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Cet essai contrôlé randomisé comparait l’efficacité des exercices du plancher pelvien vs stimulation transcutanée du nerf tibial postérieur.

There is a long history of research into body fluid biomarkers in neurodegenerative and neuroinflammatory diseases. However, only a few biomarkers in CSF are being used in clinical practice. One of the most critical factors in CSF biomarker research is the inadequate powering of studies because of the lack of sufficient samples that can be obtained in single-center studies. Therefore, collaboration between investigators is needed to establish large biobanks of well-defined samples. Standardized protocols for biobanking are a prerequisite to ensure that the statistical power gained by increasing the numbers of CSF samples is not compromised by preanalytical factors. Here, a consensus report on recommendations for CSF collection and biobanking is presented, formed by the BioMS-eu network for CSF biomarker research in multiple sclerosis. We focus on CSF collection procedures, preanalytical factors, and high-quality clinical and paraclinical information. The biobanking protocols are applicable for CSF biobanks for research targeting any neurologic disease.

Abstract:: We addressed the clinical significance of antiproteinase 3 (anti-PR3) antibody (Ab) positivity by reviewing the files of 79 patients whose serum contained antineutrophil cytoplasmic antibodies with a cytoplasmic staining pattern (cANCA) and had been tested for anti-PR3 reactivity. Vasculitis was present in most (22/35) cANCA+ PR3+ patients but in only a few (5/44) cANCA+ PR3+ patients, thereby suggesting that anti-PR3 Ab positivity in cANCA+ patients is more indicative of vasculitis than cANCA positivity alone. Noteworthy, one-third of cANCA+ PR3+ patients – those with anti-PR3 Ab titres lower than 100 U/ml – did not suffer from vasculitis. Anti-PR3 reactivity in vasculitis patients was only weakly associated with Wegener’s granulomatosis (WG), as nine out of 22 cANCA+ PR3+ vasculitis patients (41%) did not fulfil the ACR classification criteria for WG. There was no correlation between anti-PR3 Ab titres and disease activity at diagnosis. However, titres measured when patients were in remission were much lower than initial values. Taken together, our results indicate that anti-PR3 Ab positivity should be interpreted in its clinical context.

L’évolution des critères diagnostics de la sclérose en plaques (SEP) permet un diagnostic fiable plus précoce de cette affection, avec à la clé l’instauration d’un traitement préventif plus rapidement. Malgré l’identification de certains facteurs pronostics tels que l’âge, l’intervalle entre les premières poussées, ou la charge lésionnelle radiologique lors des premiers stades de la SEP, la prédiction de l’évolution à long-terme de cette pathologie reste encore un défi pour le neurologue en raison de son hétérogénéité. Les potentiels évoqués multimodaux (PEM) sont très utiles pour détecter des anomalies de conduction, parfois infra-cliniques. Précédemment, plusieurs travaux ont mis en évidence l’intérêt d’une évaluation neurophysiologique par potentiels évoqués multimodaux comme un outil supplémentaire permettant de prédire l’invalidité à long terme de la SEP. Toutefois, certaines de ces études ont inclus des populations mixtes (formes progressives et forme rémittente-récurrente (RR)) et/ou des patients qui présentaient déjà une maladie évoluée. Dans cette communication, nous discuterons de la valeur prédictive à long terme des PEM dans une cohorte de patients avec un syndrome cliniquement isolé ou une SEP de forme RR évoluant depuis moins de 6 mois.

4-aminopyridine (4-AP) is a drug that enhances interneuronal and neuromuscular synaptic transmission. It can be used as adjunctive treatment for patients with multiple sclerosis (MS). Accidental or intentional overdose results in significant neurotoxicity.

Cocaine abuse may be complicated by degenerative central nervous system (CNS) disorders such as leukoencephalopathy. The possibly synergistic role of adulterants, like levamisole, is also currently debated. We describe a recent case of massive CNS injury consistent with a Susac syndrome in a heavy chronic cocaine abuser. We discuss the possible combined role of cocaine-levamisole exposure in the pathogenesis of CNS lesions.