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Le Touquet – Paris-Plage, France

Piquard A.,University of Versailles | Derouesne C.,University of Montpellier 3 Paul Valery | Lacomblez L.,Federation de Neurologie | Le Poncin M.,Paris West University Nanterre La Defense
Geriatrie et Psychologie Neuropsychiatrie du Vieillissement | Year: 2012

The relationships between subjective cognitive difficulties and stressful events (SE) have rarely been examined. Broadbent et al. (1982) suggested that such difficulties disclose a high sensitivity to stress, independently of depression and personality. Objective: To explore the relationships between the severity of memory complaints and SE occurred during the previous year. Methods: 260 cognitively normal subjects, aged from 25 to 85 years were examined in a Memory clinic through one year. The severity of memory complaints was globally assessed by asking the participants to qualify the intensity of their subjective difficulties as major or minor, and quantitatively, by using a 8-item subjective memory scale. SE were assessed by asking the subjects whether they experienced one or more events that had negative effects on their physic or mental well-being in the domains of health, family, social environment and financial position during the last 12 months. Affective status was assessed by the Zung's depression (ZD) and anxiety (ZA) scales, and by a Wellbeing questionnaire, QBE. Cognition was assessed using a semi-computerized battery exploring memory and several cognitive abilities. Results: SE were reported in 156 subjects (60%). No differences were found between subjects with or without SE according to age, genre, familial status and activity, as well as cognitive performance. Subjects with SE reported more severe complaints and higher scores on ZD and ZA scales, and lower scores on the QBE. Severity of memory complaints was mainly correlated to QBE in subjects with SE and to ZA scale in subjects without. Subjects with age < 50 years reported more SE than subjects aged = 50 years. No difference was found between the two age groups according to the type of SE in the domain of health, family, and finances, but higher SE were reported in younger subjects in the domain of social environment. The main correlates of the severity of memory complaints were depression in younger subjects with or without SE, and anxiety in absence of SE and QBE in presence of SE in older subjects. However, the affective scores explained only a weak part of the variance of the severity of memory complaints. Conclusion: SE do not seem to play a direct role in the severity of memory complaints, but they increase the affective disturbances. We suggest that anxiety and various factors such as decrease in self-esteem and modification of self-identity result in a psychological vulnerability which contribute to memory complaints. Source

The development of the embryo and foetus fascinates, but its study in humans is difficult because of both technical and ethical problems. Auguste d'Eternod, Swiss embryologist, published in 1913an article entitled "The early stages of the human egg" in the Comptes Rendus de l'Association des Anatomistes, the ancestor of the journal Morphologie. This work is focused not only on the early stages of development: fertilization, cleavage of the egg, blastocyst formation, gastrulation, but also on the extra-embryonic processes characteristic of mammals. On the occasion of the centenary of the publication of this work, I propose a critical review by placing the data published in the literature and historical context of the time. Finally, I try to extract from these observations the concepts that are still used today by embryologists. © 2014 Elsevier Masson SAS. Source

Andrade K.,French Institute of Health and Medical Research | Andrade K.,University Pierre and Marie Curie | Samri D.,Federation de Neurologie | Sarazin M.,French Institute of Health and Medical Research | And 11 more authors.
BMC Neurology | Year: 2010

Background: In posterior cortical atrophy (PCA), there is a progressive impairment of high-level visual functions and parietal damage, which might predict the occurrence of visual neglect. However, neglect may pass undetected if not assessed with specific tests, and might therefore be underestimated in PCA. In this prospective study, we aimed at establishing the side, the frequency and the severity of visual neglect, visual extinction, and primary visual field defects in an unselected sample of PCA patients.Methods: Twenty-four right-handed PCA patients underwent a standardized battery of neglect tests. Visual fields were examined clinically by the confrontation method.Results: Sixteen of the 24 patients (66%) had signs of visual neglect on at least one test, and fourteen (58%) also had visual extinction or hemianopia. Five patients (21%) had neither neglect nor visual field defects. As expected, left-sided neglect was more severe than right-sided neglect. However, right-sided neglect resulted more frequently in this population (29%) than in previous studies on focal brain lesions.Conclusion: When assessed with specific visuospatial tests, visual neglect is frequent in patients with PCA. Diagnosis of neglect is important because of its negative impact on daily activities. Clinicians should consider the routine use of neglect tests to screen patients with high-level visual deficits. The relatively high frequency of right-sided neglect in neurodegenerative patients supports the hypothesis that bilateral brain damage is necessary for right-sided neglect signs to occur, perhaps because of the presence in the right hemisphere of crucial structures whose damage contributes to neglect. © 2010 Andrade et al; licensee BioMed Central Ltd. Source

Fayard C.,University of Burgundy | Bonaventure A.,French Institute of Health and Medical Research | Bonaventure A.,University Pierre and Marie Curie | Benatru I.,University of Burgundy | And 24 more authors.
Parkinsonism and Related Disorders | Year: 2011

Levodopa induces long-term motor complications in Parkinson's disease (PD). Therapeutic strategies that prevent motor complications are needed. Our aim was to evaluate the impact of recommendations of a French consensus conference published in 2000 on initial PD therapy. We identified 308 PD patients as part of a population-based study performed within the Mutualité Sociale Agricole in five French districts (2007). Neurologists confirmed PD diagnosis. We compared initial therapy in 102 patients treated before 12/31/2000 to that of 206 patients treated afterwards. Initial treatment was in agreement with the recommendations if dopamine agonists were used in patients <60 years (n = 49) and levodopa in patients ≥70 years (n = 133). Agreement with the recommendations increased after 2000 (66.0%) compared to before (46.3%, p = 0.025). For patients <60 years, agreement increased (64.0% vs 20.2%, p = 0.017) while it remained stable (66.4% vs 70.6%, p = 0.73) in patients ≥70 years. The publication of recommendations has influenced initial treatment choices for PD in France. © 2011 Elsevier Ltd. Source

Amarenco G.,Service de Neuro Urologie et dExplorations Perineales | Chartier-Kastler E.,GREEN UPMC | Chartier-Kastler E.,University Pierre and Marie Curie | Denys P.,Service de Reeducation Neurologique | And 3 more authors.
Multiple Sclerosis Journal | Year: 2013

Background: Urinary disorders that lead to urological complications are frequent in multiple sclerosis, resulting in diminished quality of life. Urinary management guidelines are scarce and targeted to neuro-urology specialists. Objective: This study aimed to construct and validate an algorithm dedicated to neurologists and general practitioners to facilitate first-line evaluation and treatment of urinary disorders associated with multiple sclerosis. Methods: 49 items concerning urological symptom evaluation and therapeutic strategies were derived from literature analysis and evaluated by an expert panel. The Delphi method established consensus between the experts and allowed development of the First-Line Urological Evaluation in Multiple Sclerosis (FLUE-MS) algorithm. Two questions from the Urinary Bothersome Questionnaire in Multiple Sclerosis were included and their validation to verify comprehensiveness and acceptability was also conducted. Results: Three rounds of expert review obtained consensus of all 49 items and allowed finalisation of the algorithm. Comprehension and acceptability of two Urinary Bothersome Questionnaire in Multiple Sclerosis questions were verified (mean comprehensiveness score: 1.99/2 [99.7% total comprehensiveness], mean acceptability score: 1.99/2 [99.1% complete acceptability]). Conclusion: The FLUE-MS algorithm was designed for neurologists and general practitioners, enabling identification of 'red flags', timely patient referral to specialist neuro-urology units, and appropriate first-line therapy. © The Author(s) 2013. Source

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