Universites Montpellier

Murviel-lès-Montpellier, France

Universites Montpellier

Murviel-lès-Montpellier, France
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Bayard S.,Service de Neurologie | Bayard S.,French Institute of Health and Medical Research | Langenier M.C.,Service de Neurologie | Langenier M.C.,Universites Montpellier | And 2 more authors.
Sleep | Year: 2013

Objective: To investigate the effect of psychostimulants on impulsivity, depressive symptoms, addiction, pathological gambling, and risk-taking using objective sensitivity tests in narcolepsy with cataplexy (NC). Drug-free patients with NC present alterations in reward processing, but changes with psychostimulants remain unknown. Design: Prospective case-control study. Setting: Academic sleep disorders center. Participants: There were 120 participants: 41 drug-free patients with NC, 37 patients with NC taking psychostimulants, and 42 matched healthy controls. Interventions: All participants underwent a semistructured clinical interview for impulse control and addictive behaviors and completed questionnaires for depression and impulsivity. Risk taking was analyzed through performance on a decision-making task under ambiguity (Iowa Gambling Task [IGT]) and under risk (Game of Dice Task [GDT]). All patients with NC underwent 1 night of polysomnography followed by a multiple sleep latency test for drug-free patients and a maintenance wakefulness test for treated patients. Results: Depressive symptoms were higher in drug-free patients than in treated patients and controls, with no difference between controls and treated patients. No between-group differences were found for impulsivity, substance addiction, or pathological gambling. Drug-free and treated patients showed selective reduced performance on the IGT and normal performance on the GDT compared with controls, with no differences between patients taking medication and those who did not. No clinical or polysomnographic characteristics or medication type was associated with IGT scores. Conclusions: Our results demonstrated that, whether taking psychostimulants or not, patients with narcolepsy with cataplexy preferred risky choices on a decision-making task under ambiguity. However, the lack of association with impulsivity, pathological gambling, or substance addiction remains of major clinical interest in narcolepsy with cataplexy. © 2013 Associated Professional Sleep Societies, LLC.


Bayard S.,Service de Neurologie | Langenier M.C.,Service de Neurologie | Langenier M.C.,Universites Montpellier | Dauvilliers Y.,Service de Neurologie
Journal of Sleep Research | Year: 2013

Cataplexy is pathognomonic of narcolepsy with cataplexy, and defined by a transient loss of muscle tone triggered by strong emotions. Recent researches suggest abnormal amygdala function in narcolepsy with cataplexy. Emotion treatment and emotional regulation strategies are complex functions involving cortical and limbic structures, like the amygdala. As the amygdala has been shown to play a role in facial emotion recognition, we tested the hypothesis that patients with narcolepsy with cataplexy would have impaired recognition of facial emotional expressions compared with patients affected with central hypersomnia without cataplexy and healthy controls. We also aimed to determine whether cataplexy modulates emotional regulation strategies. Emotional intensity, arousal and valence ratings on Ekman faces displaying happiness, surprise, fear, anger, disgust, sadness and neutral expressions of 21 drug-free patients with narcolepsy with cataplexy were compared with 23 drug-free sex-, age- and intellectual level-matched adult patients with hypersomnia without cataplexy and 21 healthy controls. All participants underwent polysomnography recording and multiple sleep latency tests, and completed depression, anxiety and emotional regulation questionnaires. Performance of patients with narcolepsy with cataplexy did not differ from patients with hypersomnia without cataplexy or healthy controls on both intensity rating of each emotion on its prototypical label and mean ratings for valence and arousal. Moreover, patients with narcolepsy with cataplexy did not use different emotional regulation strategies. The level of depressive and anxious symptoms in narcolepsy with cataplexy did not differ from the other groups. Our results demonstrate that narcolepsy with cataplexy accurately perceives and discriminates facial emotions, and regulates emotions normally. The absence of alteration of perceived affective valence remains a major clinical interest in narcolepsy with cataplexy, and it supports the argument for optimal behaviour and social functioning in narcolepsy with cataplexy.


Raffard S.,Universites Montpellier | Raffard S.,Montpellier University Hospital Center | Bayard S.,Service de Neurologie | Bayard S.,French Institute of Health and Medical Research
Brain and Cognition | Year: 2012

Schizophrenia is characterized by heterogeneous brain abnormalities involving cerebral regions implied in the executive functioning. The dysexecutive syndrome is one of the most prominent and functionally cognitive features of schizophrenia. Nevertheless, it is not clear to what extend executive deficits are heterogeneous in schizophrenia patients. Furthermore, it is still unknown if the executive impairments observed in schizophrenia are better characterized as specific or as reflecting generalized cognitive factors. The four executive processes (i.e. updating, inhibition, shifting and divided attention) described in Miyake et al.'s (2000) theoretical model were examined in 62 individuals with schizophrenia and 49 healthy controls. At group level, impairments in all four executive processes confirmed the marked impairment in executive functioning in patients with schizophrenia. Statistical analysis indicated that executive performances in schizophrenia patients were more heterogeneous than in healthy controls. Compared with standardized norms, 94% of patients exhibited impairment in at least one of the executive tasks. Twenty-one percent of patients exhibited impairment in one executive task, 27% in two tasks, 23% in three executive tasks and 23% exhibited impairments in the four executive tasks. Six percent of patients had normal executive profile. Regression analysis indicated that only premorbid intellectual quotient and a general slowing in processing speed predicted the executive dysfunction severity. Executive functioning was not affected by age, duration of illness, psychotic status, or by antipsychotic dosage. Our results emphasize the heterogeneity of the dysexecutive syndrome in schizophrenia when individual profile analysis is considered, and extend the view that individual cognitive differences in schizophrenia are largely underlined by general cognitive factors such as intellectual level and general processing speed. © 2012 Elsevier Inc.


Ulmann L.,French National Center for Scientific Research | Ulmann L.,French Institute of Health and Medical Research | Ulmann L.,Universites Montpellier | Hirbec H.,French National Center for Scientific Research | And 5 more authors.
EMBO Journal | Year: 2010

Prostaglandin E2 (PGE2) is a key mediator of inflammation and contributes to pain hypersensitivity by promoting sensory neurons hyperexcitability. PGE2 synthesis results from activation of a multi-step enzymatic cascade that includes cyclooxygenases (COXs), the main targets of non-steroidal anti-inflammatory drugs (NSAIDs). Although NSAIDs are widely prescribed to reduce inflammatory symptoms such as swelling and pain, associated harmful side effects restrict their long-term use. Therefore, finding new drugs that limit PG production represents an important therapeutic issue. In response to peripheral inflammatory challenges, mice lacking the ATP-gated P2X4 channel (P2X4R) do not develop pain hypersensitivity and show a complete absence of inflammatory PGE2 in tissue exudates. In resting conditions, tissue-resident macrophages constitutively express P2X4R. Stimulating P2X4R in macrophages triggers calcium influx and p38 MAPK phosphorylation, resulting in cytosolic PLA2 (cPLA2) activation and COX-dependent release of PGE2. In naive animals, pain hypersensitivity was elicited by transfer into the paw of ATP-primed macrophages from wild type, but not P2X4R-deficient mice. Thus, P2X4Rs are specifically involved in inflammatory-mediated PGE2 production and might therefore represent useful therapeutic targets. © 2010 European Molecular Biology Organization - All Rights Reserved.


PubMed | Universites Montpellier, Aggeu Magalhaes Research Center and University of Pernambuco
Type: Comparative Study | Journal: Sao Paulo medical journal = Revista paulista de medicina | Year: 2016

To monitor glycemic control in diabetic patients, regular measurement of glycated hemoglobin (HbA1c) is recommended, but this can be difficult in remote places without access to laboratories. Portable point-of-care testing devices can prove a useful alternative. Our study aimed to assess the performance of one of them: A1CNow+, from Bayer.Cross-sectional accuracy study conducted at a university hospital in Brazil.We made three successive measurements of capillary HbA1c using the A1CNow+ in 55 diabetic volunteers, while the same measurement was made on venous blood using the hospital reference method (Vitros 5,1 FS). We used the Bland-Altman graphical method to assess the A1CNow+ in relation to the Vitros 5,1 FS method. We also evaluated clinical usefulness by calculating the sensitivity and specificity of A1CNow+ for detecting patients with HbA1c lower than 7%, which is the usual limit for good glycemic control.The coefficient of variation between repeat testing for the A1CNow+ was 3.6%. The mean difference between A1CNow+ and Vitros 5,1 FS was +0.67% (95% confidence interval, CI: +0.52 to +0.81). The agreement limits of our Bland-Altman graph were -0.45 (95% CI: -0.71 to -0.19) and +1.82 (95% CI: +1.52 to +2.05). The sensitivity and specificity in relation to the 7% limit were respectively 100% and 67.7%.Although the A1CNow+ had good sensitivity, its accuracy was insufficient for use as a replacement for laboratory measurements of HbA1c, for glycemic control monitoring in diabetic patients.


The aim of this study was to expand our knowledge of the influence of emotional valence on visual word recognition by answering two questions. The first was to examine whether the emotional valence effect is sensitive to different types of task requirements, and the second was to examine whether words polysemy can modulate the effect of emotional valence. For this purpose, we manipulated orthogonally emotional valence (negative, positive and neutral words) and polysemy (polysemous vs. non polysemous words) in two versions of the lexical-decision task (one with legal nonwords and one with illegal nonwords). Results showed an effect of task: emotional valence and polysemy influenced lexical decision latencies only in the legal version of the lexical-decision task. Furthermore, results showed that the effect of polysemy was dependant on emotional valence. We observed a facilitation of polysemy for neutral words but not for emotional ones. Finally this experiment also showed that polysemy modulates the emotional valence effect. The facilitation observed for non polysemous emotional words compared to non polysemous neutral words disappeared for polysemous words. These findings fit with other studies showing facilitation for emotional word recognition and allow conclusions concerning the role of semantics on emotional word recognition. © 2012 Canadian Psychological Association.


Reynes J.,Montpellier University | Cournil A.,Montpellier University | Peyriere H.,Montpellier University | Psomas C.,Montpellier University | And 6 more authors.
AIDS | Year: 2013

Objective: To assess the frequency of glomerular and tubular proteinuria in a cohort of HIV-infected patients, and to determine the factors associated with each type of injury. Design: Cross-sectional study of 1210 consecutive HIV-infected adults followed in HIV outpatient unit (Montpellier/France). Methods: Spot urine protein to creatinine (uPCR), albumin to creatinine (uACR) and albumin to protein (uAPR) ratios were assessed. Glomerular injury was defined as uACR at least 30mg/g or uPCR at least 200mg/g with uAPR at least 0.4. Tubular injury was defined as uPCR 200mg/g or more with uAPR less than 0.4. Multivariate logistic regression identified independent factors of each type of proteinuria, in the 1158 patients with estimated glomerular filtration rate (eGFR) at least 60 ml/min per 1.73 m2, using re-expressed modification of diet in renal disease equation. Results: Frequency of proteinuria was 18.2% among patients with eGFR at least 60 ml/min per 1.73 m2 consisting in tubular proteinuria for 50.7% of them. Factors associated with glomerular proteinuria were age [OR 1.34/10-year increment (95%CI: 1.08-1.66)], diabetes [OR3.37(95%CI: 1.53-7.44)], and arterial hypertension [OR 2.52 (95%CI: 1.36-4.66)]. Factors associated with tubular proteinuria were age [OR 1.43 (95%CI: 1.14-1.79)], current tenofovir use [OR 3.52 (95%CI: 1.86-6.65)], hepatitis C co-infection [OR 1.62 (95%CI: 1.00-2.65)], AIDS stage [OR 1.83 (95%CI: 1.18-2.82)], CD4 cell count less than 200 per μl [OR 2.48 (95%CI: 1.31-4.70)]. Conclusion: This study distinguished risk factors for tubular injury, mainly related to HIV disease and its treatment (tenofovir), and glomerular injury, linked to non HIV-related variables (age, diabetes, hypertension). Measuring uPCR, uACR and uAPR may help with the detection and specific management of early chronic kidney disease in HIV-infected patients having normal or sub-normal eGFR. © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins.


Bayard S.,Universites Montpellier | Mietkiewicz M.-C.,Universites Montpellier
Geriatrie et Psychologie Neuropsychiatrie du Vieillissement | Year: 2015

The mild cognitive impairment (MCI) is described as an intermediate state of cognitive impairment whereby individuals present with mild clinical symptoms but with nearly normal daily living activities. These subjects do not meet the clinical criteria for dementia, yet their cognitive functioning is below what we would expect for age and education in healthy people. In the other hand, older adults are at risk for sleep disorders including obstructive sleep apnea syndrome, restless legs syndrome, REM sleep behavioral disorder and chronic insomnia, which could have an impact on cognitive functioning and are exclusion criteria for the MCI diagnosis. Moreover, REM sleep behavioral disorder represents a risk factor for the development of neurodegenerative diseases. In subjects more 65 years of age the association between chronic insomnia and cognitive changes is still debated. The main aim of this paper is to focus on identification of sleep disorders in the context of cognitive disturbances among professionals working with the elderly.


Ninot G.,Universites Montpellier
Revue des Maladies Respiratoires | Year: 2011

COPD does not only affect the respiratory function of a patient. It also affects his/her cognitive and affective functions. These effects can be seen particularly in the incidence of anxiety and depressive disorders at different periods during the stage of the illness. This review of the literature suggests some contemporary definitions of these disorders, their link to COPD, and procedures for their assessment during clinical practice. © 2011 SPLF. Published by Elsevier Masson SAS. All rights reserved.


PubMed | Universites Montpellier
Type: Journal Article | Journal: Geriatrie et psychologie neuropsychiatrie du vieillissement | Year: 2015

The mild cognitive impairment (MCI) is described as an intermediate state of cognitive impairment whereby individuals present with mild clinical symptoms but with nearly normal daily living activities. These subjects do not meet the clinical criteria for dementia, yet their cognitive functioning is below what we would expect for age and education in healthy people. In the other hand, older adults are at risk for sleep disorders including obstructive sleep apnea syndrome, restless legs syndrome, REM sleep behavioral disorder and chronic insomnia, which could have an impact on cognitive functioning and are exclusion criteria for the MCI diagnosis. Moreover, REM sleep behavioral disorder represents a risk factor for the development of neurodegenerative diseases. In subjects more 65 years of age the association between chronic insomnia and cognitive changes is still debated. The main aim of this paper is to focus on identification of sleep disorders in the context of cognitive disturbances among professionals working with the elderly.

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