Revue neurologique最新文献

{"title":"Does the guidance method affect the doses of botulinum toxin in writer's cramp?","authors":"A. Kreisler ,&nbsp;K. Watel ,&nbsp;L. Defebvre ,&nbsp;L. Mortain ,&nbsp;A. Duhamel","doi":"10.1016/j.neurol.2023.11.009","DOIUrl":"10.1016/j.neurol.2023.11.009","url":null,"abstract":"<div><h3>Purpose</h3><p><span>Botulinum neurotoxin (BoNT) injections are the main medical treatment of </span>writer's cramp. When the outcome is favourable, patients usually receive injections several times per year in the long-term. However, we know little about the course of BoNT doses and nothing about the impact of the guidance method on the clinical outcome or injection strategy.</p></div><div><h3>Methods</h3><p>We studied, in the long-term, the doses of BoNT and the target muscles in a group of patients with writer's cramp, according to the guidance method (electrical stimulation or ultrasound). Patients received at least three injection cycles guided by electrical stimulation, followed by at least three injection cycles guided by ultrasound.</p></div><div><h3>Results</h3><p>Twenty-four patients were included. More target muscles were injected after switching to ultrasound guidance, especially the flexor carpi ulnaris and the flexor carpi radialis. The mean dose by muscle was lower when ultrasound guidance was used. When using electrical stimulation guidance, the dose in the flexors of the fingers decreased in the long-term, but increased in the flexors of the wrist. The course of the BoNT doses and of the number of target muscles per cycle were not the same during the first period (electrical stimulation) and the second period (ultrasound).</p></div><div><h3>Conclusions</h3><p>Switching to ultrasound guidance, the BoNT dose decreased, mainly in the flexors of the wrist. Based on the results of our study, we suggest a starting dose in several muscles (flexor carpi ulnaris, flexor carpi radialis, flexor digitorum profundus and flexor pollicis longus).</p></div>","PeriodicalId":21321,"journal":{"name":"Revue neurologique","volume":"180 6","pages":"Pages 548-558"},"PeriodicalIF":3.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139712951","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}

{"title":"Evaluation of quality of life's prognostic factors in people with functional seizures","authors":"P. Capitaine ,&nbsp;B. Thomas ,&nbsp;A. Gradel ,&nbsp;T. Ferté ,&nbsp;O. Branchard ,&nbsp;E. Frison ,&nbsp;V. Renaudeau ,&nbsp;J. Aupy","doi":"10.1016/j.neurol.2023.09.007","DOIUrl":"10.1016/j.neurol.2023.09.007","url":null,"abstract":"<div><h3>Aims</h3><p>Functional non-epileptic seizures significantly impact the quality of life of patients. We aimed to identify prognostic factors associated with the quality of life in individuals with functional non-epileptic seizures.</p></div><div><h3>Subjects and methods</h3><p>Adult patients diagnosed with definite or documented functional seizures based on LaFrance's criteria (<em>n</em> <!-->=<!--> <!-->72) were enrolled at the time of diagnosis. Quality of life was assessed using the Quality of Life in Epilepsy Inventory-31 (QOLIE-31) at diagnosis and at a six-month follow-up. Demographic and medical information was collected, and psychiatric comorbidities were evaluated using validated scales.</p></div><div><h3>Results</h3><p>Comparisons between diagnosis and follow-up did not reveal any factors associated with improvement in quality of life at six months after diagnosis. However, multivariable analysis, adjusted for age, sex, diagnosis delay, and frequency of functional seizures showed a significant cross-sectional relationship with a QOLIE-31 score decrease of 0.66 [95% CI −0.93;−0.39], −0.32 [−0.61; −0.03], and −0.22 [−0.42; −0.02] for an increase of 1 point of BDI-2 score, BAI score, and CTQ score respectively.</p></div><div><h3>Conclusion</h3><p>Psychiatric comorbidities, particularly depression and anxiety, are associated with worse quality of life in patients with functional seizures. This underscores the crucial importance of multidisciplinary care involving both neurological and psychiatric expertise when managing individuals with functional seizures.</p></div>","PeriodicalId":21321,"journal":{"name":"Revue neurologique","volume":"180 6","pages":"Pages 524-531"},"PeriodicalIF":3.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138470762","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}

{"title":"SWI versus GRE-T2*: Assessing cortical superficial siderosis in advanced cerebral amyloid angiopathy","authors":"P. Assis Lopes ,&nbsp;N. Raposo ,&nbsp;A. Charidimou ,&nbsp;M.C. Zanon Zotin ,&nbsp;M. Edip Gurol ,&nbsp;S. Greenberg ,&nbsp;A. Viswanathan","doi":"10.1016/j.neurol.2023.10.008","DOIUrl":"10.1016/j.neurol.2023.10.008","url":null,"abstract":"<div><h3>Background and purpose</h3><p><span>Cortical superficial siderosis (cSS) is a key neuroimaging marker of </span>cerebral amyloid angiopathy<span> (CAA) detected on blood-sensitive magnetic resonance imaging (MRI). We aimed to assess cSS in advanced CAA patients and explore differences in its evaluation between susceptibility weighted imaging (SWI) and gradient recalled echo-T2* (GRE-T2*).</span></p></div><div><h3>Materials and methods</h3><p>Neuroimaging data gathered from a prospective cohort of CAA patients with probable or definite CAA were retrospectively analyzed by two independent raters. SWI and GRE-T2* were used to assess presence and severity (absent, focal [≤<!--> <!-->3 sulci] or disseminated [&gt;<!--> <span>3 sulci]) of cSS and number of foci. Ratings were compared between sequences and inter-rater agreement was determined. Post hoc analysis explored differences in cSS multifocality scores.</span></p></div><div><h3>Results</h3><p>We detected cSS in 38 patients with SWI and in 36 with GRE-T2* (70.4% versus 66.7%; <em>P</em> <!-->=<!--> <!-->0.5). The two raters agreed in detecting more disseminated cSS when using SWI: 16 focal (29.63%) and 20 disseminated (37.04%) cases of cSS seen on GRE-T2* and 11 (20.37%) focal and 27 (50%) disseminated cSS cases seen using SWI (<em>P</em> <!-->=<!--> <!-->0.008). Inter-rater agreement was equivalent for the two sequences (κ_presence 0.7 versus 0.69; κ_severity 0.74 versus 0.66) for assessing both presence and severity of cSS. Post hoc analysis showed higher multifocality scores from both raters’ SWI evaluations, with agreement equivalent to that for T2* evaluations.</p></div><div><h3>Conclusions</h3><p>Our findings suggest that SWI ratings could show more disseminated cSS and higher multifocality scores in advanced CAA patients with inter-rater reliability equivalent to that obtained using GRE-T2*, regardless of level of experience.</p></div>","PeriodicalId":21321,"journal":{"name":"Revue neurologique","volume":"180 6","pages":"Pages 532-538"},"PeriodicalIF":3.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138545551","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}

{"title":"“Status trigeminal neuralgia”: Analysis of 39 cases and proposal for diagnostic criteria","authors":"","doi":"10.1016/j.neurol.2024.03.014","DOIUrl":"10.1016/j.neurol.2024.03.014","url":null,"abstract":"<div><h3>Objective</h3><p>The aim of this descriptive study was to propose diagnostic criteria for acute exacerbation of trigeminal neuralgia (TN) based on the analysis of retrospective cases.</p></div><div><h3>Background</h3><p>TN is a rare and extremely painful condition whose evolution can be punctuated by major exacerbations, leading to significant functional impairment. Several denominations are used for these exacerbations: “acute exacerbation”, “status of trigeminal neuralgia”, and “status trigeminus”. There is currently no clinical definition of this state. In this manuscript, we used the term “status trigeminal neuralgia” (STN).</p></div><div><h3>Methods</h3><p>We conducted a retrospective study, in a tertiary care specialist headache center, in France. Patients were selected from January 2015 to October 2022, with the French translation of the keyword “STN”, in the medical records (outpatients) or the codage for trigeminal neuralgia (inpatients). Additional cases of STN were prospectively recruited from October 2022 to February 2023. We analyzed the clinical and paraclinical data of these patients.</p></div><div><h3>Results</h3><p>Thirty-nine patients presenting with STN were included. There was a preponderance of women (64%) with 24 cases of classic TN (62%) and 15 cases of secondary TN (38%). Concerning STN, 39 episodes were described. Pain was very severe in all patients. Cranial autonomic signs were present in 23% of cases. Pain extended beyond the usual territory in 44% of cases. A continuous pain background was present in 35% of cases. With regard to triggering factors, paroxysms of facial pain were triggered by eating (97% of patients), speaking (90%) or drinking (62% of patients). Repercussions on weight, hydration, or mood disorders were observed in 67%, 56% and 59% of the cases, respectively.</p></div><div><h3>Conclusion</h3><p>STN is a rare clinical presentation of TN. We proposed criteria and a new denomination for this condition.</p></div>","PeriodicalId":21321,"journal":{"name":"Revue neurologique","volume":"180 7","pages":"Pages 689-697"},"PeriodicalIF":2.8,"publicationDate":"2024-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S003537872400523X/pdfft?md5=2ec894f22f233746c823ed3d72537cba&pid=1-s2.0-S003537872400523X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141094010","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}

{"title":"Clinical applications of deep learning in neuroinflammatory diseases: A scoping review.","authors":"S Demuth, J Paris, I Faddeenkov, J De Sèze, P-A Gourraud","doi":"10.1016/j.neurol.2024.04.004","DOIUrl":"https://doi.org/10.1016/j.neurol.2024.04.004","url":null,"abstract":"<p><strong>Background: </strong>Deep learning (DL) is an artificial intelligence technology that has aroused much excitement for predictive medicine due to its ability to process raw data modalities such as images, text, and time series of signals.</p><p><strong>Objectives: </strong>Here, we intend to give the clinical reader elements to understand this technology, taking neuroinflammatory diseases as an illustrative use case of clinical translation efforts. We reviewed the scope of this rapidly evolving field to get quantitative insights about which clinical applications concentrate the efforts and which data modalities are most commonly used.</p><p><strong>Methods: </strong>We queried the PubMed database for articles reporting DL algorithms for clinical applications in neuroinflammatory diseases and the radiology.healthairegister.com website for commercial algorithms.</p><p><strong>Results: </strong>The review included 148 articles published between 2018 and 2024 and five commercial algorithms. The clinical applications could be grouped as computer-aided diagnosis, individual prognosis, functional assessment, the segmentation of radiological structures, and the optimization of data acquisition. Our review highlighted important discrepancies in efforts. The segmentation of radiological structures and computer-aided diagnosis currently concentrate most efforts with an overrepresentation of imaging. Various model architectures have addressed different applications, relatively low volume of data, and diverse data modalities. We report the high-level technical characteristics of the algorithms and synthesize narratively the clinical applications. Predictive performances and some common a priori on this topic are finally discussed.</p><p><strong>Conclusion: </strong>The currently reported efforts position DL as an information processing technology, enhancing existing modalities of paraclinical investigations and bringing perspectives to make innovative ones actionable for healthcare.</p>","PeriodicalId":21321,"journal":{"name":"Revue neurologique","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141076686","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}

{"title":"Metabolic syndrome and the phenotype of multiple sclerosis","authors":"","doi":"10.1016/j.neurol.2024.03.009","DOIUrl":"10.1016/j.neurol.2024.03.009","url":null,"abstract":"<div><h3>Background</h3><p>Comorbidities, particularly vascular comorbidities, have been shown to exacerbate the progression of disability in multiple sclerosis (MS). Metabolic syndrome (MetS) is a cluster of conditions including abdominal obesity, insulin resistance, atherogenic dyslipidemia, and vascular dysfunction, which contribute to vascular morbidity and chronic inflammation.</p></div><div><h3>Objective</h3><p>To describe the characteristics of MetS in a cohort of MS patients and evaluate its relationship with the MS phenotype.</p></div><div><h3>Methods</h3><p>A monocentric cohort study was conducted on MS patients, collecting demographic, clinical, radiological, and therapeutic data, as well as metabolic data including waist circumference, blood pressure, serum triglycerides, high-density lipoprotein cholesterol, and fasting blood glucose.</p></div><div><h3>Results</h3><p>Among the 84 patients included in the study, 27% were diagnosed with MetS. MetS was found to be associated with secondary progressive MS (SPMS). Patients with SPMS had a higher prevalence of MetS compared to those with relapsing-remitting MS (RRMS), even after adjusting for disease duration. While MetS was associated with Expanded Disability Status Scale (EDSS) progression in the 3-year period according to univariate analysis, it did not show a significant association with disease activity.</p></div><div><h3>Conclusion</h3><p>This study provides evidence supporting the connection between MetS and the progression of disability in MS, independent of disease relapse activity.</p></div>","PeriodicalId":21321,"journal":{"name":"Revue neurologique","volume":"180 7","pages":"Pages 673-681"},"PeriodicalIF":2.8,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0035378724005022/pdfft?md5=cbb3f37e9647c7c8d82cca29eec8d954&pid=1-s2.0-S0035378724005022-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140904742","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}

{"title":"Diagnosis and management of acute trigeminal neuralgia","authors":"","doi":"10.1016/j.neurol.2024.04.002","DOIUrl":"10.1016/j.neurol.2024.04.002","url":null,"abstract":"","PeriodicalId":21321,"journal":{"name":"Revue neurologique","volume":"180 7","pages":"Pages 581-582"},"PeriodicalIF":2.8,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140904689","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}

{"title":"Association of clopidogrel resistance and ABCD-GENE score with long-term clinical prognosis in patients with ischemic stroke or TIA","authors":"","doi":"10.1016/j.neurol.2024.03.011","DOIUrl":"10.1016/j.neurol.2024.03.011","url":null,"abstract":"<div><h3>Background</h3><p><span>Clopidogrel resistance (CR) is associated with adverse clinical outcomes in </span>acute ischemic stroke<span> or transient ischemic attack (TIA) patients. However, whether CR affects the long-term clinical prognosis remains to be clarified. The ABCD-GENE score is a novel risk model that identifies CR in cardiovascular disease patients; its diagnostic ability and application in ischemic stroke or TIA remain to be studied. This study aimed to investigate the diagnostic ability of the ABCD-GENE score for CR and analyze the relationship between CR and long-term clinical prognosis in patients with ischemic stroke or TIA.</span></p></div><div><h3>Methods</h3><p><span><span>From January 2018 to January 2021, 251 ischemic stroke or TIA patients who were treated with clopidogrel for more than three months after onset and maintained the medication until the follow-up time were enrolled, and platelet reactivity was detected by </span>thromboelastography. </span><span><span>CYP2C19</span></span> gene analysis was performed. Adverse clinical outcomes were recorded from 3<!--> <!-->months after onset. The median follow-up time was 878<!--> <!-->days.</p></div><div><h3>Results</h3><p><span>The prevalence of CR was 33.9%. The proportion of CYP2C19 loss-of-function carriers was 62.2%. The ABCD-GENE score</span> <!-->≥<!--> <!-->10 was independently associated with CR (OR<!--> <!-->=<!--> <!-->1.82, 95% CI: 1.02–3.24, <em>P</em> <!-->=<!--> <!-->0.041), and the C-statistic value of the score (as a binary and integer variable) on CR was 0.58 and 0.63, respectively. The risk of long-term adverse clinical outcomes was not significantly different between CR and clopidogrel sensitive groups (12.94% vs. 11.44%, HR<!--> <!-->=<!--> <!-->1.22, 95% CI: 0.57–2.62, <em>P</em> <!-->=<!--> <!-->0.603). A similar result was observed between ABCD-GENE score<!--> <!-->≥<!--> <!-->10 and ABCD-GENE score<!--> <!-->&lt;<!--> <!-->10 groups (10.38% vs. 12.64%, HR<!--> <!-->=<!--> <!-->1.19, 95% CI: 0.55–2.60, <em>P</em> <!-->=<!--> <!-->0.666).</p></div><div><h3>Conclusions</h3><p>In ischemic stroke or TIA patients, the ABCD-GENE score could identify the risk of CR. CR was not associated with long-term adverse clinical outcomes.</p></div>","PeriodicalId":21321,"journal":{"name":"Revue neurologique","volume":"180 7","pages":"Pages 682-688"},"PeriodicalIF":2.8,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140892657","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}

{"title":"Development of an Objective Structured Clinical Examination (OSCE) to evaluate the diagnosis announcement of chronic neurological disease by residents in neurology","authors":"","doi":"10.1016/j.neurol.2024.02.390","DOIUrl":"10.1016/j.neurol.2024.02.390","url":null,"abstract":"<div><h3>Background</h3><p><span>There is little consensus on how to make a diagnosis announcement of severe chronic disease<span> in neurology. Other medical specialties, such as </span></span>oncology<span>, have developed assessment methods similar to the Objective Structured Clinical Examination (OSCE) to address this issue. Here we report the implementation of an OSCE focused on the diagnosis announcement of chronic disease in neurology by residents.</span></p></div><div><h3>Objective</h3><p>We aimed to evaluate the acceptability, feasibility and validity in routine practice of an OSCE combined with a theoretical course focused on diagnosis announcement in neurology.</p></div><div><h3>Method</h3><p>Eighteen neurology residents were prospectively included between 2019 and 2022. First, they answered a questionnaire on their previous level of training in diagnosis announcement. Second, in a practical session with a simulated patient, they made a 15-min diagnosis announcement and then had 5<!--> <span>mins of immediate feedback with an expert observer, present in the room. The OSCE consisted of 4 different stations, with standardized scenarios dedicated to the announcement of multiple sclerosis<span><span><span> (MS), Parkinson's disease (PD), </span>Alzheimer's disease (AD) and </span>amyotrophic lateral sclerosis (ALS). Third, in a theory session, expert observers covered the essential theoretical points. All residents and expert observers completed an evaluation of the “practical session” and the “theory session”.</span></span></p></div><div><h3>Results</h3><p>Residents estimated their previous level of diagnosis announcement training at 3.1/5. The most feared announcements were AD and ALS. The “practical session” was rated at a mean of 4.1/5 by the residents and 4.8/5 by the expert observers, and the “theory session” at a mean of 4.7/5 by the residents and 5/5 by the expert observers. After the OSCEs, 11 residents felt more confident about making an announcement.</p></div><div><h3>Conclusion</h3><p>This study has shown a benefit of using an OSCE to learn how to make a diagnosis announcement of severe chronic disease in neurology. OSCEs could be used in many departments in routine practice and seem adapted to residents.</p></div>","PeriodicalId":21321,"journal":{"name":"Revue neurologique","volume":"180 7","pages":"Pages 655-660"},"PeriodicalIF":2.8,"publicationDate":"2024-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140865697","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}

{"title":"Antibody responses to SARS-CoV-2 vaccines in neuromuscular disorders may depend on their etiology and current drug treatment","authors":"J. Finsterer","doi":"10.1016/j.neurol.2024.01.001","DOIUrl":"10.1016/j.neurol.2024.01.001","url":null,"abstract":"","PeriodicalId":21321,"journal":{"name":"Revue neurologique","volume":"180 5","pages":"Pages 470-471"},"PeriodicalIF":3.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139680263","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}