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Biomedical subjects

G Couvreur

Publications and source records attributed to G Couvreur.

10 recordsLinked to original sources

[Contribution of ecological evaluation of executive disorders in multiple sclerosis].

INTRODUCTION: Multiple sclerosis (MS) is a major cause of neurological disability among young adults. The cognitive disorders are the second cause of alteration of quality of life after physical handicap and are often responsible for loss of social-occupational adaptability. The prevalence of cognitive disorders is 40 to 65%. The alteration of executive functions predominates whereas instrumental functions are generally preserved. The assessment of these disorders is often underestimated by the usual battery of neuropsychological tests. However, the link between psychometric results and executive difficulties of daily life is uncertain. OBJECTIVES: To evaluate the sensitivity of an ecological test compared to standard psychometric tests in assessment of executive disorders in MS. METHODS: Twenty subjects with clinically definite MS were matched for age, sex and pre-morbid intellectual level with control subjects. A battery of neuropsychological and ecological tests was applied to all subjects. The performances on these tests formed a global score of executive function (SFE). The "paper and pencil" multiple errands test was used as the ecological test to examine planning and goal-oriented behavior. We also assessed fatigue and depression with the Fatigue Severity Scale and the Beck Depression Inventory. RESULTS: There was no significant differences between MS patients and controls in neuropsychological executive tests, except for verbal fluencies (p=0.01). The performances were significantly decreased in the MS group for the multiple errands test (p=0.01). 75% of MS subjects have a pathological score for this test. There was a significant link between the performances with this test and SFE (p=0.009). CONCLUSIONS: Executive disorders are underestimated in MS. However, we suggest that an ecological approach is more reliable than standard neuropsychological tests to estimate the cognitive difficulties in daily life in MS subjects. The results of our study favor further research to ascertain the usefulness of ecological assessment in MS.

Adult↗

[Immunofixation compared to isoelectric focusing in the detection of oligoclonal bands in cerebrospinal fluid of multiple sclerosis patients].

INTRODUCTION: Intrathecal immunoglobulins (Ig) synthesis, reflected by oligoclonal bands (OCBs) in cerebrospinal fluid (CSF) is observed in up to 90 percent of patients with clinically definite Multiple Sclerosis (MS). The gold standard laboratory test to establish the presence of OCBs in CSF of MS patients is isoelectric focusing (IEF). However, a quicker and less expensive method has been developed: immunofixation (IF). METHODS: The aim of this study was to compare these two methods carried out 74 CSF/serum pairs of MS, 103 CSF/serum pairs of subject controls and to determine their sensitivity and specificity. RESULTS: The agreement between results from IEF and IF was excellent (Kappa = 0.84). IEF sensitivity (78 percent) was not significantly different from that of IF (74 percent) (p = 0.3). Similarly, the specificity of IEF (93 percent) was not significantly different from that of IF (95 percent) (p = 0.2). CONCLUSION: IF is a semi automated method which is easier to perform than IEF and which appears to be as efficient as IEF.

Humans↗

[Seasonal variation in strokes incidence and the influence of the meteorological conditions].

The aim of this paper was to study the seasonal and Monthly distribution of different subtypes of strokes, and also the influence of the most usual meteorological factors on their incidence. The study, based on the population-based data of the Dijon register of stroke (France), involved 3287 patients with a cerebrovascular event during the Years 1985-1998. The seasonal distribution pointed out a summer decrease for all stroke subtypes. The cerebrovascular risk was the highest in autumn for small artery atheroma infarcts and for cerebral infarcts and, among these later, for cardioembolic infarcts and large artery atheroma infarcts, as well as for subarachnoid hemorrhages and for the total number of strokes. It was followed by spring (total number of strokes, small artery atheroma infarcts, cerebral infarcts) and/or winter (subarachnoid hemorrhages, cerebral infarcts, cardioembolic infarcts and large artery atheroma infarcts). For intracerebral hemorrhages, the risk peaked in spring and secondly in autumn. But the difference from one season to another was significant only for total number of strokes, cerebral infarcts and, among the later, for cardioembolic infarcts and large artery atheroma infarcts. As regards the Monthly distribution, the difference between Months was significant only for the total number of strokes and cerebral infarcts, with a minimum from July to September and a maximum in October for the later. Correlations with meteorological data were found for the total number of strokes, cerebral infarcts, cardioembolic infarcts, large artery atheroma infarcts and small artery atheroma infarcts. They showed an influence of temperature and relative humidity of the day of stroke or of the one to five days before. Correlations with wind speed, duration of sunshine or snow, even if less frequent, could also be found. Such results sometimes differ from those of some earlier studies, for which the climate and the risk factors were not the same, showing that regional epidemiological studies are necessary in order to determine the relations between seasons, meteorological factors and strokes.

Adolescent↗

[Alien hand syndrome due to a corpus callosum infarct: a case report].

A 64-year-old man with alien hand syndrome presented with abnormal feelings in the left upper limb, associated with an intermanual conflict. There were no clinical signs of frontal or parietal apraxia. This syndrome was induced by an infarct localized in the right posterior area of the splenium, subsequent to a cardiogenic embolus. This observation enlightens the rising syndrome of callosal type alien syndrome due to a posterior callosal infarct.

Brain↗

[Gustatory disorders during multiple sclerosis relapse].

Gustatory dysfunction is a known but uncommon element in the course of multiple sclerosis. Gustatory dysfunction has been described during the chronic progressive phase and during the relapse phase. We report five patients with clinically definite multiple sclerosis who developed transient gustatory disorders during the relapse phase of their disease. Agueusia occurred as one of the first symptoms in three patients, revealing the disease. Symptoms generally improved with remission or corticosteroid administration. These disorders are due to demyelinating lesions of the gustatory pathways in the thalamus or brainstem. MRI studies were not performed during the relapse phase and no clinical neuroimaging correlations could be established. Agueusia may be accompanied by olfactory dysfunction which is due to plaque demyelinization of the olfactory pathways, particularly in the temporal and inferior frontal lobes. Taste anomalies can also be observed in other diseases, including systemic diseases such as sarcoidosis or Sjogrën's syndrome. Drug-induced gustatory disorders are also reported.

Adult↗

[Epidemiology of hemorrhagic strokes].

Hemorrhagic stroke (HS) may be secondary to spontaneous intracerebral hemorrhage or to subarachnoid hemorrhage. There are no clinical symptoms that differentiate hemorrhagic stroke form ischemic stroke (IS) and only imaging can make the difference. But epidemiology, pathologic process and management are different in HS and IS. We will discuss the different risk factors of spontaneous intracerebral hemorrhage and subarachnoid hemorrhage.

Cerebral Hemorrhage↗

[Evaluation of follow-up and evolution of multiple sclerosis].

The aim of this paper is to review the quantitative methods used for assessing neurological status in multiple sclerosis patients. The Expanded Disability Status Scale (EDSS) is the most wide used. Its psychometric properties, validity, and inter- and intra-rater reliability are modest and responsiveness is weak. Similar results are obtained with the other scales used. The recently developed Multiple Sclerosis Functional Composite (MSFC) scale for clinical trials satisfies this requirement, but is not suitable for individual evaluation. There is no scale in French for assessment of cognitive disturbances and only one, the SEP-90, for quality of life. Brain and spinal cord abnormalities with conventional magnetic resonance imaging parameters (T1, T2-weighted and gadolinium enhanced images) have a weak relationship with disability. New magnetic resonance techniques (magnetic resonance spectroscopy and magnetized transfer imaging) would be more sensitive and should be further investigated.

Clinical Trials as Topic↗

Immunolocalization and characterization of the low molecular weight antigen (4-5 kDa) of Toxoplasma gondii that elicits an early IgM response upon primary infection.

A striking feature of toxoplasmic seroconversion is the prominent and early IgM response to a low molecular weight antigen of 4-5 kDa. Two different monoclonal antibodies directed against the 4-5 kDa antigen have been generated and used to characterize this molecule. Using these monoclonal antibodies, we could demonstrate the surface localization of the low M(r) antigen by immunofluorescence and immuno-electron microscopy assays. By immunoblotting, we observed that one of the monoclonal antibodies was unable to recognize the 4-5 kDa antigen in tachyzoites propagated in cell culture, indicating an epitope variability between Toxoplasma gondii tachyzoites grown in vivo and in vitro. We discuss the implications of this latter finding in the design of diagnostic reagents.

Adult↗

Surface antigens of Toxoplasma gondii.

Monoclonal antibodies reacting with pellicular antigens of Toxoplasma gondii tachyzoites have been selected among hybridomas produced against this organism by immunofluorescence assay. These antigens have been further characterized by immunofluorescence on living zoites, Western immunoblotting and immunoprecipitation of lactoperoxidase surface radio-iodinated tachyzoite lysates. The simultaneous characterization of 5 different surface antigens (P43, P35, P30, P23, P22) some of which have already been studied individually allowed a better definition of these antigens and the characterization of a yet undescribed surface molecule (P23).

Animals↗