ECOBES Recherche et Transfert

Saguenay, Canada

ECOBES Recherche et Transfert

Saguenay, Canada
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Laberge L.,ECOBES Recherche et Transfert | Laberge L.,University of Quebec at Chicoutimi | Laberge L.,Université de Sherbrooke | Mathieu J.,Université de Sherbrooke | And 3 more authors.
European Neurology | Year: 2013

Aims: To identify sociodemographic, clinical, and central correlates of health-related quality of life (HRQoL) in DM1 patients. Methods: 200 DM1 patients had assessments of muscular impairment, CTG repeats, and intelligence. Validated instruments were used to assess sociodemographic and clinical factors as well as social support, social participation, daytime sleepiness, fatigue, personality, mood, and quality of life. Regression analysis was used to identify correlates of SF-36 physical and mental component summary scores. Results: Patients scored lower on all SF-36 physical health subscales compared with normative data but did not differ with respect to mental health function. Regression analysis revealed that psychological distress, fatigue, severe muscular impairment, emotional stability, not having worked within the last 12 months, and lower intellectual quotient were associated with lower scores in physical health function. Moreover, neuroticism, daytime sleepiness, dissatisfaction with social participation, and lower conscientiousness were associated with lower scores in mental health function. Conclusion: DM1 has an impact on SF-36 physical summary scores but not on mental summary scores. Factors such as fatigue, daytime sleepiness, psychological distress, unemployment, and social participation dissatisfaction that significantly affect HRQoL in DM1 are amenable to treatment and psychosocial interventions, namely by providing care that integrate health, social, and community services. © 2013 S. Karger AG, Basel.


Laberge L.,ECOBES Recherche et transfert | Laberge L.,University of Quebec at Chicoutimi | Laberge L.,Université de Sherbrooke | Gagnon C.,Université de Sherbrooke | Dauvilliers Y.,Service de Neurologie
Current Neurology and Neuroscience Reports | Year: 2013

Myotonic dystrophy type 1 (DM1) represents the 1 chronic neuromuscular disease with the most prominent sleep disorders, including excessive daytime sleepiness (EDS), sleep apneas, periodic leg movements during sleep, and rapid eye movement sleep dysregulation. The large majority of DM1 patients complain about EDS, which may have a deleterious impact on work, domestic responsibilities, social life, and quality of life. Here, we review the extant literature and report that studies are largely supportive of the view that DM1-related EDS is primarily caused by a central dysfunction of sleep regulation rather than by sleep-related disordered breathing (SRDB) or sleep fragmentation. The pathogenesis of EDS in DM1 still remains unclear but several arguments favor a model in which brain/brainstem nuclear accumulations of toxic expanded DM protein kinase (DMPK) gene are responsible for aberrant genes expression in modifying alternative splicing. Regarding management, early recognition, and treatment of SRDB with nocturnal noninva-sive mechanical ventilation is first mandatory. However, despite its appropriate management, EDS often persists and may require a psychostimulant but no consensus has been yet established. Further studies are needed to clarify the discrepancies between daytime sleepiness/fatigue complaints and subjective/objective measurement of daytime sleepiness, the role of cognitive impairment and apathy in this relationship, and its reversibility with appropriate management. © Springer Science+Business Media New York 2013.


PubMed | Paris 8 University, Groupe de recherche interdisciplinaire sur les maladies neuromusculaires GRIMN, ECOBES Recherche et transfert and CHU Salpetriere
Type: | Journal: BMC neurology | Year: 2015

Apathy in DM1 has long been acknowledged in clinical practice. However, a major drawback is that the concept has been only sparsely explored in previous specific studies. This study aimed to determine the prevalence of apathy in myotonic dystrophy (DM1), to compare it with facioscapulohumeral dystrophy (FSHD) patients and normal healthy controls, and explore its relationship to psychopathological features and cognitive function.Levels of apathy in 38 DM1 patients with adult phenotypes were compared with 19 patients with FSHD and 20 matched controls. Patient participants were consecutively recruited, regarding their interdisciplinary annual evaluation at the neuromuscular pathology reference center (Institute of Myology, Paris, France), within an 18-month period. Additional measurements included motor disability, fatigue, depression, anxiety, and cognitive abilities. Inter-group comparisons were performed using non-parametric Kruskal-Wallis tests and Mann-Whitney U Tests. Intra-group comparisons were carried out with the Wilcoxon Signed rank and Friedman tests. Also, Spearmans correlations were used to assess the strength of linear relationships between pairs of variables. The significance level was set at 0.05.Global score of apathy was significantly higher in DM1 patients than in FSHD patients (p<0.01) and in controls (p<0.001). Sixteen of 38 DM1 patients (39.5%) met the criterion for apathy, contrasting with only 4 of the 19 (21.1%) FSHD patients. No control subject was apathetic. Moreover, apathy in DM1 patients was negatively correlated to MMSE (r=-.46, p<.05) and Stroop Word (r=-.55, p<.01) scores, but not with age, educational level, disease duration, CTG repeats, motor functional disability, fatigue, depression, and anxiety.Apathy is a frequent symptom in DM1 (almost 40%). It is more prevalent than in a similarly disabled group of patients with FSHD and in controls. Results also show that apathy in DM1 is independent of the psychopathological domain, fatigue, age, and motor disability, but associated to general cognitive status. These results altogether could suggest a central cause for apathy in DM1 rather than an adjustment process to cope with the progressive and debilitating nature of the disease. Data emphasize the importance to evaluate this symptom in routine clinical management of DM1 patients.


Martin J.S.,ECOBES Recherche et Transfert | Martin J.S.,Laval University | Hebert M.,Laval University | Ledoux E.,Institute Of Recherche Robert Sauve En Sante Et En Securite Du Travail | And 3 more authors.
Chronobiology International | Year: 2012

Students who work during the school year face the potential of sleep deprivation and its effects, since they have to juggle between school and work responsibilities along with social life. This may leave them with less time left for sleep than their nonworking counterparts. Chronotype is a factor that may exert an influence on the sleep of student workers. Also, light and social zeitgebers may have an impact on the sleep-related problems of this population. This study aimed to document sleep, light exposure patterns, social rhythms, and work-related fatigue of student workers aged 1921 yrs and explore possible associations with chronotype. A total of 88 student workers (mean±SD: 20.18±.44 yrs of age; 36 males/52 females) wore an actigraph (Actiwatch-L; Mini-Mitter/Respironics,Bend, OR) and filled out the Social Rhythm Metric for two consecutive weeks during the school year. Also, they completed the Morningness-Eveningness Questionnaire (MEQ), Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI), and Occupational Fatigue Exhaustion/Recovery Scale (OFER). Repeated and one-way analyses of variance (ANOVAs), Pearson's chi-square tests, and correlation coefficients were used for statistical comparisons. Subjects slept an average of 06:28h/night. Actigraphic sleep parameters, such as sleep duration, sleep efficiency, wake after sleep onset, and sleep latency, did not differ between chronotypes. Results also show that evening types (n=17) presented lower subjective sleep quality than intermediate types (n=58) and morning types (n=13). Moreover, evening types reported higher levels of chronic work-related fatigue, exhibited less regular social rhythms, and were exposed to lower levels of light during their waking hours (between 2 and 11 h after wake time) as compared to intermediate types and morning types. In addition, exposure to light intensities between 100 and 500 lux was lower in evening types than in intermediate types and morning types. However, bright light exposure (≥1000 lux) did not differ between chronotypes. In conclusion, results suggest that student workers may constitute a high-risk population for sleep deprivation. Evening types seemed to cope less well with sleep deprivation, reporting poorer sleep quality and higher levels of work-related fatigue than intermediate types and morning types. The higher chronic work-related fatigue of evening types may be linked to their attenuated level of light exposure and weaker social zeitgebers. These results add credence to the hypothesis that eveningness entails a higher risk of health-impairing behaviors. Copyright © Informa Healthcare USA, Inc.


Laberge L.,ECOBES Recherche et Transfert | Laberge L.,University of Quebec at Chicoutimi | Ledoux E.,Institute Of Recherche Robert Sauve En Sante Et En Securite Du Travail | Auclair J.,ECOBES Recherche et Transfert | And 5 more authors.
Journal of Adolescent Health | Year: 2011

Purpose: To explore potential risk factors for acute and chronic work-related fatigue in students working at a paid job while pursuing school studies. Although work-related fatigue was identified as a potential hazard for youth health, academic achievement, and occupational safety, very few studies have specifically addressed its correlates and possible predictors. Methods: Cross-sectional data from an ongoing prospective cohort study of health risk behaviors in adolescents was used to identify factors associated with increased levels of acute and chronic fatigue in 209 students aged 17-18 years working during the school year. Multiple stepwise regression analyses were performed with acute and chronic fatigue levels as dependent variables, and demographic, work, and health factors as potential explanatory variables. Results: Average hours worked per week by students was 14.7 hours. It was observed that higher psychological distress, poorer health perception, greater sleep debt, and higher exposure to physical work factors were associated with higher levels of acute fatigue. Also, it was observed that higher psychological distress, poorer health perception, higher exposure to physical work factors, and holding multiple jobs were associated with higher levels of chronic fatigue. The number of hours worked weekly was associated with neither acute nor chronic work-related fatigue. Conclusions: Findings suggest that prevention strategies devised to minimize work-related fatigue in students should consider exposure to physical work factors. Results also re-emphasize the importance of obtaining sufficient sleep so as to prevent high levels of acute work-related fatigue. Crown copyright © 2011 Published by Elsevier Inc. on behalf of Society for Adolescent Health and Medicine. All rights reserved.


Martin J.S.,Laval University | Martin J.S.,Linstitut En Sante Mentale Of Quebec | Gaudreault M.M.,ECOBES Recherche et Transfert | Perron M.,University of Quebec at Chicoutimi | And 2 more authors.
Journal of Biological Rhythms | Year: 2016

Adolescent maturation is associated with delays of the endogenous circadian phase. Consequently, early school schedules may lead to a mismatch between internal and external time, which can be detrimental to adolescent sleep and health. In parallel, chronotype is known to play a role in adolescent health; evening chronotype adolescents are at higher risk for sleep problems and lower academic achievement. In the summer of 2008, Kénogami High School (Saguenay, Canada) was destroyed by fire. Kénogami students were subsequently relocated to Arvida High School (situated 5.3 km away) for the 2008-2009 academic year. A dual school schedule was implemented, with Arvida students attending a morning schedule (0740-1305 h) and Kénogami students an afternoon schedule (1325-1845 h). This study aimed to investigate the effects of such school schedules and chronotype on sleep, light exposure, and daytime functioning. Twenty-four morning and 33 afternoon schedule students wore an actigraph during 7 days to measure sleep and light exposure. Academic achievement was obtained from school. Subjects completed validated questionnaires on daytime sleepiness, psychological distress, social rhythms, school satisfaction, alcohol, and chronotype. Overall, afternoon schedule students had longer sleep duration, lower sleepiness, and lower light exposure than morning schedule students. Evening chronotypes (E-types) reported higher levels of sleepiness than morning chronotypes (M-types) in both morning and afternoon schedules. Furthermore, M-types attending the morning schedule reported higher sleepiness than M-types attending the afternoon schedule. No difference was found between morning and afternoon schedule students with regard to academic achievement, psychological distress, social rhythms, school satisfaction, and alcohol consumption. However, in both schedules, M-type had more regular social rhythms and lower alcohol consumption. In summary, this study emphasizes that an early school schedule is associated with detrimental effects in terms of sleep deprivation and daytime sleepiness, even for M-types. Furthermore, irrespective of school schedule, E-type adolescents face an increased risk for poor daytime functioning. © SAGE Publications.


PubMed | University of Quebec at Montréal, ECOBES Recherche et transfert, University of Montréal, Laval University and University of Quebec at Chicoutimi
Type: | Journal: Journal of affective disorders | Year: 2015

Transition into adulthood is a critical developmental period that may be influenced by adverse life events as well as by protective factors. This study aimed at investigating the effect of different forms of child maltreatment experienced prior to age 14 (i.e., sexual abuse, physical abuse and exposure to intimate partner violence), and of friend support at age 14 on the psychological distress trajectory from age 14 to 24.Participants were 605 adolescents from the general population involved in a 10-year longitudinal study. Psychological distress was evaluated at ages 14, 16, 18 and 24. Child maltreatment prior to 14 years was retrospectively assessed at 14 and 24 years while perception of support from friends was evaluated at age 14.Multilevel growth modeling indicated that psychological distress followed a significant decreasing curvilinear trajectory, with participants reporting fewer distressing psychological symptoms after 18 years. All three forms of child maltreatment, as well as their cumulative effect, predicted more psychological distress over 10 years above and beyond the protective effect of support from friends. Higher support from friends at age 14 was related to lower distress at baseline andover 10 years, beyond the effect of child maltreatment.Self-report nature of all measures, attrition, and measures of child maltreatment forms.Psychological distress decreased during the transition from adolescence to emerging adulthood. Results also revealed the detrimental impact of child maltreatment and the promotive role of friend support, which underscore the importance of early intervention.


PubMed | ECOBES Recherche et transfert, Laval University and University of Quebec at Chicoutimi
Type: Journal Article | Journal: Journal of biological rhythms | Year: 2016

Adolescent maturation is associated with delays of the endogenous circadian phase. Consequently, early school schedules may lead to a mismatch between internal and external time, which can be detrimental to adolescent sleep and health. In parallel, chronotype is known to play a role in adolescent health; evening chronotype adolescents are at higher risk for sleep problems and lower academic achievement. In the summer of 2008, Knogami High School (Saguenay, Canada) was destroyed by fire. Knogami students were subsequently relocated to Arvida High School (situated 5.3 km away) for the 2008-2009 academic year. A dual school schedule was implemented, with Arvida students attending a morning schedule (0740-1305 h) and Knogami students an afternoon schedule (1325-1845 h). This study aimed to investigate the effects of such school schedules and chronotype on sleep, light exposure, and daytime functioning. Twenty-four morning and 33 afternoon schedule students wore an actigraph during 7 days to measure sleep and light exposure. Academic achievement was obtained from school. Subjects completed validated questionnaires on daytime sleepiness, psychological distress, social rhythms, school satisfaction, alcohol, and chronotype. Overall, afternoon schedule students had longer sleep duration, lower sleepiness, and lower light exposure than morning schedule students. Evening chronotypes (E-types) reported higher levels of sleepiness than morning chronotypes (M-types) in both morning and afternoon schedules. Furthermore, M-types attending the morning schedule reported higher sleepiness than M-types attending the afternoon schedule. No difference was found between morning and afternoon schedule students with regard to academic achievement, psychological distress, social rhythms, school satisfaction, and alcohol consumption. However, in both schedules, M-type had more regular social rhythms and lower alcohol consumption. In summary, this study emphasizes that an early school schedule is associated with detrimental effects in terms of sleep deprivation and daytime sleepiness, even for M-types. Furthermore, irrespective of school schedule, E-type adolescents face an increased risk for poor daytime functioning.


Boudreault-Bouchard A.-M.,University of Quebec at Chicoutimi | Dion J.,University of Quebec at Chicoutimi | Hains J.,University of Quebec at Chicoutimi | Laberge L.,University of Quebec at Chicoutimi | And 2 more authors.
Journal of Adolescence | Year: 2013

This study aims at investigating the impact of parental practices on youths' adjustment. In all, 605 adolescents completed questionnaires at ages 14, 16 and 18. Self-esteem, psychological distress as well as parental emotional support and coercive control were measured. Analyses based on individual growth models revealed that self-esteem increased with age, but psychological distress remained stable over time. Boys reported higher levels of self-esteem and lower levels of psychological distress than girls. Maternal and paternal emotional support reinforced self-esteem over time. Maternal coercive control undermined self-esteem, but only at ages 16 and 18. Psychological distress decreased with parental emotional support but increased with parental coercive control at ages 14, 16 and 18. Overall, these results indicate that positive parental practices are related to youths' well-being. These findings support the importance of establishing intervention strategies designed to promote best practices among parents of teenagers to help them develop into well-adjusted adults. © 2013 The Foundation for Professionals in Services for Adolescents.


Laberge L.,ECOBES Recherche et transfert
Current neurology and neuroscience reports | Year: 2013

Myotonic dystrophy type 1 (DM1) represents the 1 chronic neuromuscular disease with the most prominent sleep disorders, including excessive daytime sleepiness (EDS), sleep apneas, periodic leg movements during sleep, and rapid eye movement sleep dysregulation. The large majority of DM1 patients complain about EDS, which may have a deleterious impact on work, domestic responsibilities, social life, and quality of life. Here, we review the extant literature and report that studies are largely supportive of the view that DM1-related EDS is primarily caused by a central dysfunction of sleep regulation rather than by sleep-related disordered breathing (SRDB) or sleep fragmentation. The pathogenesis of EDS in DM1 still remains unclear but several arguments favor a model in which brain/brainstem nuclear accumulations of toxic expanded DM protein kinase (DMPK) gene are responsible for aberrant genes expression in modifying alternative splicing. Regarding management, early recognition, and treatment of SRDB with nocturnal noninvasive mechanical ventilation is first mandatory. However, despite its appropriate management, EDS often persists and may require a psychostimulant but no consensus has been yet established. Further studies are needed to clarify the discrepancies between daytime sleepiness/fatigue complaints and subjective/objective measurement of daytime sleepiness, the role of cognitive impairment and apathy in this relationship, and its reversibility with appropriate management.

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