Revue neurologique最新文献

{"title":"Diffuse cerebral vasodilatation at the initial stage of reversible cerebral vasoconstriction syndrome (RCVS)","authors":"M. Bertin Terrom ,&nbsp;P. Constant dit Beaufils ,&nbsp;S. de Gaalon ,&nbsp;H. Desal ,&nbsp;R. Bourcier ,&nbsp;J. Aguilar","doi":"10.1016/j.neurol.2025.01.411","DOIUrl":"10.1016/j.neurol.2025.01.411","url":null,"abstract":"<div><h3>Background and purpose</h3><div>Reversible cerebral vasoconstriction syndrome (RCVS) is characterized by recurrent thunderclap headaches and segmental vasoconstriction of cerebral arteries resolutive within three months. However, two case reports in the literature revealed diffuse cerebral vasodilatation rather than vasoconstriction at the early phase of RCVS (Kobayashi, 2016; Oikawa et al., 2017). This study aims at reporting the occurrence of diffuse cerebral vasodilatation at the initial stage of RCVS and at analyzing the clinical and prognostic characteristics of patients with diffuse vasodilatation.</div></div><div><h3>Materials and methods</h3><div>Patients with RCVS were retrospectively gathered from medical files. Initial and follow-up vascular imaging were compared to assess vasodilatation and vasoconstriction for each segment of the circle of Willis on the initial angiogram. Diffuse vasodilatation was defined as dilatation of four or more of the circle of Willis arteries both in the anterior and posterior circulations, without previously described “string of beads” appearance of cerebral arteries. Patients were split into two groups based on the presence of diffuse cerebrovascular dilatation for comparison.</div></div><div><h3>Results</h3><div>Among 148 patients with RCVS, 45 patients (30%) had diffuse cerebral vasodilatation. Diffuse vasodilatation was proved to occur at the early phase of RCVS (mean delay between thunderclap headache onset and initial imaging of 2.25<!--> <!-->days versus 7.63<!--> <!-->days, <em>P</em> <!-->=<!--> <!-->0.047) and mainly affected the first and second segments of major cerebral arteries. It was significatively associated with distal vasoconstriction (44.44% versus 25.24%, <em>P</em> <!-->=<!--> <!-->0.033). Patients with diffuse cerebral vasodilatation had a greater risk of hemorrhage (15.56% for subarachnoid hemorrhage versus 3.88%, <em>P</em> <!-->=<!--> <!-->0.035; 8.89% for intracranial hemorrhage versus 0.97%, <em>P</em> <!-->=<!--> <!-->0.03). Vasodilatation was more frequent in women (71.11% versus 41.75%, <em>P</em> <!-->=<!--> <!-->0.001). Secondary forms of RCVS were associated with diffuse vasodilatation (51% versus 27%, <em>P</em> <!-->=<!--> <!-->0.008).</div></div><div><h3>Conclusion</h3><div>The early cerebral angiogram may reveal diffuse cerebrovascular dilatation in patients with RCVS. Vasodilatation might have a pathophysiological implication in RCVS with clinical and prognostic consequences for patients.</div></div>","PeriodicalId":21321,"journal":{"name":"Revue neurologique","volume":"181 4","pages":"Pages 305-313"},"PeriodicalIF":2.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524170","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":"Trigeminal autonomic cephalalgia after common eye surgery: Case series and literature review","authors":"M. Beltramone ,&nbsp;S. Redon ,&nbsp;A. Donnet","doi":"10.1016/j.neurol.2025.01.305","DOIUrl":"10.1016/j.neurol.2025.01.305","url":null,"abstract":"<div><h3>Background</h3><div>Secondary cases of trigeminal autonomic cephalalgia have been described, most commonly following tumor, trauma, or vascular causes.</div></div><div><h3>Cases</h3><div>We report a series of 6 patients who experienced ipsilateral headache responding to the International Headache Society criteria for cluster headache, hemicrania continua or probable hemicrania continua. It occurred immediately or in the following days or weeks after cataract or glaucoma surgery. We complete these descriptions with 4 cases from a literature review of trigeminal autonomic cephalalgia attributed to non-destructive eye surgery.</div></div><div><h3>Conclusion</h3><div>We report the largest series of patients who developed TAC after ocular surgery, supplemented by 4 cases from the literature. For many of these patients, TAC treatments can be effective either as a preventive or as an attack.</div></div>","PeriodicalId":21321,"journal":{"name":"Revue neurologique","volume":"181 4","pages":"Pages 284-288"},"PeriodicalIF":2.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399897","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":"Artificial intelligence applied to epilepsy imaging: Current status and future perspectives.","authors":"M Berger, R Licandro, K-H Nenning, G Langs, S B Bonelli","doi":"10.1016/j.neurol.2025.03.006","DOIUrl":"https://doi.org/10.1016/j.neurol.2025.03.006","url":null,"abstract":"<p><p>In recent years, artificial intelligence (AI) has become an increasingly prominent focus of medical research, significantly impacting epileptology as well. Studies on deep learning (DL) and machine learning (ML) - the core of AI - have explored their applications in epilepsy imaging, primarily focusing on lesion detection, lateralization and localization of epileptogenic areas, postsurgical outcome prediction and automatic differentiation between people with epilepsy and healthy individuals. Various AI-driven approaches are being investigated across different neuroimaging modalities, with the ultimate goal of integrating these tools into clinical practice to enhance the diagnosis and treatment of epilepsy. As computing power continues to advance, the development, research integration, and clinical implementation of AI applications are expected to accelerate, making them even more effective and accessible. However, ensuring the safety of patient data will require strict regulatory measures. Despite these challenges, AI represents a transformative opportunity for medicine, particularly in epilepsy neuroimaging. Since ML and DL models thrive on large datasets, fostering collaborations and expanding open-access databases will become increasingly pivotal in the future.</p>","PeriodicalId":21321,"journal":{"name":"Revue neurologique","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143773093","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":"Long-lasting improvement of memory after targeted cognitive remediation in temporal epilepsy: A randomized control study","authors":"N. Forthoffer ,&nbsp;L. Maillard ,&nbsp;A. Thiriaux ,&nbsp;M. Lemesle Martin ,&nbsp;J.P. Vignal ,&nbsp;H. Brissart","doi":"10.1016/j.neurol.2025.02.001","DOIUrl":"10.1016/j.neurol.2025.02.001","url":null,"abstract":"<div><h3>Background</h3><div>Memory deficits are a major burden in temporal lobe epilepsy (TLE), contributing to the impaired quality of life of patients. Short- and long-term efficacy of memory remediation in TLE is still debated. The aim of our study was to assess the short- and long-term efficacy of a cognitive remediation program, COMETE (COgnitive Rehabilitation of MEmory in Temporal Epilepsy), targeting specifically episodic memory in patients with TLE.</div></div><div><h3>Methods</h3><div>In this prospective randomized single-blinded trial, patients from different French epilepsy centers were randomly assigned in a 2:4 ratio, via a computer-generated code, to receive remediation intervention or no intervention between neuropsychological assessments. Neuropsychologists assessing the cognitive performance at baseline, at immediate follow-up (3<!--> <!-->months after baseline) and in long-term follow-up (10 to 12<!--> <!-->months after baseline) were blinded to the intervention allocation.</div></div><div><h3>Results</h3><div>Sixty out of 66 included patients were randomized. Patients in the Remediation group significantly improved their performances in the subtests addressed by the program (verbal and non-verbal memory; <em>P</em> <!-->&lt;<!--> <!-->0.001 at 3<!--> <!-->months and <em>P</em> <!-->&lt;<!--> <!-->0.001 at 10/12<!--> <!-->months) while patients in the Control group did not. In verbal memory, 56% of the patients in the Remediation group normalized their performance in verbal memory learning score while 7% of the patients in the Control group did.</div></div><div><h3>Conclusions</h3><div>Cognitive remediation targeting memory is efficient at short and long term in temporal lobe epilepsy patients.</div></div>","PeriodicalId":21321,"journal":{"name":"Revue neurologique","volume":"181 4","pages":"Pages 320-331"},"PeriodicalIF":2.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573921","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":"Psychiatric and cognitive symptoms of Parkinson's disease: A life's tale","authors":"D. Amstutz ,&nbsp;M. Sousa ,&nbsp;M.E. Maradan-Gachet ,&nbsp;I. Debove ,&nbsp;E. Lhommée ,&nbsp;P. Krack","doi":"10.1016/j.neurol.2024.11.004","DOIUrl":"10.1016/j.neurol.2024.11.004","url":null,"abstract":"<div><h3>Introduction</h3><div>Neuropsychiatric symptoms are highly prevalent in Parkinson's disease (PD) and significantly affect the quality of life of patients and their significant others. The aim of this work is to describe typical neuropsychiatric symptoms and their treatment.</div></div><div><h3>Methods</h3><div>This is a narrative opinion paper, illustrated by a fictional case report. The most common neuropsychiatric symptoms such as depressive symptoms, anxiety, apathy, psychotic symptoms, impulse control disorders, as well as cognitive impairment are discussed in the context of prodromal stage, early stage, fluctuations stage, post-surgical intervention, and late stage of PD.</div></div><div><h3>Results</h3><div>Multiple factors such as pathophysiology, dopaminergic medication, deep brain stimulation, personality traits and individual life circumstances influence neuropsychiatric symptoms. Since the complexity and causes of neuropsychiatric symptoms can change, management strategies have to be adapted and individualised throughout the disease trajectory.</div></div><div><h3>Discussion</h3><div>Recognising neuropsychiatric symptoms within the framework of the disease stage and identifying their potential causes is pivotal to provide adequate interventions.</div></div>","PeriodicalId":21321,"journal":{"name":"Revue neurologique","volume":"181 4","pages":"Pages 265-283"},"PeriodicalIF":2.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877823","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":"Professor Michel Fardeau","authors":"B. Eymard","doi":"10.1016/j.neurol.2025.03.002","DOIUrl":"10.1016/j.neurol.2025.03.002","url":null,"abstract":"","PeriodicalId":21321,"journal":{"name":"Revue neurologique","volume":"181 4","pages":"Pages 263-264"},"PeriodicalIF":2.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143808419","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":"Epilepsy and Alzheimer disease: New insights and perspectives.","authors":"Sophie Dupont","doi":"10.1016/j.neurol.2025.03.005","DOIUrl":"https://doi.org/10.1016/j.neurol.2025.03.005","url":null,"abstract":"<p><p>Numerous epidemiological and pathophysiological arguments suggest a bidirectional link between late-onset epilepsy and Alzheimer's disease. However, the temporal and causal relationship between the pathophysiological processes underlying these two conditions remains unclear. It is likely that these connections are complex, requiring consideration of various scenarios of causality and reciprocity. In the absence of targeted therapies that effectively address the progression of both diseases, specific measures can be taken to improve patient care. These include screening for cognitive disorders in patients with late-onset epilepsy, detecting subclinical EEG activity in patients with Alzheimer's disease, and identifying and managing cardiovascular risk factors in both populations. Looking ahead, it is evident that global population aging and the potential demographic surge in these two patient groups will necessitate greater efforts to raise awareness and enhance the training of physicians and healthcare professionals in the emerging field of \"epileptogeriatrics\".</p>","PeriodicalId":21321,"journal":{"name":"Revue neurologique","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764918","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":"Trends in the real-world management of patients with active relapsing-remitting multiple sclerosis treated with natalizumab (TYSABRI®) in France: An analysis of the PMSI database over five years (2019-2023).","authors":"E Le Page, C Emery, A Fravalo, F Fagnani, A Clement","doi":"10.1016/j.neurol.2025.03.001","DOIUrl":"https://doi.org/10.1016/j.neurol.2025.03.001","url":null,"abstract":"<p><p>Several factors are changing the way relapsing-remitting multiple sclerosis (RRMS) is currently managed with natalizumab (NTZ), with increasing use of injections in home hospitalization structures, change in treatment formulation, strategy of use regarding pregnancies and sometimes extending interval dosing (EID) to reduce the risk of adverse events (AEs), notably progressive multifocal leukoencephalopathy (PML).</p><p><strong>Objective: </strong>To describe changes in the real-world management of people with multiple sclerosis (PwMS) treated with natalizumab in France over the period 2019-2023.</p><p><strong>Methods: </strong>This is a retrospective observational study using data extracted from the French national hospital database (PMSI) from the first of January 2019 to the 31st of December 2023 including data on all reimbursements of NTZ: patients' demographic characteristics, dates of deliveries and of infusions, formulation of the drug, type of facilities used (acute care, home hospitalization) and eventual pregnancies.</p><p><strong>Results: </strong>A total number of 5,708 patients treated with NTZ were identified in 2019, increasing to 7,181 in 2023. The age/gender distribution was stable over the period with 76.9% of women and a mean age of 39.9 years (SD 11.40). The number of at home injections increased substantially from 6 in 2019 to 3,501 in 2023, particularly after COVID-19 health care reorganization. Since December 2021, when the NTZ subcutaneous (SC) formulation was launched, the percentage of intravenous infusions decreased from 71.0% in January 2022 to 29.2% in December 2023. Over the whole 5-year period, frequency of using NTZ with EID between 36-42 days increased from 5.9% in 2019 to 17.0% in 2023. Practices changed regarding NTZ and pregnancies since the number of patients with a delivery increased from 117 in 2019 to 179 in 2023. NTZ was stopped in nearly 20% of patients during the three months before conception in 2019 and 7-8% only from 2020. Maintenance of NTZ during the first as well as the second trimester of pregnancy clearly increased over the 2019-2023 period from 75% to 90% in the first trimester and 44% to nearly 78% in the second trimester.</p><p><strong>Conclusion: </strong>Natalizumab use was maintained and even increased in France over the 2019-2023 period despite enrichment of the therapeutic arsenal for PwMS. It was certainly facilitated by better therapeutic management with the development of at-home injections, simplification of the procedure with the SC formulation, the possibility of EID every 5-6 weeks for the intravenous formulation and better use regarding pregnancies.</p>","PeriodicalId":21321,"journal":{"name":"Revue neurologique","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764922","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":"Artificial intelligence applied to electroencephalography in epilepsy.","authors":"C Alvarado-Rojas, G Huberfeld","doi":"10.1016/j.neurol.2025.02.007","DOIUrl":"https://doi.org/10.1016/j.neurol.2025.02.007","url":null,"abstract":"<p><p>Artificial intelligence (AI) is progressively transforming all fields of medicine, promising substantial changes in clinical practice. In the context of epilepsy, electroencephalography (EEG), a technique used for over a century, has historically been resistant to automated analysis due to the complexity of the signals and the challenges posed by artifact management. While the human eye excels at recognizing patterns, algorithms have demonstrated superior capabilities in detecting and characterizing specific features, such as long-term dynamics and synchrony. Furthermore, the advent of wearable EEG devices has led to an exponential increase in data volume, surpassing the limits of visual interpretation. AI algorithms are now being developed to address these limitations, offering enhanced efficiency in both identifying subtle signal features and managing massive datasets. This review explores the fundamental principles of AI and its transformative potential in the field of EEG. It discusses the implications and the current limitations, including improvements limited to aggregation of already known knowledge, for epilepsy diagnosis, medical and surgical treatment, and innovative approaches to patient monitoring, including seizure forecasting, highlighting how AI is poised to redefine the management of epilepsy.</p>","PeriodicalId":21321,"journal":{"name":"Revue neurologique","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754015","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":"Recent progress and challenges in gene therapy for pharmacoresistant focal epilepsy.","authors":"D M Kullmann","doi":"10.1016/j.neurol.2025.02.008","DOIUrl":"https://doi.org/10.1016/j.neurol.2025.02.008","url":null,"abstract":"<p><p>Pharmacoresistant focal epilepsy represents a major unmet need. Recent years have seen several gene therapy strategies validated mainly in rodent models of temporal lobe epilepsy, and some of these have been de-risked for clinical trials. This review considers some of the challenges in progressing from experimental models to the clinic. Among these are identifying promising promoter-transgene combinations, establishing safe and efficacious doses, achieving optimal delivery, and extrapolating across different aetiologies.</p>","PeriodicalId":21321,"journal":{"name":"Revue neurologique","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754029","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}