份(与延迟时间较长有关)和学生身份(与延迟时间较短有关)。移民身份、性别和社会经济水平(通过教育水平和社会职业类别间接反映)并未成为影响患者接受视频脑电图检查的歧视性因素。我们的研究与国外研究之间的差异可能归因于各国医疗系统和医疗覆盖范围的不同。法国在提高手术可及性方面的努力应侧重于加强从业人员之间的沟通,以便及时将任何 MTLE-HS 患者转诊至癫痫手术中心,无论其年龄大小。
{"title":"Discriminating factors in access to video-EEG for epilepsy surgery in a French tertiary epilepsy center","authors":"","doi":"10.1016/j.neurol.2024.04.003","DOIUrl":"10.1016/j.neurol.2024.04.003","url":null,"abstract":"<div><div><span>Equitable access to care and management is a priority for patients with epilepsy and may vary depending on each country's healthcare system. As this issue has not been specifically addressed in France, we conducted a retrospective study to identify discriminating factors in access to surgery at a French tertiary epilepsy center. Initially, we examined factors previously identified in other countries as influential in surgery access, including age at diagnosis, affected side, gender, years of education, socio-professional categories, and density of general practitioners in the residential area, in 293 consecutive French-native patients with refractory medial temporal lobe epilepsy and </span>hippocampal sclerosis<span> (MTLE-HS). Subsequently, we conducted a case-control study comparing patients born in France with 22 patients born abroad to specifically explore migratory status. The analysis revealed that the only three factors statistically influencing the delay between the onset of epilepsy and entry into video-EEG were early age at onset (associated with a longer delay), pensioner status (associated with a longer delay), and student status (associated with a shorter delay). Migratory status, gender, and socio-economic level (indirectly reflected by the level of education and socio-professional category) were not found to be discriminatory factors in access to video-EEG. Discrepancies between our study and foreign studies may be attributed to differences in healthcare systems and medical coverage among countries. Efforts in France to improve access to surgery should focus on enhancing communication among practitioners to promptly refer any MTLE-HS patient to an epilepsy surgery center, regardless of their age.</span></div></div>","PeriodicalId":21321,"journal":{"name":"Revue neurologique","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141162065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
French guidelines for the diagnosis and management of Tourette syndrome. 法国图雷特综合征诊断和管理指南。
IF 2.8 4区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-10-01 Epub Date: 2024-05-17 DOI: 10.1016/j.neurol.2024.04.005
A Hartmann, S Ansquer, C Brefel-Courbon, P Burbaud, A Castrioto, V Czernecki, P Damier, E Deniau, S Drapier, I Jalenques, O Marechal, T Priou, M Spodenkiewicz, S Thobois, A Roubertie, T Witjas, M Anheim
<p><p>The term "Gilles de la Tourette syndrome", or the more commonly used term "Tourette syndrome" (TS) refers to the association of motor and phonic tics which evolve in a context of variable but frequent psychiatric comorbidity. The syndrome is characterized by the association of several motor tics and at least one phonic tic that have no identifiable cause, are present for at least one year and appear before the age of 18. The presence of coprolalia is not necessary to establish or rule out the diagnosis, as it is present in only 10% of cases. The diagnosis of TS is purely clinical and is based on the symptoms defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). No additional tests are required to confirm the diagnosis of TS. However, to exclude certain differential diagnoses, further tests may be necessary. Very frequently, one or more psychiatric comorbidities are also present, including attention deficit hyperactivity disorder, obsessive-compulsive disorder, anxiety, explosive outbursts, self-injurious behaviors, learning disorders or autism spectrum disorder. The condition begins in childhood around 6 or 7 years of age and progresses gradually, with periods of relative waxing and waning of tics. The majority of patients experience improvement by the end of the second decade of life, but symptoms may persist into adulthood in around one-third of patients. The cause of TS is unknown, but genetic susceptibility and certain environmental factors appear to play a role. The treatment of TS and severe forms of tics is often challenging and requires a multidisciplinary approach (involving the general practitioner (GP), pediatrician, psychiatrist, neurologist, school or occupational physicians, psychologist and social workers). In mild forms, education (of young patients, parents and siblings) and psychological management are usually recommended. Medical treatments, including antipsychotics, are essential in the moderate to severe forms of the disease (i.e. when there is a functional and/or psychosocial discomfort linked to tics). Over the past decade, cognitive-behavioral therapies have been validated for the treatment of tics. For certain isolated tics, botulinum toxin injections may also be useful. Psychiatric comorbidities, when present, often require a specific treatment. For very severe forms of TS, treatment by deep brain stimulation offers real therapeutic hope. If tics are suspected and social or functional impairment is significant, specialist advice should be sought, in accordance with the patient's age (psychiatrist/child psychiatrist; neurologist/pediatric neurologist). They will determine tic severity and the presence or absence of comorbidities. The GP will take over the management and prescription of treatment: encouraging treatment compliance, assessing side effects, and combating stigmatization among family and friends. They will also play an important role in rehabilitation therapies, as well as in ensur
吉勒-德拉-图雷特综合征 "或更常用的术语 "图雷特综合征"(TS)是指运动性抽动和发音性抽动的综合征,这些抽动是在精神疾病并发症多变但频繁的情况下发生的。该综合征的特征是,患者伴有几种运动性抽动和至少一种发音性抽动,这些抽动无法确定原因,至少持续一年,并且在 18 岁之前出现。秽语抽动并不是确诊或排除诊断的必要条件,因为只有 10% 的病例会出现秽语抽动。TS 的诊断纯属临床诊断,以《精神疾病诊断与统计手册》(DSM-5)中定义的症状为依据。确诊 TS 无需进行其他检查。不过,为了排除某些鉴别诊断,可能需要进行进一步检查。很多情况下,TS 还伴有一种或多种精神并发症,包括注意力缺陷多动障碍、强迫症、焦虑症、爆发力、自伤行为、学习障碍或自闭症谱系障碍。这种病在儿童期约 6 或 7 岁时开始出现,病情逐渐发展,抽搐症状会有相对的消长期。大多数患者在第二个十年结束时症状会有所改善,但约有三分之一的患者症状会持续到成年。TS 的病因尚不清楚,但遗传易感性和某些环境因素似乎在其中发挥了作用。TS 和严重抽搐症的治疗通常具有挑战性,需要采用多学科方法(包括全科医生、儿科医生、精神科医生、神经科医生、学校或职业医生、心理学家和社会工作者)。对于轻度抽搐,通常建议对年轻患者、父母和兄弟姐妹进行教育和心理治疗。对于中度至重度患者(即因抽搐导致功能和/或心理不适),包括抗精神病药物在内的药物治疗是必不可少的。在过去十年中,认知行为疗法已被证实可用于治疗抽搐。对于某些孤立的抽搐,注射肉毒杆菌毒素也可能有用。如果存在精神并发症,通常需要进行特殊治疗。对于非常严重的 TS,脑深部刺激疗法带来了真正的治疗希望。如果怀疑患有抽搐症,且社交或功能障碍严重,则应根据患者的年龄寻求专科医生的建议(精神科医生/儿童精神科医生;神经科医生/儿童神经科医生)。他们将确定抽搐的严重程度以及是否存在合并症。全科医生将负责管理和开具治疗处方:鼓励患者遵从治疗、评估副作用、消除家人和朋友对患者的鄙视。他们还将在康复治疗中发挥重要作用,并确保在患者的学校或职业环境中为其提供便利。
{"title":"French guidelines for the diagnosis and management of Tourette syndrome.","authors":"A Hartmann, S Ansquer, C Brefel-Courbon, P Burbaud, A Castrioto, V Czernecki, P Damier, E Deniau, S Drapier, I Jalenques, O Marechal, T Priou, M Spodenkiewicz, S Thobois, A Roubertie, T Witjas, M Anheim","doi":"10.1016/j.neurol.2024.04.005","DOIUrl":"10.1016/j.neurol.2024.04.005","url":null,"abstract":"&lt;p&gt;&lt;p&gt;The term \"Gilles de la Tourette syndrome\", or the more commonly used term \"Tourette syndrome\" (TS) refers to the association of motor and phonic tics which evolve in a context of variable but frequent psychiatric comorbidity. The syndrome is characterized by the association of several motor tics and at least one phonic tic that have no identifiable cause, are present for at least one year and appear before the age of 18. The presence of coprolalia is not necessary to establish or rule out the diagnosis, as it is present in only 10% of cases. The diagnosis of TS is purely clinical and is based on the symptoms defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). No additional tests are required to confirm the diagnosis of TS. However, to exclude certain differential diagnoses, further tests may be necessary. Very frequently, one or more psychiatric comorbidities are also present, including attention deficit hyperactivity disorder, obsessive-compulsive disorder, anxiety, explosive outbursts, self-injurious behaviors, learning disorders or autism spectrum disorder. The condition begins in childhood around 6 or 7 years of age and progresses gradually, with periods of relative waxing and waning of tics. The majority of patients experience improvement by the end of the second decade of life, but symptoms may persist into adulthood in around one-third of patients. The cause of TS is unknown, but genetic susceptibility and certain environmental factors appear to play a role. The treatment of TS and severe forms of tics is often challenging and requires a multidisciplinary approach (involving the general practitioner (GP), pediatrician, psychiatrist, neurologist, school or occupational physicians, psychologist and social workers). In mild forms, education (of young patients, parents and siblings) and psychological management are usually recommended. Medical treatments, including antipsychotics, are essential in the moderate to severe forms of the disease (i.e. when there is a functional and/or psychosocial discomfort linked to tics). Over the past decade, cognitive-behavioral therapies have been validated for the treatment of tics. For certain isolated tics, botulinum toxin injections may also be useful. Psychiatric comorbidities, when present, often require a specific treatment. For very severe forms of TS, treatment by deep brain stimulation offers real therapeutic hope. If tics are suspected and social or functional impairment is significant, specialist advice should be sought, in accordance with the patient's age (psychiatrist/child psychiatrist; neurologist/pediatric neurologist). They will determine tic severity and the presence or absence of comorbidities. The GP will take over the management and prescription of treatment: encouraging treatment compliance, assessing side effects, and combating stigmatization among family and friends. They will also play an important role in rehabilitation therapies, as well as in ensur","PeriodicalId":21321,"journal":{"name":"Revue neurologique","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140958976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Importance of glucose and its metabolism in neurodegenerative disorder, as well as the combination of multiple therapeutic strategies targeting α-synuclein and neuroprotection in the treatment of Parkinson's disease 葡萄糖及其代谢在神经退行性疾病中的重要性,以及针对α-突触核蛋白和神经保护的多种治疗策略在帕金森病治疗中的联合应用。
IF 2.8 4区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-10-01 DOI: 10.1016/j.neurol.2023.08.011
According to recent findings, Phosphoglycerate Kinase 1 (pgk-1) enzyme is linked to Parkinson's disease (PD). Mutations in the PGK-1 gene lead to decreases in the pgk-1 enzyme which causes an imbalance in the levels of energy demand and supply. An increase in glycolytic adenosine triphosphate (ATP) production would help alleviate energy deficiency and sustain the acute energetic need of neurons. Neurodegeneration is caused by an imbalance or reduction in ATP levels. Recent data suggest that medications that increase glycolysis and neuroprotection can be used to treat PD. The current study focuses on treatment options for disorders associated with the pgk-1 enzyme, GLP-1, and A2A receptor which can be utilized to treat PD. A combination of metformin and terazosin, exenatide and meclizine, istradefylline and salbutamol treatments may benefit parkinsonism. The review also looked at potential target-specific new techniques that might assist in satisfying unfulfilled requirements in the treatment of PD.
根据最近的研究发现,磷酸甘油酸激酶1 (pgk-1)酶与帕金森病(PD)有关。PGK-1基因的突变导致PGK-1酶的减少,从而导致能量需求和供应水平的不平衡。糖酵解三磷酸腺苷(ATP)产生的增加有助于缓解能量缺乏和维持神经元的急性能量需求。神经退行性变是由ATP水平失衡或减少引起的。最近的数据表明,增加糖酵解和神经保护的药物可用于治疗帕金森病。目前的研究重点是与pgk-1酶、GLP-1和A2A受体相关的疾病的治疗选择,这些疾病可用于治疗PD。二甲双胍和特拉唑嗪、艾塞那肽和美甲嗪、依曲替林和沙丁胺醇联合治疗可能对帕金森病有益。该综述还着眼于潜在的靶向性新技术,这些新技术可能有助于满足PD治疗中未实现的要求。
{"title":"Importance of glucose and its metabolism in neurodegenerative disorder, as well as the combination of multiple therapeutic strategies targeting α-synuclein and neuroprotection in the treatment of Parkinson's disease","authors":"","doi":"10.1016/j.neurol.2023.08.011","DOIUrl":"10.1016/j.neurol.2023.08.011","url":null,"abstract":"<div><div>According to recent findings, Phosphoglycerate Kinase 1 (pgk-1) enzyme is linked to Parkinson's disease (PD). Mutations in the <em>PGK-1</em> gene lead to decreases in the pgk<em>-1</em> enzyme which causes an imbalance in the levels of energy demand and supply. An increase in glycolytic adenosine triphosphate (ATP) production would help alleviate energy deficiency and sustain the acute energetic need of neurons. Neurodegeneration is caused by an imbalance or reduction in ATP levels. Recent data suggest that medications that increase glycolysis and neuroprotection can be used to treat PD. The current study focuses on treatment options for disorders associated with the pgk<em>-1</em> enzyme, <em>GLP-1</em>, and A<sub>2A</sub> receptor which can be utilized to treat PD. A combination of metformin and terazosin, exenatide and meclizine, istradefylline and salbutamol treatments may benefit parkinsonism. The review also looked at potential target-specific new techniques that might assist in satisfying unfulfilled requirements in the treatment of PD.</div></div>","PeriodicalId":21321,"journal":{"name":"Revue neurologique","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138470764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Advocating for rituximab as first-line treatment for NMOSD-AQP4 patients in France: Cost and efficacy considerations 在法国倡导将利妥昔单抗作为 NMOSD-AQP4 患者的一线治疗:成本和疗效考虑因素。
IF 2.8 4区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-10-01 DOI: 10.1016/j.neurol.2024.06.003
{"title":"Advocating for rituximab as first-line treatment for NMOSD-AQP4 patients in France: Cost and efficacy considerations","authors":"","doi":"10.1016/j.neurol.2024.06.003","DOIUrl":"10.1016/j.neurol.2024.06.003","url":null,"abstract":"","PeriodicalId":21321,"journal":{"name":"Revue neurologique","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141538506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Pathways to epilepsy surgery in children with tuberous sclerosis complex-associated epilepsy 结节性硬化症复合体相关癫痫患儿接受癫痫手术的途径。
IF 2.8 4区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-10-01 DOI: 10.1016/j.neurol.2024.04.009

Background

Previous studies showed the efficacy of epilepsy surgery in carefully selected children with epilepsy associated with tuberous sclerosis complex. However, how this selection is conducted, and the characteristics of the patients brought to surgery are still poorly described. By conducting a multicentric retrospective cohort study covering the practice of the last twenty years, we describe the paths leading to epilepsy surgery in children with epilepsy associated with tuberous sclerosis complex.

Methods

We identified 84 children diagnosed with tuberous sclerosis complex and epilepsy by matching two exhaustive registries of genetic diseases and subsequent medical records reviews within two French neuropediatric and epilepsy centers. Demographic, clinical, longitudinal, and diagnostic and surgical procedures data were collected.

Results

Forty-six percent of the children were initially drug-resistant and 19% underwent resective surgery, most often before the age of four. Stereotactic electroencephalography was performed prior to surgery in 44% of cases. Fifty-seven and 43% of patients remained seizure-free one and ten years after surgery, respectively. In addition, 52% of initially drug-resistant patients who did not undergo surgery were seizure-free at the last follow-up. The number of anti-seizure medications required decreased in 50% of cases after surgery. Infantile spasms, intellectual disability, autism spectrum disorder or severe behavioral disorders were not contraindications to surgery but were associated with a higher rate of complications and a lower rate of seizure freedom after surgery.

Conclusion

Despite the assumption of complex multifocal epilepsy and practical difficulties in young children with tuberous sclerosis complex, successful surgery results are comparable with other populations of patients with drug-resistant epilepsy, and a spontaneous evolution to drug-sensitive epilepsy may occur in non-operated patients.
背景:以往的研究表明,对经过严格挑选的结节性硬化综合征癫痫患儿进行癫痫手术治疗具有疗效。然而,对于如何进行选择以及接受手术治疗的患者的特征,目前仍缺乏充分的描述。通过对过去二十年的临床实践进行多中心回顾性队列研究,我们描述了结节性硬化综合症相关癫痫患儿接受癫痫手术的途径:我们通过比对两份详尽的遗传病登记表以及随后在两家法国神经儿科和癫痫中心进行的病历审查,确定了 84 名被诊断患有结节性硬化症综合征和癫痫的儿童。收集了人口统计学、临床、纵向、诊断和手术数据:结果:46%的患儿最初具有耐药性,19%的患儿接受了切除手术,其中大部分患儿在四岁之前就接受了手术。44%的病例在手术前进行了立体定向脑电图检查。分别有57%和43%的患者在术后一年和十年仍无癫痫发作。此外,在最初耐药但未接受手术的患者中,52%的患者在最后一次随访时没有癫痫发作。50%的患者在手术后所需的抗癫痫药物数量有所减少。婴儿痉挛症、智力障碍、自闭症谱系障碍或严重行为障碍并非手术禁忌症,但与较高的并发症发生率和较低的术后无癫痫发作率有关:结论:尽管假定结节性硬化综合征幼儿患有复杂的多灶性癫痫并存在实际困难,但手术的成功率与其他耐药性癫痫患者不相上下,而且未接受手术的患者可能会自发演变为对药物敏感的癫痫。
{"title":"Pathways to epilepsy surgery in children with tuberous sclerosis complex-associated epilepsy","authors":"","doi":"10.1016/j.neurol.2024.04.009","DOIUrl":"10.1016/j.neurol.2024.04.009","url":null,"abstract":"<div><h3>Background</h3><div>Previous studies showed the efficacy of epilepsy surgery in carefully selected children with epilepsy associated with tuberous sclerosis complex. However, how this selection is conducted, and the characteristics of the patients brought to surgery are still poorly described. By conducting a multicentric retrospective cohort study covering the practice of the last twenty years, we describe the paths leading to epilepsy surgery in children with epilepsy associated with tuberous sclerosis complex.</div></div><div><h3>Methods</h3><div>We identified 84 children diagnosed with tuberous sclerosis complex and epilepsy by matching two exhaustive registries of genetic diseases and subsequent medical records reviews within two French neuropediatric and epilepsy centers. Demographic, clinical, longitudinal, and diagnostic and surgical procedures data were collected.</div></div><div><h3>Results</h3><div>Forty-six percent of the children were initially drug-resistant and 19% underwent resective surgery, most often before the age of four. Stereotactic electroencephalography was performed prior to surgery in 44% of cases. Fifty-seven and 43% of patients remained seizure-free one and ten years after surgery, respectively. In addition, 52% of initially drug-resistant patients who did not undergo surgery were seizure-free at the last follow-up. The number of anti-seizure medications required decreased in 50% of cases after surgery. Infantile spasms, intellectual disability, autism spectrum disorder or severe behavioral disorders were not contraindications to surgery but were associated with a higher rate of complications and a lower rate of seizure freedom after surgery.</div></div><div><h3>Conclusion</h3><div>Despite the assumption of complex multifocal epilepsy and practical difficulties in young children with tuberous sclerosis complex, successful surgery results are comparable with other populations of patients with drug-resistant epilepsy, and a spontaneous evolution to drug-sensitive epilepsy may occur in non-operated patients.</div></div>","PeriodicalId":21321,"journal":{"name":"Revue neurologique","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141311599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cortical type memory impairment in CADASIL: Watch out for the second train! CADASIL 的皮层型记忆障碍:小心第二列火车!
IF 2.8 4区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-10-01 DOI: 10.1016/j.neurol.2024.05.005
{"title":"Cortical type memory impairment in CADASIL: Watch out for the second train!","authors":"","doi":"10.1016/j.neurol.2024.05.005","DOIUrl":"10.1016/j.neurol.2024.05.005","url":null,"abstract":"","PeriodicalId":21321,"journal":{"name":"Revue neurologique","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141427507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The effectiveness and safety of non-pharmacological intervention for pain management in Parkinson's disease: A systematic review 帕金森病疼痛管理的非药物干预的有效性和安全性:一项系统综述。
IF 2.8 4区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-10-01 DOI: 10.1016/j.neurol.2023.04.010
Chronic pain is a non-motor symptom affecting from 60 to 80% of patients with Parkinson's disease (PD). PD patients can suffer from different types of pain, either specific or not specific of the disease, and depending on various pathophysiological mechanisms (nociceptive, nociplastic or neuropathic), which can be present at any stage of the disease. Non-pharmacological interventions (NPIs) are essential to complement routine care interventions in PD pain management. Moreover, in the literature, it has been shown that 42% of PD patients are already using complementary therapies. Hence, our aim was to investigate the effectiveness and safety of NPIs for pain management in PD. A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Eighteen published randomized control trials (RCTs) were included between 2004 and 2021 leading to a total of 976 PD patients. From them, we reported fifteen different NPIs classified in seven categories: physical exercises, balneotherapy, manual therapy, acupuncture, botanical preparation, body-psychological practice and multiprotection care. Our results have shown that NPIs for PD pain management had a low-to-moderate level of evidence showing mainly favourable results, even if some NPIs presented inconclusive results. Moreover, our review highlighted the clinical relevance of some specific NPIs in PD pain management: NPIs consisting of active physical activities, opposed to passive activities. The safety of NPIs was also confirmed since only few minor transient adverse events were reported. Nevertheless, even if some interesting results were found, the methodology of future studies needs to be more robust and to include comprehensive descriptions in order to offer reliable and sound recommendations to clinicians.
慢性疼痛是一种非运动症状,影响60%至80%的帕金森病(PD)患者。PD患者可能会遭受不同类型的疼痛,无论是疾病的特异性还是非特异性,并取决于各种病理生理机制(伤害性、伤害性或神经性),这些机制可能存在于疾病的任何阶段。非药物干预(NPI)对于补充PD疼痛管理中的常规护理干预至关重要。此外,在文献中,已经表明42%的帕金森病患者已经在使用补充疗法。因此,我们的目的是研究NPI在帕金森病疼痛管理中的有效性和安全性。根据系统评价和荟萃分析的首选报告项目(PRISMA)声明进行了系统评价。2004年至2021年间,纳入了18项已发表的随机对照试验(RCT),共有976名帕金森病患者。从中,我们报告了15种不同的NPI,分为七类:体育锻炼、温和疗法、手法疗法、针灸、植物制剂、身体心理实践和多重保护护理。我们的研究结果表明,用于PD疼痛管理的NPI具有低到中等水平的证据,显示出主要有利的结果,即使一些NPI呈现出不确定的结果。此外,我们的综述强调了一些特定NPI在PD疼痛管理中的临床相关性:NPI由主动的身体活动组成,而不是被动的活动。NPI的安全性也得到了证实,因为只有少数轻微的短暂不良事件被报道。然而,即使发现了一些有趣的结果,未来研究的方法也需要更加稳健,并包括全面的描述,以便为临床医生提供可靠和合理的建议。
{"title":"The effectiveness and safety of non-pharmacological intervention for pain management in Parkinson's disease: A systematic review","authors":"","doi":"10.1016/j.neurol.2023.04.010","DOIUrl":"10.1016/j.neurol.2023.04.010","url":null,"abstract":"<div><div>Chronic pain is a non-motor symptom affecting from 60 to 80% of patients with Parkinson's disease (PD). PD patients can suffer from different types of pain, either specific or not specific of the disease, and depending on various pathophysiological mechanisms (nociceptive, nociplastic or neuropathic), which can be present at any stage of the disease. Non-pharmacological interventions (NPIs) are essential to complement routine care interventions in PD pain management. Moreover, in the literature, it has been shown that 42% of PD patients are already using complementary therapies. Hence, our aim was to investigate the effectiveness and safety of NPIs for pain management in PD. A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Eighteen published randomized control trials (RCTs) were included between 2004 and 2021 leading to a total of 976 PD patients. From them, we reported fifteen different NPIs classified in seven categories: physical exercises, balneotherapy, manual therapy, acupuncture, botanical preparation, body-psychological practice and multiprotection care. Our results have shown that NPIs for PD pain management had a low-to-moderate level of evidence showing mainly favourable results, even if some NPIs presented inconclusive results. Moreover, our review highlighted the clinical relevance of some specific NPIs in PD pain management: NPIs consisting of active physical activities, opposed to passive activities. The safety of NPIs was also confirmed since only few minor transient adverse events were reported. Nevertheless, even if some interesting results were found, the methodology of future studies needs to be more robust and to include comprehensive descriptions in order to offer reliable and sound recommendations to clinicians.</div></div>","PeriodicalId":21321,"journal":{"name":"Revue neurologique","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41211163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Self-reported outcomes and quality of life of patients with non-dystrophic myotonia: The French IMPACT 2022 survey 非萎缩性肌张力障碍患者的自我报告结果和生活质量:法国 IMPACT 2022 调查。
IF 2.8 4区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-10-01 DOI: 10.1016/j.neurol.2024.04.007
Non-dystrophic myotonias (NDM) are disabling genetic diseases that impact quality of life. To reduce the impact of NDM, patients develop coping strategies such as lifestyle adaptation and avoiding key triggers. To understand how myotonia affects patients’ lives, the IMPACT survey, an online questionnaire on patient-reported outcomes, was developed based on international IMPACT questionnaire. The French IMPACT 2022 survey was completed by 47 NDM French patients. Besides muscle stiffness (98%), patients reported muscle pain (83%), falls (70%) and anxiety (77%). These issues negatively impacted abilities to work/study (49%), daily life at home (49%) and overall mobility outside (49%). Most patients (96%) reported ongoing pharmacological treatment (mexiletine, 91%) associated with improvement in muscle stiffness (100%) and reduction in falls (94%), muscle pain (87%) and anxiety (80%). Patients were moderately satisfied (19.1%), satisfied (42.6%) and very satisfied (29.8%) with the current management; 32% rated their quality of life positively (≥ 8 on 10-point scale). In conclusion, this French survey confirms the impact of myotonia on daily life and quality of life. The improvement in patient-reported outcomes in treated participants highlights the importance of managing myotonia with effective treatments. More work should be initiated to assess the importance of NDM symptom management and patients’ adherence and compliance to treatment.
非萎缩性肌营养不良症(NDM)是一种影响生活质量的致残性遗传疾病。为了减少 NDM 的影响,患者会制定应对策略,如调整生活方式和避免关键诱因。为了了解肌张力障碍对患者生活的影响,我们在国际IMPACT调查问卷的基础上开发了IMPACT调查,这是一份关于患者报告结果的在线调查问卷。47 名法国 NDM 患者完成了法国 IMPACT 2022 调查。除肌肉僵硬(98%)外,患者还报告了肌肉疼痛(83%)、跌倒(70%)和焦虑(77%)。这些问题对工作/学习能力(49%)、家庭日常生活能力(49%)和户外整体活动能力(49%)产生了负面影响。大多数患者(96%)表示正在接受药物治疗(美西律汀,91%),肌肉僵硬得到改善(100%),跌倒(94%)、肌肉疼痛(87%)和焦虑(80%)有所减轻。患者对目前的治疗方法表示基本满意(19.1%)、满意(42.6%)和非常满意(29.8%);32%的患者对自己的生活质量给予积极评价(10 分制≥ 8 分)。总之,这项法国调查证实了肌张力障碍对日常生活和生活质量的影响。接受治疗者的患者报告结果有所改善,这凸显了通过有效治疗控制肌张力障碍的重要性。应开展更多工作来评估非传染性肌张力障碍症状管理的重要性以及患者对治疗的依从性和顺应性。
{"title":"Self-reported outcomes and quality of life of patients with non-dystrophic myotonia: The French IMPACT 2022 survey","authors":"","doi":"10.1016/j.neurol.2024.04.007","DOIUrl":"10.1016/j.neurol.2024.04.007","url":null,"abstract":"<div><div>Non-dystrophic myotonias (NDM) are disabling genetic diseases that impact quality of life. To reduce the impact of NDM, patients develop coping strategies such as lifestyle adaptation and avoiding key triggers. To understand how myotonia affects patients’ lives, the IMPACT survey, an online questionnaire on patient-reported outcomes, was developed based on international IMPACT questionnaire. The French IMPACT 2022 survey was completed by 47 NDM French patients. Besides muscle stiffness (98%), patients reported muscle pain (83%), falls (70%) and anxiety (77%). These issues negatively impacted abilities to work/study (49%), daily life at home (49%) and overall mobility outside (49%). Most patients (96%) reported ongoing pharmacological treatment (mexiletine, 91%) associated with improvement in muscle stiffness (100%) and reduction in falls (94%), muscle pain (87%) and anxiety (80%). Patients were moderately satisfied (19.1%), satisfied (42.6%) and very satisfied (29.8%) with the current management; 32% rated their quality of life positively (≥ 8 on 10-point scale). In conclusion, this French survey confirms the impact of myotonia on daily life and quality of life. The improvement in patient-reported outcomes in treated participants highlights the importance of managing myotonia with effective treatments. More work should be initiated to assess the importance of NDM symptom management and patients’ adherence and compliance to treatment.</div></div>","PeriodicalId":21321,"journal":{"name":"Revue neurologique","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141176212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Imaging of impulse control disorders in Parkinson's disease. 帕金森病冲动控制障碍的成像。
IF 2.8 4区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-09-27 DOI: 10.1016/j.neurol.2024.09.004
S Prange, S Thobois

Impulse control disorders (ICD) are frequent and cumbersome behavioral disorders in patients with Parkinson's disease (PD). Understanding their pathophysiological underpinnings is crucial. Molecular imaging using positron emission tomography (PET) and single-photon emission computed tomography (SPECT) clearly indicates preexisting vulnerability and abnormal sensitization of the pre- and postsynaptic dopaminergic system. Functional magnetic resonance imaging (fMRI) studies reveal abnormal connectivity within the reward system involving the ventral striatum and orbitofrontal cortex. These alterations pinpoint the dysfunction of reinforcement learning in ICD, which is biased toward the overvaluation of reward and underestimation of risk, and the deficit in inhibitory control mechanisms related to abnormal connectivity within and between the limbic and the associative and motor networks.

冲动控制障碍(ICD)是帕金森病(PD)患者经常出现的繁琐行为障碍。了解其病理生理基础至关重要。使用正电子发射断层扫描(PET)和单光子发射计算机断层扫描(SPECT)进行的分子成像清楚地显示了突触前和突触后多巴胺能系统预先存在的脆弱性和异常敏感性。功能磁共振成像(fMRI)研究显示,奖赏系统内涉及腹侧纹状体和眶额皮层的连接异常。这些改变指出了 ICD 患者强化学习的功能障碍,即偏向于高估奖赏和低估风险,以及抑制控制机制的缺陷,这与边缘、联想和运动网络内部和之间的异常连接有关。
{"title":"Imaging of impulse control disorders in Parkinson's disease.","authors":"S Prange, S Thobois","doi":"10.1016/j.neurol.2024.09.004","DOIUrl":"https://doi.org/10.1016/j.neurol.2024.09.004","url":null,"abstract":"<p><p>Impulse control disorders (ICD) are frequent and cumbersome behavioral disorders in patients with Parkinson's disease (PD). Understanding their pathophysiological underpinnings is crucial. Molecular imaging using positron emission tomography (PET) and single-photon emission computed tomography (SPECT) clearly indicates preexisting vulnerability and abnormal sensitization of the pre- and postsynaptic dopaminergic system. Functional magnetic resonance imaging (fMRI) studies reveal abnormal connectivity within the reward system involving the ventral striatum and orbitofrontal cortex. These alterations pinpoint the dysfunction of reinforcement learning in ICD, which is biased toward the overvaluation of reward and underestimation of risk, and the deficit in inhibitory control mechanisms related to abnormal connectivity within and between the limbic and the associative and motor networks.</p>","PeriodicalId":21321,"journal":{"name":"Revue neurologique","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142352997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Eculizumab as rescue therapy in a context of dramatic NMOSD attack: Report of two cases. 在 NMOSD 急剧发作的情况下,将 Eculizumab 作为抢救疗法:两个病例的报告。
IF 2.8 4区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2024-09-23 DOI: 10.1016/j.neurol.2024.09.001
A San-Galli, H Chaumont, Q Bourgeois, J Roge, Q Lobjois, P Cabre
{"title":"Eculizumab as rescue therapy in a context of dramatic NMOSD attack: Report of two cases.","authors":"A San-Galli, H Chaumont, Q Bourgeois, J Roge, Q Lobjois, P Cabre","doi":"10.1016/j.neurol.2024.09.001","DOIUrl":"https://doi.org/10.1016/j.neurol.2024.09.001","url":null,"abstract":"","PeriodicalId":21321,"journal":{"name":"Revue neurologique","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142352996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Revue neurologique
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1