Abstract
Non-Pharmacological Interventions (NPIs) are increasingly being introduced into healthcare, but their mechanisms are unclear. In this study, 30 healthy participants received foot reflexology ...(FR) and sham massage, and went through a resting-state functional magnetic resonance imaging (rs-fMRI) to evaluate NPIs effect on brain. Rs-fMRI revealed an effect of both NPIs on functional connectivity with changes occurring in the default-mode network, the sensorimotor network and a Neural Network Correlates of Pain (NNCP—a newly discovered network showing great robustness). Even if no differences were found between FR and SM, this study allowed to report brain biomarkers of well-being as well as the safety of NPIs. In further research, it could be relevant to study it in patients to look for a true reflexology induced-effect dependent of patient reported outcomes. Overall, these findings enrich the understanding of the neural correlates of well-being experienced with NPIs and provided insight into the basis of the mechanisms of NPIs.
Studies assessing personality dimensions by the "Temperament and Character Inventory" (TCI) have previously found an association between Parkinson's disease (PD) and lower Novelty Seeking and higher ...Harm Avoidance scores. Here, we aimed to describe personality dimensions of PD patients with motor fluctuations and compare them to a normative population and other PD populations.
All PD patients awaiting Deep Brain Stimulation (DBS) answered the TCI before neurosurgery. Their results were compared to those of historical cohorts (a French normative population, a de novo PD population, and a PD population with motor fluctuations).
Most personality dimensions of our 333 included PD patients with motor fluctuations who are candidates for DBS were different from those of the normative population and some were also different from those of the De Novo PD population, whereas they were similar to those of another population of PD patients with motor fluctuations.
During the course of PD, personality dimensions can change in parallel with the development of motor fluctuations, either due to the evolution of the disease and/or dopaminergic treatments.
Pain is a frequent and disabling non-motor symptom of Parkinson’s Disease (PD). Yet, no treatment to date can efficiently reduce this pain. This article investigates the brain functional connectivity ...of PD patients with central pain and the effects of levodopa and oxycodone on this connectivity.
Thirty-eight PD patients received either levodopa, oxycodone, or a placebo during an eight-week period. Pain intensity was evaluated using the Visual Analogue Scale and resting-state functional connectivity was measured before and after treatments. PD patients were also separated into two groups: responders and non-responders.
At baseline, the intensity of pain was correlated with the connectivity between the anterior insula and the posterior cingulate cortex and between the nucleus accumbens, the brainstem, and the hippocampus. Levodopa and oxycodone had no specific effects on functional connectivity. Responders had a decrease in connectivity between the anterior insula and the posterior cingulate cortex, while non-responders showed an increase in connectivity.
The correlation between pain intensity and specific brain connectivity may represent a “hyper-awareness” of pain and a distortion of learning and memory systems in PD patients with central pain, leading to a state of chronic pain. The placebo effect could explain the changes in connectivity that are associated with a potential reduction in pain awareness.
•PD central pain correlates with insula and nucleus accumbens functional connectivity.•Levodopa and oxycodone had no specific effect on brain functional connectivity in PD.•Pain response is associated with changes in insula’s functional connectivity.
Dans l’objectif de comprendre les effets spécifiques et les mécanismes sous-jacents à la réflexologie plantaire, la connectivité fonctionnelle de repos de différents réseaux cérébraux ainsi que ...différentes mesures électro-physiologiques et de bien-être ont été étudiées. Pour cela une séance brève de réflexologie plantaire a été réalisée dans une population de volontaires sains, en comparaison d’une séance de massage fictif (contrôle). A la suite des deux interventions, cette étude a montré un changement de connectivité fonctionnelle au niveau des réseaux par défaut, sensorimoteur et d’un réseau lié à la douleur nouvellement proposé, indépendamment du groupe. Une amélioration de différents paramètres biologiques et du bien-être subjectif des sujets a aussi été mise en évidence après la réflexologie plantaire comme le massage, ce qui tend à mettre en avant un effet de prise en charge globale des interventions non-médicamenteuses. Ces résultats sont prometteurs en vue de prochaines études sur des populations de patients.
Plusieurs études suggèrent des spécificités de personnalité dans la maladie de Parkinson (MP), principalement sur des populations de faible effectif et assez hétérogènes.
Décrire les dimensions de ...personnalité du Temperament and Character Inventory (TCI) sur une grande cohorte de patients parkinsoniens fluctuants et vérifier les propriétés psychométriques de ce questionnaire.
Au total, 570 patients issus de la cohorte PREDI-STIM ont répondu au TCI avant la mise en place d’un traitement par stimulation cérébrale profonde. Une description du TCI ainsi que des corrélations entre les sept dimensions de personnalité du TCI et différentes variables motrices, comportementales et cognitives ont été effectuées. Des analyses psychométriques du TCI ont aussi été réalisées.
Évitement du danger, dépendance à la récompense et coopérativité étaient supérieurs chez les femmes. Le TCI n’était pas corrélé à la durée de la maladie, au MDS-UPDRS ni à la LED, mais à la dépression, l’anxiété, la qualité de vie et l’impulsivité (corrélations avec évitement du danger/auto-détermination/recherche de la nouveauté). La recherche de la nouveauté était supérieure chez les patients avec troubles impulsifs-compulsifs. Le TCI présentait une bonne consistance interne et structurelle dans cette cohorte.
Le TCI présente de bonnes propriétés psychométriques chez les patients parkinsoniens et les caractéristiques de la MP (symptômes moteurs, traitements, durée de la maladie, etc.) ne semblent pas influencer les dimensions de personnalité. Seul l’état anxiodépressif, la qualité de vie et l’impulsivité sont corrélées avec certaines dimensions de personnalité, en accord avec la littérature de manière non-spécifique à la MP.
Le TCI semble donc adapté pour l’évaluation de la personnalité des patients parkinsoniens.
Abstract People with Parkinson’s disease with motor fluctuations can be treated by continuous subcutaneous apomorphine infusion (CSAI) to reduce their symptoms. Nonetheless, factors are lacking to ...predict patients’ quality-of-life amelioration after CSAI. This pilot study aimed to evaluate associations between personality dimensions and quality-of-life improvement after 6 months of CSAI. Thirty-nine people with Parkinson’s disease awaiting CSAI were included. Linear regression models between ‘Temperament and Character Inventory’ personality dimensions at baseline and percentage of change in Parkinson’s Disease Questionnaire-39 scores after 6 months of CSAI were realized (n = 35). The Temperament and Character Inventory was also compared between patients awaiting CSAI and patients awaiting deep brain stimulation of the sub-thalamic nucleus (n = 39 from the PREDI-STIM study). Higher reward dependence scores were associated with a better quality-of-life outcome after 6 months of CSAI, while self-directedness scores were associated with a better quality of life before CSAI (as opposed to harm avoidance, reward dependence and self-transcendence scores associated with a worse quality of life). Moreover, people with Parkinson’s disease awaiting deep brain stimulation of the sub-thalamic nucleus had similar Temperament and Character Inventory dimensions compared to patients awaiting CSAI. People with Parkinson’s disease with higher reward dependence scores at baseline had the best quality-of-life improvement after 6 months of CSAI. This finding could be used to better prepare and accompany people with Parkinson’s disease during CSAI establishment. Moreover, this result could serve as an orientation factor to second-line treatments.
La qualité de vie (QdV) est altérée dans la maladie de Parkinson et elle pourrait être influencée par la personnalité des patients.
Nous voulions évaluer l’association entre les dimensions de ...personnalité et la QdV de patients parkinsoniens avec fluctuations motrices en attente de stimulation cérébrale profonde des noyaux sous-thalamiques (SCP-NST).
Les données proviennent de la cohorte française PREDI-STIM incluant des patients parkinsoniens en attente de SCP-NST. Tous les patients ont répondu aux questionnaires « Temperament and Character Inventory » (TCI) et PDQ-39 (Parkinson Disease Questionnaire-39) avant la stimulation. Les analyses ont été réalisées avec des modèles de régression linéaire généralisés univariés et ajustés pour évaluer une potentielle association entre les différentes dimensions de personnalité (TCI) et les différents scores de QdV (PDQ-39).
Chez les 363 patients, il existait une association négative significative entre le tempérament d’Évitement du Danger et la QdV (p=3e-11, R2=0,18), et une association positive significative entre les caractères d’Auto-Détermination et de Coopération et la QdV (respectivement, p=2e-11, R2=0,19 ; p=1e-3, R2=0,1). Ces associations étaient principalement élevées avec les composantes mentales de cette QdV.
Trois dimensions de personnalité (Évitement du Danger, Auto-Détermination et Coopération) sont associées avec la QdV des patients particulièrement aux niveaux émotionnel et social. L’Évitement du Danger étant associé à la dépression et l’Auto-Détermination et la Coopération à la maturité personnelle et sociale, l’éducation thérapeutique renforçant les ressources personnelles de ces patients semble importante pour améliorer leur bien-être.
Des scores bas en Évitement du Danger et élevés en Auto-Détermination et Coopération sont associés à une meilleure QdV chez les patients parkinsoniens au stade des fluctuations motrices.
People with Parkinson’s disease with motor fluctuations can be treated by Continuous Subcutaneous Apomorphine Infusion (CSAI) to reduce their symptoms. Nonetheless, factors are lacking to predict ...patients’ quality-of-life amelioration after CSAI. This pilot study aimed to evaluate associations between personality dimensions and quality-of-life improvement after six months of CSAI. Thirty-nine people with Parkinson’s disease awaiting CSAI were included. Linear regression models between “Temperament and Character Inventory” personality dimensions at baseline and percentage of change in PDQ-39 (Parkinson’s Disease Questionnaire-39) scores after six months of CSAI were realized (n = 35). Temperament and Character Inventory was also compared between patients awaiting CSAI and patients awaiting deep brain stimulation of the sub-thalamic nucleus (n = 39 from the PREDI-STIM study). Higher Reward Dependence scores were associated with a better quality-of-life outcome after six months of CSAI, while Self-Directedness scores were associated with a better quality of life before CSAI (as opposed to Harm Avoidance, Reward Dependence, and Self-Transcendence scores associated with a worse quality of life). Moreover, people with Parkinson’s disease awaiting deep brain stimulation of the sub-thalamic nucleus had similar Temperament and Character Inventory dimensions compared to patients awaiting CSAI. People with Parkinson’s disease with higher Reward Dependence scores at baseline had the best quality-of-life improvement after six months of CSAI. This finding could be used to better prepare and accompany people with Parkinson’s disease during CSAI establishment. Moreover, this result could serve as an orientation factor to second-line treatments.
Deep brain stimulation of the sub-thalamic nucleus (DBS-STN) reduces symptoms in Parkinson's disease (PD) patients with motor fluctuations. However, some patients may not feel ameliorated afterwards, ...despite an objective motor improvement. It is thus important to find new predictors of patients' quality of life (QoL) amelioration after DBS-STN. We hypothesized that personality dimensions might affect QoL after DBS-STN.
To evaluate associations between personality dimensions and QoL improvement one year after DBS-STN.
DBS-STN-PD patients (n = 303) having answered the "Temperament and Character Inventory" (TCI) before surgery and the PDQ-39 before and one year after surgery were included, from the cohort study PREDI-STIM. Linear regression models were used to evaluate associations between TCI dimensions and change in PDQ-39 scores after DBS-STN.
Novelty Seeking and Cooperativeness scores before surgery were positively associated with PDQ-39 scores improvement after DBS-STN (FDR-adjusted p < 0.01). Moreover, paradoxically unimproved patients with deterioration of their PDQ-39 scores after DBS-STN despite improvement of their MDS-UPDRS-IV scores had lower Cooperativeness scores, while paradoxically improved patients with amelioration of their PDQ-39 scores despite deterioration of their MDS-UPDRS-IV scores had higher Reward Dependence scores.
Some presurgical personality dimensions were significantly associated with QoL amelioration and discrepancy between motor state and QoL changes after DBS-STN in PD. Educational programs before DBS-STN should take in account patient personality dimensions to better deal with their expectations.
The epileptogenic processes leading to recurrent seizures in Genetic Epilepsies are largely unknown. Using the Genetic Absence Epilepsy Rat from Strasbourg, we investigated in vivo the network and ...single neuron mechanisms responsible for the early emergence of epileptic activity. Local field potential recordings in the primary somatosensory cortex (SoCx), from the second post-natal week to adulthood, showed that immature cortical discharges progressively evolved into typical spike-and-wave discharges following a 3-step maturation process. Intracellular recordings from deep-layer SoCx neurons revealed that this maturation was associated with an age-dependent increase in cortical neurons intrinsic excitability, combining a membrane depolarization and an enhancement of spontaneous firing rate with a leftward shift in their input-output relation. These cellular changes were accompanied by a progressive increase in the strength of the local synaptic activity associated with a growing propensity of neurons to generate synchronized oscillations. Chronic anti-absence treatment before the occurrence of mature cortical discharges did not alter epileptogenesis or the drug efficiency at adulthood. These findings demonstrate that recurrent absence seizures originate from the progressive acquisition of pro-ictogenic properties in SoCx neurons and networks during the post-natal period and that these processes cannot be interrupted by early anti-absence treatment.
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