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Le Touquet – Paris-Plage, France

Talfournier J.,University Paris Diderot | Bitu J.,University Paris Diderot | Paquet C.,University Paris Diderot | Paquet C.,French Institute of Health and Medical Research | And 7 more authors.
Diabetes and Metabolism | Year: 2013

Aims: This study aimed to assess the relationship between blood pressure and cognitive function in elderly patients with diabetes mellitus (DM). Methods: A total of 32 patients with DM aged. ≥. 65 years (seven women and 25 men; mean. ±. SD age: 74.3. ±. 6.4 years) were included in this cross-sectional study. Relationships between blood pressure and neuropsychological tests were determined using Spearman's rank correlations (ρ) and multivariable linear regression models. Results: Lower diastolic blood pressure was associated with lower scores on the Frontal Assessment Battery (ρ. = 0.32, P= 0.02), longer times to complete the Trail Making Test Part B (ρ. = 0.51, P= 0.003), lower scores for the Finger Tapping Test (ρ. = 0.36, P= 0.046) and less verbal fluency (ρ. = 0.36, P= 0.047). In multivariable models, these relationships were attenuated after adjusting for levels of education. Conclusion: There was an association between lower diastolic blood pressure and poorer executive function in this cohort of elderly DM patients. These results underline the importance of systematic cognitive evaluation in elderly patients with DM, and suggest that a too-low diastolic blood pressure may have deleterious effects on mental function. Larger studies in the future are required to confirm these preliminary results. © 2013 Elsevier Masson SAS.

Deroide N.,Physiologie Clinique Explorations Fonctionnelles | Deroide N.,University Paris Diderot | Bousson V.,Radiologie Osteo Articulaire | Bousson V.,University Paris Diderot | And 21 more authors.
Muscle and Nerve | Year: 2012

Introduction: Muscle magnetic resonance imaging (MRI) is an innovative tool for exploring focal neuropathies. However, its usefulness in mild, proximal, or chronic lesions, when electromyography (EMG), the current "gold standard" sensitivity is inadequate, has yet to be studied. Methods: Clinical, MRI, and EMG examinations were performed in 113 muscles of 17 consecutive patients with clinically diagnosed lower limb focal neuropathies. The sensitivity and specificity of MRI and EMG were evaluated in relation to disease duration, severity, and anatomical location. Results: Muscle MRI was highly sensitive for the detection of denervated muscle, and, unlike EMG, its sensitivity did not decrease regardless of the anatomical location, duration, or severity of the neuropathy. Five MRI false positives were noted, including three in the thigh muscles. Conclusions: Muscle MRI is an alternative tool to EMG in proximal, mild, or chronic clinical diagnoses of lower limb focal neuropathies. However, it also seems prone to false-positive results, particularly in proximal muscles. © 2012 Wiley Periodicals, Inc.

Lozeron P.,Physiologie Clinique Explorations Fonctionnelles | Lozeron P.,Hopitaux universitaires Paris Sud | Lacroix C.,Physiologie Clinique Explorations Fonctionnelles | Lacroix C.,Hopitaux universitaires Paris Sud | And 8 more authors.
Amyloid | Year: 2013

Objective: Familial amyloid polyneuropathy (FAP) is typically a predominantly sensory and autonomic neuropathy with progressive and late motor involvement leading to death within 10 years. Recently, prognosis was transformed with liver transplantation. Methods: We report an atypical sporadic pure motor and bulbar neuropathy initially mistaken for amyotrophic lateral sclerosis (ALS) in a 50-year-old Malian man. Results: The diagnostic procedure of this clinical purely motor and bulbar neuropathy disclosed amyloid deposits on nerve biopsy which led to the identification of a new Val93Met mutation of transthyretin. This case was also remarkable by its slow progression. Conclusions: This report confirms the motor phenotype of TTR-FAP. That should be considered in the differential diagnosis of motor neuron diseases in order to start accurate therapy. © 2013 Informa UK Ltd. All rights reserved.

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