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The pattern of cortical thickness associated with executive dysfunction in MCI and SCC: The MEMENTO cohort. 与 MCI 和 SCC 执行功能障碍相关的皮层厚度模式:MEMENTO 队列。
IF 3 4区 医学 Q2 Medicine Pub Date : 2024-06-11 DOI: 10.1016/j.neurol.2024.02.394
D Andriuta, M Roussel, G Chene, C Fischer, J-F Mangin, B Dubois, B Vellas, F Pasquier, F Tison, F Blanc, O Hanon, C Paquet, A Gabelle, M Ceccaldi, C Annweiler, P Krolak-Salmon, R David, I Rouch-Leroyer, A Benetos, O Moreaud, F Sellal, I Jalenques, P Vandel, V Bouteloup, O Godefroy

Background: The association between the pattern of cortical thickness (CT) and executive dysfunction (ED) in mild cognitive impairment (MCI) and subjective cognitive complaints (SCC) is still poorly understood. We aimed to investigate the association between CT and ED in a large French cohort (MEMENTO) of 2323 participants with MCI or SCC.

Methods: All participants with available CT and executive function data (verbal fluency and Trail Making Test [TMT]) were selected (n=1924). Linear regressions were performed to determine relationships between executive performance and the brain parenchymal fraction (BPF) and CT using FreeSurfer.

Results: The global executive function score was related to the BPF (sß: 0.091, P<0.001) and CT in the right supramarginal (sß: 0.060, P=0.041) and right isthmus cingulate (sß: 0.062, P=0.011) regions. Literal verbal fluency was related to the BPF (sß: 0.125, P<0.001) and CT in the left parsorbitalis region (sß: 0.045, P=0.045). Semantic verbal fluency was related to the BPF (sß: 0.101, P<0.001) and CT in the right supramarginal region (sß: 0.061, P=0.042). The time difference between the TMT parts B and A was related to the BPF (sß: 0.048, P=0.045) and CT in the right precuneus (sß: 0.073, P=0.019) and right isthmus cingulate region (sß: 0.054, P=0.032).

Conclusions: In a large clinically based cohort of participants presenting with either MCI or SCC (a potential early stage of Alzheimer's disease [AD]), ED was related to the BPF and CT in the left pars orbitalis, right precuneus, right supramarginal, and right isthmus cingulate regions. This pattern of lesions adds knowledge to the conventional anatomy of ED and could contribute to the early diagnosis of AD.

背景:人们对轻度认知障碍(MCI)和主观认知抱怨(SCC)患者皮层厚度(CT)模式与执行功能障碍(ED)之间的关系仍然知之甚少。我们的目的是在一个由 2323 名 MCI 或 SCC 患者组成的大型法国队列(MEMENTO)中调查 CT 与 ED 之间的关系:我们选取了所有具有 CT 和执行功能数据(言语流畅性和寻迹测试 [TMT])的参与者(n=1924)。使用FreeSurfer进行线性回归,以确定执行力表现与脑实质分数(BPF)和CT之间的关系:结果:总体执行功能得分与 BPF 相关(sß:0.091,PC结论:在一个以临床为基础的大型参与者队列中,在出现 MCI 或 SCC(阿尔茨海默病 [AD] 的潜在早期阶段)时,ED 与左侧眶旁区、右侧楔前区、右侧边际上区和右侧扣带回峡区的 BPF 和 CT 有关。这种病变模式增加了对 ED 传统解剖学的了解,有助于早期诊断 AD。
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引用次数: 0
Neuropsychological assessment in pediatric epilepsy surgery: A French procedure consensus 小儿癫痫手术的神经心理学评估:法国手术共识。
IF 3 4区 医学 Q2 Medicine Pub Date : 2024-06-01 DOI: 10.1016/j.neurol.2023.08.019
V. Laguitton , M. Boutin , H. Brissart , D. Breuillard , M. Bilger , N. Forthoffer , V. Guinet , S. Hennion , C. Kleitz , H. Mirabel , C. Mosca , S. Pradier , S. Samson , V. Voltzenlogel , M. Planton , M. Denos , C. Bulteau

Neuropsychological assessment is a mandatory part of the pre- and post-operative evaluation in pediatric epilepsy surgery. The neuropsychology task force of the ILAE - French Chapter aims to define a neuropsychological procedure consensus based on literature review and adapted for French practice. They performed a systematic review of the literature published between 1950 and 2023 on cognitive evaluation of individuals undergoing presurgical work-up and post-surgery follow-up and focused on the pediatric population aged 6–16. They classified publications listed in the PubMed database according to their level of scientific evidence. The systematic literature review revealed no study with high statistical power and only four studies using neuropsychological scales in their French version. Afterwards, the experts defined a neuropsychological consensus strategy in pediatric epilepsy surgery according to the psychometric determinants of cognitive tests, specificity of epilepsy, surgery context, French culture and literature reports. A common French neuropsychological procedure dedicated to pediatric epilepsy surgery is now available. This procedure could serve as a guide for the pre- and post-surgical work-up in French centers with pediatric epilepsy surgery programs. The main goal is to anticipate the functional risks of surgery, to support the postoperative outcome beyond the seizure-related one, while taking into consideration the plasticity and vulnerability of the immature brain and allowing the possibility of collaborative studies.

神经心理学评估是小儿癫痫手术术前和术后评估的强制性组成部分。ILAE-法国分会的神经心理学工作组旨在根据文献综述和法国实践,定义一种神经心理学程序共识。他们对1950年至2023年间发表的关于接受术前检查和术后随访的个体认知评估的文献进行了系统综述,重点关注6-16岁的儿科人群。他们根据科学证据的水平对PubMed数据库中列出的出版物进行了分类。系统文献综述显示,没有一项研究具有较高的统计能力,只有四项研究使用了法语版的神经心理学量表。之后,专家们根据认知测试的心理测量决定因素、癫痫的特异性、手术背景、法国文化和文献报道,在儿童癫痫手术中定义了一种神经心理学共识策略。法国一种常见的专门用于儿童癫痫手术的神经心理学程序现已问世。该程序可作为法国儿童癫痫手术中心手术前和手术后检查的指南。主要目标是预测手术的功能风险,支持癫痫相关的术后结果,同时考虑到未成熟大脑的可塑性和脆弱性,并允许进行合作研究。
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引用次数: 0
Spreading of motor neuron degeneration in ALS is not so random 肌萎缩性脊髓侧索硬化症运动神经元变性的扩散并不是随机的。
IF 3 4区 医学 Q2 Medicine Pub Date : 2024-06-01 DOI: 10.1016/j.neurol.2024.02.384
P. Corcia , P. Couratier
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引用次数: 0
Emerging autophagic endo-lysosomal targets in the management of Parkinson's disease 治疗帕金森病的新自噬内溶酶体靶点
IF 3 4区 医学 Q2 Medicine Pub Date : 2024-06-01 DOI: 10.1016/j.neurol.2023.07.007
T. Siddiqui, L.K. Bhatt

Synucleopathies, specifically Parkinson's disease, are still incurable and available therapeutic options are scarce and symptomatic. The autophagy-lysosomal-endosomal system is an indigenous mechanism to manage the proteome. Excess/misfolded protein accumulation activates this system, which degrades the undesired proteins via lysosomes. Cells also eliminate these proteins by releasing them into the extracellular space via exosomes. However, the sutophagy-lysosomal-endosomal system becomes unfunctional in Parkinson's disease and there is accumulation and spread of pathogenic alpha-synuclein. Neuronal degeneration results Owing to pathogenic alpha-synuclein. Thus, the autophagy-lysosomal-endosomal system could be a promising target for neuroprotection. In the present review, we discuss the autophagy-lysosomal-endosomal system as an emerging target for the management of Parkinson's disease. Modulation of these targets associated with the autophagy-lysosomal-endosomal system can aid in clearing pathogenic alpha-synuclein and prevent the degeneration of neurons.

突触核病,特别是帕金森病,仍然无法治愈,现有的治疗方案很少,而且症状不明显。自噬-溶酶体-内体系统是一种管理蛋白质组的本地机制。过量/折叠不良蛋白质的积累会激活该系统,通过溶酶体降解不需要的蛋白质。细胞还会通过外泌体将这些蛋白质释放到细胞外空间,从而消除这些蛋白质。然而,在帕金森病中,溶酶体-内泌体系统功能失调,致病性α-突触核蛋白积累和扩散。致病性α-突触核蛋白导致神经元变性。因此,自噬-溶酶体-内体系统可能是一个很有前景的神经保护靶点。在本综述中,我们将讨论自噬-溶酶体-内体系统作为治疗帕金森病的一个新兴靶点。调节这些与自噬-溶酶体-内体系统相关的靶点有助于清除致病性α-突触核蛋白并防止神经元变性。
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引用次数: 0
In young patients with stroke of undetermined etiology, large vessel occlusions are less frequent in the group with high-risk patent foramen ovale 在病因不明的中风年轻患者中,大血管闭塞在高危的卵圆孔未闭组中发生率较低
IF 3 4区 医学 Q2 Medicine Pub Date : 2024-06-01 DOI: 10.1016/j.neurol.2023.11.002
A. Ter Schiphorst , A. Lippi , L. Corti , I. Mourand , P. Prin , A. Agullo , F. Cagnazzo , J.-C. Macia , C. Arquizan

Introduction

Patent foramen ovale (PFO) is present in a significant proportion of young patients with stroke of undetermined etiology, but is not always causal. Therefore, classifications (RoPE, PASCAL) have been developed to determine the probability that PFO is the stroke cause. However, the presence of an initial arterial occlusion as a prediction factor was not studied when these classifications were built. Our aim was to evaluate the presence of arterial occlusion in young patients with stroke of undetermined etiology with/without high-risk PFO.

Methods

From a prospectively-built monocentric database, we identified patients aged  18 to < 60-years with strokes of undetermined etiology and complete etiological work-up, including transesophageal echocardiography. We divided patients in two groups: (i) with high-risk PFO [i.e. PFO with large interatrial shunt (> 30 microbubbles) or associated with atrial septal aneurysm] and (ii) with low-risk/without PFO. We recorded the presence of arterial occlusion and large vessel occlusion (LVO) in the acute phase.

Results

We included 96 patients; 55 (57%) had high-risk PFO. Their median age was 48 (40–52) years, and 28 (29%) were women. The percentages of patients with arterial occlusion and with LVO were lower in the high-risk PFO group than in the low-risk/without PFO group: 11 (20%) versus 19 (46%) (P = 0.008), and 5 (9%) versus 15 (37%) (P = 0.002), respectively. There was no difference in the median RoPE score between groups (P = 0.30).

Conclusion

The presence of LVO could represent a “red flag” of PFO causality in stroke of undetermined etiology, and could be implemented in future PFO-related stroke classifications.

导言在病因未明的卒中年轻患者中,有相当一部分存在闭孔 (PFO),但并不总是因果关系。因此,已开发出一些分类方法(RoPE、PASCAL)来确定 PFO 是卒中病因的可能性。然而,在建立这些分类时,并未将是否存在初始动脉闭塞作为预测因素进行研究。我们的目的是评估病因不明、伴有/不伴有高危 PFO 的年轻中风患者中是否存在动脉闭塞。方法我们从一个前瞻性建立的单中心数据库中确定了年龄≥ 18 至 60 岁、病因不明的中风患者,并进行了完整的病因学检查,包括经食道超声心动图检查。我们将患者分为两组:(i) 高危 PFO 患者[即 PFO 伴有较大的房室间分流(30 微气泡)或伴有房间隔动脉瘤];(ii) 低危/无 PFO 患者。我们记录了急性期动脉闭塞和大血管闭塞(LVO)的情况。他们的中位年龄为 48(40-52)岁,28(29%)人为女性。高危 PFO 组中动脉闭塞和 LVO 患者的比例低于低危/无 PFO 组:分别为 11 (20%) 对 19 (46%) (P = 0.008) 和 5 (9%) 对 15 (37%) (P = 0.002)。结论 LVO 的存在可作为病因未确定的卒中中 PFO 病因的 "红旗",可在未来 PFO 相关卒中分类中应用。
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引用次数: 0
Tribute to Maurice Collard (1931–2024) 向莫里斯-科拉尔德(1931-2024 年)致敬。
IF 3 4区 医学 Q2 Medicine Pub Date : 2024-06-01 DOI: 10.1016/j.neurol.2024.05.002
F. Sellal
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引用次数: 0
Seizure recurrences in generalized convulsive status epilepticus under sedation: What are its predictors and its impact on outcome? 镇静状态下全身抽搐性癫痫的发作复发:其预测因素及其对预后的影响是什么?
IF 3 4区 医学 Q2 Medicine Pub Date : 2024-06-01 DOI: 10.1016/j.neurol.2023.09.006
M. Dhoisne , A. Delval , D. Mathieu , A. Mazeraud , L. Bournisien , P. Derambure , R. Tortuyaux

Background

Management of status epilepticus (SE) is focused on the early seizure termination. Refractory SE is an indication for sedation in patients with SE, but up to 75% of patients may be ventilated due to a neurological or respiratory failure. In patients requiring sedation, the clinical assessment is not sufficient to assess seizure control. Identifying those at risk of recurrent seizures could be useful to adapt their management. On the other hand, patients with low risk could benefit from an early withdrawal of sedation to avoid the impact of inappropriate sedation on outcome.

Objective

To determine the prevalence and the predictors of uncontrolled SE and its impact on outcome in patients with generalized convulsive SE (GCSE) requiring mechanical ventilation (MV).

Methods

We retrospectively included patients admitted to the intensive care unit with GCSE requiring MV. Uncontrolled SE was defined as persistent or recurrent seizures during sedation or within 24 hours following withdrawal. A multivariable logistic regression model was used to assess the associated factors.

Results

Uncontrolled SE occurred in 37 out of 220 patients (17%). Persistent seizures at admission, higher SAPS II and central nervous system infection were associated with a higher risk of uncontrolled SE. Acute toxic or metabolic etiologies were associated with a decreased risk of uncontrolled SE. In a supplementary analysis, decrease of albumin blood levels was associated with uncontrolled SE. Uncontrolled SE was associated with a poor functional outcome and mortality at 90 days.

Conclusions

Seventeen percent of patients with a GCSE requiring MV suffered from uncontrolled SE. Etiology and persistent seizures at admission were the main predictors of uncontrolled SE. Patients with uncontrolled SE had a longer duration of sedation and MV, a poor functional outcome and a higher mortality. Further studies are required to determine the impact of continuous electroencephalogram monitoring on the clinical course.

背景:癫痫状态(SE)的治疗重点在于尽早终止发作。难治性 SE 是 SE 患者镇静的指征,但多达 75% 的患者可能因神经或呼吸衰竭而需要通气。对于需要使用镇静剂的患者,临床评估不足以评估癫痫发作的控制情况。识别有复发风险的患者有助于调整对他们的管理。另一方面,低风险患者可受益于尽早撤除镇静剂,以避免不适当的镇静剂对预后产生影响:目的:确定需要机械通气(MV)的全身惊厥性 SE(GCSE)患者中未控制 SE 的发生率、预测因素及其对预后的影响:我们回顾性地纳入了重症监护病房收治的需要机械通气的全身抽搐性休克(GCSE)患者。无法控制的 SE 被定义为镇静期间或停药后 24 小时内的持续或反复发作。采用多变量逻辑回归模型评估相关因素:220例患者中有37例(17%)出现了无法控制的癫痫发作。入院时癫痫持续发作、SAPS II较高和中枢神经系统感染与SE失控风险较高有关。急性中毒或代谢性病因与 SE 不受控制的风险降低有关。在一项补充分析中,白蛋白血药浓度下降与 SE 不受控制有关。未控制的SE与功能预后差和90天后的死亡率有关:结论:在需要进行 MV 的 GCSE 患者中,17% 患有未受控制的 SE。病因和入院时癫痫持续发作是预测 SE 不受控制的主要因素。SE 不受控制的患者镇静和 MV 持续时间较长,功能预后较差,死亡率较高。需要进一步研究确定持续脑电图监测对临床过程的影响。
{"title":"Seizure recurrences in generalized convulsive status epilepticus under sedation: What are its predictors and its impact on outcome?","authors":"M. Dhoisne ,&nbsp;A. Delval ,&nbsp;D. Mathieu ,&nbsp;A. Mazeraud ,&nbsp;L. Bournisien ,&nbsp;P. Derambure ,&nbsp;R. Tortuyaux","doi":"10.1016/j.neurol.2023.09.006","DOIUrl":"10.1016/j.neurol.2023.09.006","url":null,"abstract":"<div><h3>Background</h3><p>Management of status epilepticus (SE) is focused on the early seizure termination. Refractory SE is an indication for sedation in patients with SE, but up to 75% of patients may be ventilated due to a neurological or respiratory failure. In patients requiring sedation, the clinical assessment is not sufficient to assess seizure control. Identifying those at risk of recurrent seizures could be useful to adapt their management. On the other hand, patients with low risk could benefit from an early withdrawal of sedation to avoid the impact of inappropriate sedation on outcome.</p></div><div><h3>Objective</h3><p>To determine the prevalence and the predictors of uncontrolled SE and its impact on outcome in patients with generalized convulsive SE (GCSE) requiring mechanical ventilation (MV).</p></div><div><h3>Methods</h3><p>We retrospectively included patients admitted to the intensive care unit with GCSE requiring MV. Uncontrolled SE was defined as persistent or recurrent seizures during sedation or within 24<!--> <!-->hours following withdrawal. A multivariable logistic regression model was used to assess the associated factors.</p></div><div><h3>Results</h3><p>Uncontrolled SE occurred in 37 out of 220 patients (17%). Persistent seizures at admission, higher SAPS II and central nervous system infection were associated with a higher risk of uncontrolled SE. Acute toxic or metabolic etiologies were associated with a decreased risk of uncontrolled SE. In a supplementary analysis, decrease of albumin blood levels was associated with uncontrolled SE. Uncontrolled SE was associated with a poor functional outcome and mortality at 90 days.</p></div><div><h3>Conclusions</h3><p>Seventeen percent of patients with a GCSE requiring MV suffered from uncontrolled SE. Etiology and persistent seizures at admission were the main predictors of uncontrolled SE. Patients with uncontrolled SE had a longer duration of sedation and MV, a poor functional outcome and a higher mortality. Further studies are required to determine the impact of continuous electroencephalogram monitoring on the clinical course.</p></div>","PeriodicalId":21321,"journal":{"name":"Revue neurologique","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138488347","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
Neurodystrophic hand dermatitis – Sannino-Barduagni syndrome 神经营养不良性手部皮炎--桑尼诺-巴杜亚尼综合征
IF 3 4区 医学 Q2 Medicine Pub Date : 2024-06-01 DOI: 10.1016/j.neurol.2023.11.007
A. Demas , T. Apard , A.-L. Bedat-Millet , T. Maisonobe
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引用次数: 0
Silent brain infarct in migraine: Systematic review and meta-analysis 偏头痛的无症状脑梗死:系统综述和荟萃分析。
IF 3 4区 医学 Q2 Medicine Pub Date : 2024-06-01 DOI: 10.1016/j.neurol.2023.05.003
A. Espanol , F. Lerebours , L. Calviere , F. Bonneville , A. Ducros , V. Larrue , C. Gollion

Background

While migraine, particularly migraine with aura, is a recognized risk factor for ischemic stroke, the association of migraine with silent brain infarction is a matter of debate, as studies on this topic have yielded conflicting results.

Methods

A systematic review of the literature was conducted of studies reporting migraine and silent brain infarction, assessed by magnetic resonance imaging, between January 1980 and April 2022, by consulting Medline and Embase databases. Studies with a control group were included in a meta-analysis of population-based studies. An exploratory meta-analysis of both population-based and clinical-based studies was further performed to test the association between migraine with aura and silent brain infarction.

Results

A total of 2,408 articles were identified, among which 24 were included in the systematic review and 10 in the meta-analysis. The meta-analysis of population-based studies showed no association of migraine with silent brain infarction (odds ratio (OR) = 1.32 [95% CI 0.92;1.90], P = 0.13) and migraine with aura with silent brain infarction (OR = 1.56 [0.74;3.30], P = 0.24). However, in the exploratory meta-analysis of population-based and clinical-based studies, migraine with aura was significantly associated with silent brain infarction (OR = 1.91 [1.02;3.59], P = 0.04) and to silent cerebellar infarcts (OR = 2.57 [1.01;6.56], P = 0.05).

Conclusion

In this updated systematic review and meta-analysis of population-based studies, migraine and migraine with aura were not associated with silent brain infarction.

背景:虽然偏头痛,特别是先兆偏头痛,是缺血性中风的一个公认的风险因素,但偏头痛与无症状脑梗死的关系是一个有争议的问题,因为关于这一主题的研究得出了相互矛盾的结果。方法:通过查阅Medline和Embase数据库,对1980年1月至2022年4月期间通过磁共振成像评估的偏头痛和无症状脑梗死研究的文献进行系统回顾。对照组的研究被纳入一项基于人群的研究的荟萃分析。对基于人群和临床的研究进行了一项探索性荟萃分析,以测试先兆偏头痛与无症状脑梗死之间的关系。结果:共鉴定出2408篇文章,其中24篇纳入系统综述,10篇纳入荟萃分析。基于人群研究的荟萃分析显示,偏头痛与无症状性脑梗死(比值比(OR)=1.32[95%CI 0.92;1.90],P=0.013)和先兆偏头痛与无障碍性脑梗死(OR=1.56[0.74;3.30],P=0.024)之间没有关联。然而,在基于人群和临床研究的探索性荟萃分析中,先兆偏头痛与无症状脑梗死(OR=1.91[1.02;3.59],P=0.04)和无症状小脑梗死(OR=2.57[1.01;6.56],P=0.05)显著相关。
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引用次数: 0
The effect of gabapentin and pregabalin on agitation in dementia: Case series of ten patients 加巴喷丁和普瑞巴林对痴呆症躁动的影响:十名患者的病例系列
IF 3 4区 医学 Q2 Medicine Pub Date : 2024-06-01 DOI: 10.1016/j.neurol.2023.11.006
M. Kandemir Yilmaz
{"title":"The effect of gabapentin and pregabalin on agitation in dementia: Case series of ten patients","authors":"M. Kandemir Yilmaz","doi":"10.1016/j.neurol.2023.11.006","DOIUrl":"10.1016/j.neurol.2023.11.006","url":null,"abstract":"","PeriodicalId":21321,"journal":{"name":"Revue neurologique","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139677862","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
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