A5000070153- Botulinum Toxin and Related Neurological Disorders
- Neurological disorders and treatments
- Pain Mechanisms and Treatments
- Cerebral Palsy and Movement Disorders
- Transcranial Magnetic Stimulation Studies
- Parkinson's Disease Mechanisms and Treatments
- Nerve Injury and Rehabilitation
- Pain Management and Treatment
- Musculoskeletal pain and rehabilitation
- Trigeminal Neuralgia and Treatments
- Peripheral Nerve Disorders
- Advanced Neuroimaging Techniques and Applications
- Pain Management and Placebo Effect
- Meningioma and schwannoma management
- Anesthesia and Pain Management
- Spine and Intervertebral Disc Pathology
- Spinal Fractures and Fixation Techniques
- Stroke Rehabilitation and Recovery
- Neurosurgical Procedures and Complications
- Pain Management and Opioid Use
- Hereditary Neurological Disorders
- Cerebrospinal fluid and hydrocephalus
- Facial Nerve Paralysis Treatment and Research
- Intracranial Aneurysms: Treatment and Complications
- Myofascial pain diagnosis and treatment
Hôpital Pierre Wertheimer
2014-2025
Hospices Civils de Lyon
2015-2025
Université Claude Bernard Lyon 1
2016-2025
Inserm
2012-2024
Centre de Recherche en Neurosciences de Lyon
1998-2024
Centre National de la Recherche Scientifique
2022-2024
Sorbonne Université
2024
Assistance Publique – Hôpitaux de Paris
2019-2024
Hôpital Nord
2024
Lyon College
1991-2023
Subthalamic stimulation reduces motor disability and improves quality of life in patients with advanced Parkinson's disease who have severe levodopa-induced complications. We hypothesized that neurostimulation would be beneficial at an earlier stage disease.In this 2-year trial, we randomly assigned 251 early complications (mean age, 52 years; mean duration disease, 7.5 years) to undergo plus medical therapy or alone. The primary end point was life, as assessed the use Disease Questionnaire...
Although electrical stimulation of the precentral gyrus (MCS) is emerging as a promising technique for pain control, its mechanisms action remain obscure, and application largely empirical. Using positron emission tomography (PET) we studied regional changes in cerebral flood flow (rCBF) 10 patients undergoing motor cortex seven whom also underwent somatosensory evoked potentials nociceptive spinal reflex recordings. The most significant MCS-related increase rCBF concerned ventral-lateral...
Apathy has been reported to occur after subthalamic nucleus stimulation, a treatment of motor complications in advanced Parkinson's disease. We carried out prospective study the occurrence apathy and associated symptoms, predictors mechanisms year following stimulation. Dopamine agonist drugs were discontinued immediately surgery levodopa was markedly reduced within 2 weeks. depression assessed monthly, using Starkstein scale Beck Depression Inventory. agonists re-introduced if patients...
Addictions to dopaminergic drugs or pleasant behaviours are frequent and potentially devastating neuropsychiatric disorders observed in Parkinson's disease. They encompass impulse control disorders, punding dopamine dysregulation syndrome. A relationship with treatment is strongly suggested. Subthalamic stimulation improves motor complications allows for drastic reductions medication. This might, therefore, be considered patients behavioural addictions, when attempts reduce medication have...
Apathy is one of the most common symptoms encountered in Parkinson's disease, and defined as a lack motivation accompanied by reduced goal-directed cognition, behaviour emotional involvement. In previous study we have described delayed withdrawal syndrome after successful motor improvement related to subthalamic stimulation allowing for major decrease dopaminergic treatment. This correlated with diffuse mesolimbic denervation. To confirm our hypothesis parkinsonian apathy being denervation,...
<b>Background: </b> Motor cortex stimulation (MCS) for neuropathic pain control induces focal cerebral blood flow changes involving regions with high density of opioid receptors. We studied the possible contribution endogenous system to MCS-related relief. <b>Methods: Changes in receptor availability induced by MCS were PET scan and [<sup>11</sup>C]diprenorphine eight patients refractory pain. Each patient underwent two preoperative (test–retest) scans one postoperative acquired after 7...
Cortico-basal ganglia networks are considered to comprise several parallel and mostly segregated loops, where segregation is achieved in space through topographic connectivity. Recently, it has been suggested that functional may also be the frequency domain, by selective coupling of related activities at different frequencies. So far, however, any across human only modeled terms unidirectional influences, a misplaced assumption given looped architecture basal ganglia, static terms. Here, we...
Thirty-one patients with medically refractory neuropathic pain were included in a prospective evaluation of motor cortex stimulation. The long-term outcome was evaluated using five variables: (a) rate (percentage) relief, (b) scores as assessed on VAS, (c) postoperative decrease VAS scores, (d) reduction analgesic drug intake, (e) dichotomic (yes/no) response to the question whether patient would accept, under similar circumstances, be operated again. Pain relief rated excellent (>70 %...
Chronic cluster headache (CCH) is a disabling primary headache, considering the severity and frequency of pain attacks. Deep brain stimulation (DBS) has been used to treat severe refractory CCH, but assessment its efficacy limited open studies. We performed prospective crossover, double-blind, multicenter study assessing safety unilateral hypothalamic DBS in 11 patients with CCH. The randomized phase compared active sham during 1-month periods, was followed by 1-year phase. CCH assessed...
This study used positron emission tomography (PET) and [11C]diprenorphine to compare the in vivo distribution abnormalities of brain opioid receptors (OR) patients with peripheral (n=7) central post-stroke pain (CPSP, n=8), matched for intensity duration. Compared age- sex-matched controls, neuropathic (NP) showed bilateral symmetrical OR binding decrease, while CPSP decrease predominated hemisphere contralateral pain. In patients, interhemispheric comparison demonstrated a significant...
<h3>Objective</h3> To investigate predictors for improvement of disease-specific quality life (QOL) after deep brain stimulation (DBS) the subthalamic nucleus (STN) Parkinson disease (PD) with early motor complications. <h3>Methods</h3> We performed a secondary analysis data from previously published EARLYSTIM study, prospective randomized trial comparing STN-DBS (n = 124) to best medical treatment 127) 2 years follow-up QOL (39-item Parkinson9s Disease Questionnaire summary index...
Object. Most patients with preganglionic lesions after brachial plexus injuries suffer pain that is hard to control through medication or neuromodulation. Lesioning in the dorsal root entry zone (DREZ) undeniably effective. Fifty-five who had undergone so-called microsurgical DREZotomy (MDT) procedure were studied two following objectives: 1) describe anatomical observed during MDT correlation sensory deficits and features; 2) analyze results 44 followed for more than 1 year (mean 6 years)....
We studied regional changes in cerebral flood flow (rCBF) 9 patients undergoing motor cortex stimulation (MCS) for pain control. Significant increase rCBF was observed the lateral thalamus ipsilateral to MCS probably reflecting corticothalamic connections from motor/premotor areas. Subsignificant increases were anterior cingulate, left insula and upper brainstem. Mean cingulate increased during with good analgesic efficacy, while it decreased those poor clinical outcome; conversely, thalamic...
To assess, against placebo, the pain-relieving effects of high-rate repetitive transcranial magnetic stimulation (rTMS) on neuropathic pain.Double-blind, randomized, cross-over study rTMS placebo in 28 patients. The effect a change coil orientation (posteroanterior vs lateromedial) different subtypes pain was further tested subset 16 Pain relief evaluated daily during 1 week.High-frequency, posteroanterior decreased scores significantly more than placebo. Posteroanterior also outmatched...
Abstract One of the most frequent neurological sequelae seen by specialist in rehabilitation is spastic foot. Spasticity foot may be responsible for abnormal posture and painful or trophic disturbances impairing standing walking. This disability can corrected a simple neurosurgical procedure, selective tibial neurotomy. In this one sections nerve branches to muscles sustaining spasticity, i.e, soleus and/or gastrocnemius nerves equinus ankle clonus posterior tibialis branch varus flexor...
Deep brain stimulation of the posterior hypothalamus is a therapeutic approach to treatment refractory chronic cluster headache, but precise anatomical location electrode contacts has not been clearly assessed. Our aim was study used for stimulation, projecting each contact centre on anatomic atlases. Electrodes were implanted in series 10 patients (prospective controlled trial) so-called 'posteroinferior hypothalamus' according previously described coordinates, i.e. 2 mm lateral, 3 and 5...