Showing papers by "Ophélia Godin published in 2016"

Predictors of Clinical Worsening in Cerebral Autosomal Dominant Arteriopathy With Subcortical Infarcts and Leukoencephalopathy: Prospective Cohort Study

Abstract: Background and Purpose— Predictors of clinical worsening in cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy remain unknown. This study aims to identify demographic, clinical, and magnetic resonance imaging predictors of incident strokes, incident dementia, clinical deterioration, and death in patients with this genetically proven disease. Methods— Two hundred ninety subjects (mean age, 50.6±11.4 years) were assessed at baseline and followed up for 36 months. Incident clinical events were recorded, and clinical scores included the Mini Mental State Examination, Mattis Dementia Rating Scale, modified Rankin Scale, and Barthel index. The number of lacunes and microbleeds, the volume of white-matter hyperintensities, and brain parenchymal fraction were assessed on baseline magnetic resonance imaging. Data were analyzed by ANCOVA, multivariable logistic regression, and Cox proportional hazard models. Results— Incident stroke occurred in 55 of 278 patients (19.8%). Moderate or severe disability developed in 19 of 210 (9%) nondisabled individuals, incident dementia in 49 of 231 (20%) nondemented subjects, and 4.8% of patients died. Active smoking, the number of lacunes, and brain parenchymal fraction independently predicted incident stroke during follow-up. Gait disturbance, dementia, and brain parenchymal fraction predicted progression toward moderate or severe disability. Active smoking, disability, and brain parenchymal fraction predicted incident dementia. Age was the only significant predictor of death. Conclusions— Clinical assessment and brain magnetic resonance imaging aid in predicting incident clinical events and clinical deterioration in cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy. There is a bidirectional relationship between dementia and moderate or severe disability in predicting each other’s onset. Active smoking is a modifiable risk factor associated with clinical progression in Notch3 mutation carriers.

Chronic Peripheral Inflammation is Associated With Cognitive Impairment in Schizophrenia: Results From the Multicentric FACE-SZ Dataset

Abstract: Objectives: Inflammation, measured by abnormal blood C-reactive protein a (CRP) level, has been described in schizophrenia (SZ), being a inconsistently related to impaired cognitive functions. The aim of the a present study is to investigate cognitive impairment associated with a abnormal CRP levels in a large multi-centric sample of a community-dwelling SZ patients, using a comprehensive neuropsychological a battery. Method: Three hundred sixty-nine community-dwelling stable SZ a subjects (76.2% men, mean age 32.7 y) were included and tested with a a comprehensive battery of neuropsychological tests. Abnormal CRP level a was defined as >3 mg/L. Results: Multiple factor analysis revealed that a abnormal CRP levels, found in 104 patients (28.2%), were associated a with impaired General Intellectual Ability and Abstract Reasoning (aOR = a 0.56, 95% CI 0.35-0.90, P = .014), independently of age, sex, education a level, psychotic symptomatology, treatments, and addiction a comorbidities. Abnormal CRP levels were also associated with the decline a of all components of working memory (respectively effect size [ ES] = a 0.25, P = .033; ES = 0.27, P = .04; ES = 0.33, P = .006; and ES = 0.38, a P = .004) and a wide range of other impaired cognitive functions, a including memory (ES = 0.26, P = .026), learning abilities (ES = 0.28, P a = .035), semantic memory (ES = 0.26, P = .026), mental flexibility (ES = a 0.26, P = .044), visual attention (ES = 0.23, P = .004) and speed of a processing (ES = 0.23, P = .043). Conclusion: Our results suggest that a abnormal CRP level is associated with cognitive impairment in SZ. a Evaluating the effectiveness of neuroprotective anti-inflammatory a strategies is needed in order to prevent cognitive impairment in SZ.

Prevalence and characteristics of migraine in CADASIL.

Abstract: Background and objective Migraine with aura (MA) is a major symptom of cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL). We assessed the spectrum of migraine symptoms and their potential correlates in a large prospective cohort of CADASIL individuals. Methods A standardized questionnaire was used in 378 CADASIL patients for assessing headache symptoms, trigger factors, age at first attack, frequency of attacks and associated symptoms. MRI lesions and brain atrophy were quantified. Results A total of 54.5% of individuals had a history of migraine, mostly MA in 84% of them; 62.4% of individuals with MA were women and age at onset of MA was lower in women than in men. Atypical aura symptoms were experienced by 59.3% of individuals with MA, and for 19.7% of patients with MA the aura was never accompanied by headache. MA was the inaugural manifestation in 41% of symptomatic patients and an isolated symptom in 12.1% of individuals. Slightly higher MMSE and MDRS scores and lower Rankin score were detected in the MA group. Conclusion MA is observed in almost half of all CADASIL patients. Atypical aura symptoms are reported by more than one in two of them. MA is often inaugural, can remain isolated and is not associated with the severity of the disorder.

Differential effects of childhood trauma and cannabis use disorders in ă patients suffering from schizophrenia

Abstract: Background: Childhood trauma (CT) and cannabis use are both a environmental and modifier risk factors for schizophrenia. However, a little is known about how they interact in schizophrenia. We examined a the main effect of each of these two environmental factors on the a clinical expression of the disease using a large set of variables, and a we tested whether and how cannabis and CT interact to influence the a course and the presentation of the illness. a Methods: A sample of 366 patients who met the DSM-IV-TR criteria for a schizophrenia was recruited through the FACE-SCZ (Fondamental Advanced a Centre of Expertise - Schizophrenia) network. Patients completed a large a standardized clinical evaluation including Structured Clinical Interview a for DSM Disorders-I (SCID-I), Positive and Negative Symptoms Scale a (PANSS), Columbia-Suicide Severity Rating Scale (C-SSRS), Global a Assessment of Functioning (GAF), Short-Quality of Life-18 (S-QoL-18), a and Medication Adherence Rating Scale (MARS). We assessed CT with the a Childhood Trauma Questionnaire and cannabis status with SCID-I. a Results: CT significantly predicted the number of hospitalizations, GAF, a and S-QoL-18 scores, as well as the PANSS total, positive, excitement, a and emotional distress scores. Cannabis use disorders significantly a predicted age of onset, and MARS. There was no significant interaction a between CT and cannabis use disorders. However, we found evidence of a a correlation between these two risk factors. a Conclusions: CT and cannabis both have differential deleterious effects a on clinical and functional outcomes in patients with schizophrenia. Our a results highlight the need to systematically assess the presence of a these risk factors and adopt suitable therapeutic interventions. (C) a 2016 Elsevier B.V. All rights reserved.

Syndrome métabolique et troubles bipolaires : le sommeil est-il le chaînon manquant ?

Abstract: De nombreuses etudes montrent que la prevalence du syndrome metabolique est plus elevee chez les patients bipolaires que dans la population generale. En effet, entre 36 et 49 % de ces patients presentent des troubles metaboliques (Vancampfort, 2013), ce qui aggrave leur pronostic. La presence de troubles metaboliques chez ces patients peut etre expliquee par de nombreux facteurs comme une hygiene de vie a risque, une vulnerabilite genetique, la frequence des episodes depressifs ou les comorbidites psychiatriques, et les traitements psychotropes. D’autre part, ces patients presentent des perturbations de leurs rythmes circadiens, meme lors des periodes normothymiques. Plusieurs etudes recentes ont montre une correlation entre des perturbations circadiennes et des marqueurs metaboliques chez des patients bipolaires. L’objectif de cette revue est de mettre en evidence un lien possible entre troubles circadiens et du sommeil et anomalies metaboliques chez les patients bipolaires, et les voies physiopathologiques possiblement impliquees. Dans la population generale, des voies de regulation ont ete mises en evidence pour expliquer de tels liens, via des hormones comme la leptine et la ghreline. Une de nos hypotheses est l’implication de ces voies dans la vulnerabilite des patients bipolaires aux troubles metaboliques. Cette hypothese est appuyee par des donnees de la litterature recente sur des perturbations de ces hormones dans des maladies psychiatriques dont le trouble bipolaire. D’autres mecanismes semblent egalement en jeu, impliquant une deregulation de la secretion de melatonine et des mecanismes inflammatoires [Resume d'auteur]

Chronic Peripheral Inflammation is Associated With Cognitive Impairment ă in Schizophrenia: Results From the Multicentric FACE-SZ Dataset

Abstract: Objectives: Inflammation, measured by abnormal blood C-reactive protein a (CRP) level, has been described in schizophrenia (SZ), being a inconsistently related to impaired cognitive functions. The aim of the a present study is to investigate cognitive impairment associated with a abnormal CRP levels in a large multi-centric sample of a community-dwelling SZ patients, using a comprehensive neuropsychological a battery. Method: Three hundred sixty-nine community-dwelling stable SZ a subjects (76.2% men, mean age 32.7 y) were included and tested with a a comprehensive battery of neuropsychological tests. Abnormal CRP level a was defined as >3 mg/L. Results: Multiple factor analysis revealed that a abnormal CRP levels, found in 104 patients (28.2%), were associated a with impaired General Intellectual Ability and Abstract Reasoning (aOR = a 0.56, 95% CI 0.35-0.90, P = .014), independently of age, sex, education a level, psychotic symptomatology, treatments, and addiction a comorbidities. Abnormal CRP levels were also associated with the decline a of all components of working memory (respectively effect size [ ES] = a 0.25, P = .033; ES = 0.27, P = .04; ES = 0.33, P = .006; and ES = 0.38, a P = .004) and a wide range of other impaired cognitive functions, a including memory (ES = 0.26, P = .026), learning abilities (ES = 0.28, P a = .035), semantic memory (ES = 0.26, P = .026), mental flexibility (ES = a 0.26, P = .044), visual attention (ES = 0.23, P = .004) and speed of a processing (ES = 0.23, P = .043). Conclusion: Our results suggest that a abnormal CRP level is associated with cognitive impairment in SZ. a Evaluating the effectiveness of neuroprotective anti-inflammatory a strategies is needed in order to prevent cognitive impairment in SZ.