Abstract Fragile X-associated tremor/ataxia syndrome (FXTAS), a late-onset movement disorder affecting FMR1 premutation carriers, is associated with cerebral and cerebellar lesions. The aim of this ...study was to test whether computational anatomy can detect similar patterns in asymptomatic FMR1 premutation carriers (mean age 46.7 years) with qualitatively normal -appearing grey and white matter on brain MRI. We used a multimodal imaging protocol to characterize brain anatomy by automated assessment of gray matter volume and white matter properties. Structural changes in the hippocampus and in the cerebellar motor network with decreased gray matter volume in lobule VI and white matter alterations of the corresponding afferent projections through the middle cerebellar peduncles are demonstrated. Diffuse subcortical white matter changes in both hemispheres, without corresponding gray matter alterations, are only identified through age × group interactions. We interpret the hippocampal fimbria and cerebellar changes as early alterations with a possible neurodevelopmental origin. In contrast, progression of the diffuse cerebral hemispheric white matter changes suggests a neurodegenerative process, leading to late-onset lesions, which may mark the imminent onset of FXTAS.
An eligibility assessment for deep brain stimulation is performed in order to select patients who are likely to benefit from it. Parkinson's patients have to stop dopaminergic drugs the day before ...surgery. During the operation, the patient must remain awake for recording of neuronal activity and for test stimulations to optimize the position of the electrodes. Postoperatively, the stimulation is increased progressively in parallel with a decrease of dopaminergic treatments. After about ten days, the patient can return to home and controls continue as an outpatient. Three months postoperatively, a complete testing of the neurostimulator is performed and at the one year follow-up visit, the effectiveness of the DBS is assessed.
Temi tabu. Parte 2, Shopping compulsivo e Parkinson Gronchi Perrin, Aline
Parkinson : das Magazin von Parkinson Schweiz = le magazine de Parkinson Suisse = la rivista di Parkinson Svizzera,
06/2019
134
Journal Article
Sujets tabous. Partie 2, Achats compulsifs et Parkinson Gronchi Perrin, Aline
Parkinson : das Magazin von Parkinson Schweiz = le magazine de Parkinson Suisse = la rivista di Parkinson Svizzera,
06/2019
134
Journal Article
Tabu-Themen. Teil 2, Kaufsucht und Parkinson Gronchi Perrin, Aline
Parkinson : das Magazin von Parkinson Schweiz = le magazine de Parkinson Suisse = la rivista di Parkinson Svizzera,
06/2019
134
Journal Article
Abstract Background Hippocampal atrophy (HA) is a known predictor of dementia in Alzheimer's disease. HA has been found in advanced Parkinson's disease (PD), but no predicting value has been ...demonstrated yet. The identification of such a predictor in candidates for subthalamic deep brain stimulation (STN-DBS) would be of value. Our objective was to compare preoperative hippocampal volumes (HV) between PD patients who subsequently converted to dementia (PDD) after STN-DBS and those who did not (PDnD). Methods From a cohort of 70 consecutive STN-DBS treated PD patients, 14 converted to dementia over 25.6 ± 20.2 months (PDD). They were compared to 14 matched controls (PDnD) who did not convert to dementia after 43.9 ± 11.7 months. On the preoperative 3D MPRAGE MRI images, HV and total brain volumes (TBV) were measured by a blinded investigator using manual and automatic segmentation respectively. Results PDD had smaller preoperative HV than PDnD (1.95 ± 0.29 ml; 2.28 ± 0.33 ml; p < 0.01). This difference reinforced after normalization for TBV (3.28 ± 0.48, 3.93 ± 0.60; p < 0.01). Every 0.1 ml decrease of HV increased the likelihood to develop dementia by 24.6%. A large overlap was found between PD and PDnD HVs, precluding the identification of a cut-off score. Conclusions As in Alzheimer's disease, HA may be a predictor of the conversion to dementia in PD. This preoperative predictor suggests that the development of dementia after STN-DBS is related to the disease progression, rather then the procedure. Further studies are needed to define a cut-off score for HA, in order to affine its predictive value for an individual patient.
