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1. A deep learning model for the diagnosis of sacroiliitis according to Assessment of SpondyloArthritis International Society classification criteria with magnetic resonance imaging

Author

Adrien Bordner, Théodore Aouad, Clementina Lopez Medina, Sisi Yang, Anna Molto, Hugues Talbot, Maxime Dougados, Antoine Feydy, Sorbonne Université - Faculté de Médecine (SU FM), Sorbonne Université (SU), Dèpartement de Radiologie, Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre de vision numérique (CVN), Institut National de Recherche en Informatique et en Automatique (Inria)-CentraleSupélec-Université Paris-Saclay, Department of Rheumatology, Universidad de Córdoba = University of Córdoba [Córdoba], Université Paris Cité (UPCité), Equipe 4 : ECaMO - Épidémiologie clinique appliquée aux maladies rhumatismales et musculo-squelettiques (CRESS - U1153), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), and Dèpartement de Rheumatologie

Subjects
Artificial intelligence, Magnetic resonance imaging, Radiological and Ultrasound Technology, [SDV.IB.IMA]Life Sciences [q-bio]/Bioengineering/Imaging, [SDV]Life Sciences [q-bio], Spondyloarthritis, Radiology, Nuclear Medicine and imaging, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, General Medicine, Sacroiliac joint, Deep-learning, [INFO.INFO-AI]Computer Science [cs]/Artificial Intelligence [cs.AI]
Abstract

International audience; PurposeThe purpose of this study was to develop and evaluate a deep learning model to detect bone marrow edema (BME) in sacroiliac joints and predict the MRI Assessment of SpondyloArthritis International Society (ASAS) definition of active sacroiliitis in patients with chronic inflammatory back pain.Materials and methodsMRI examinations of patients from the French prospective multicenter DESIR cohort (DEvenir des Spondyloarthropathies Indifférenciées Récentes) were used for training, validation and testing. Patients with inflammatory back pain lasting three months to three years were recruited. Test datasets were from MRI follow-ups at five years and ten years. The model was evaluated using an external test dataset from the ASAS cohort. A neuronal network classifier (mask-RCNN) was trained and evaluated for sacroiliac joints detection and BME classification. Diagnostic capabilities of the model to predict ASAS MRI active sacroiliitis (BME in at least two half-slices) were assessed using Matthews correlation coefficient (MCC), sensitivity, specificity, accuracy and AUC. The gold standard was experts' majority decision.ResultsA total of 256 patients with 362 MRI examinations from the DESIR cohort were included, with 27% meeting the ASAS definition for experts. A total of 178 MRI examinations were used for the training set, 25 for the validation set and 159 for the evaluation set. MCCs for DESIR baseline, 5-years, and 10-years follow-up were 0.90 (n = 53), 0.64 (n = 70), and 0.61 (n = 36), respectively. AUCs for predicting ASAS MRI were 0.98 (95% CI: 0.93–1), 0.90 (95% CI: 0.79–1), and 0.80 (95% CI: 0.62–1), respectively. The ASAS external validation cohort included 47 patients (mean age 36 ± 10 [SD] years; women, 51%) with 19% meeting the ASAS definition. MCC was 0.62, sensitivity 56% (95% CI: 42–70), specificity 100% (95% CI: 100–100) and AUC 0.76 (95% CI: 0.57–0.95).ConclusionThe deep learning model achieves performance close to those of experts for BME detection in sacroiliac joints and determination of active sacroiliitis according to the ASAS definition.

Published
2023
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2. Incrementally semi-supervised classification of arthritis inflammation on a clinical dataset

Author

Theodore Aouad, Clementina Lopez-Medina, Charlotte Martin-Peltier, Adrien Bordner, Sisi Yang, Anna Molto, Maxime Dougados, Antoine Feydy, Hugues Talbot, OPtimisation Imagerie et Santé (OPIS), Inria Saclay - Ile de France, Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)-Centre de vision numérique (CVN), Institut National de Recherche en Informatique et en Automatique (Inria)-CentraleSupélec-Université Paris-Saclay-CentraleSupélec-Université Paris-Saclay, Centre de vision numérique (CVN), Institut National de Recherche en Informatique et en Automatique (Inria)-CentraleSupélec-Université Paris-Saclay, Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), IEEE, and Aouad, Théodore

Subjects
Image segmentation, Benchmark testing, [INFO.INFO-CV] Computer Science [cs]/Computer Vision and Pattern Recognition [cs.CV], Deep Learning, [INFO.INFO-TI] Computer Science [cs]/Image Processing [eess.IV], Arthritis, [INFO.INFO-TI]Computer Science [cs]/Image Processing [eess.IV], Annotations, [INFO.INFO-NE] Computer Science [cs]/Neural and Evolutionary Computing [cs.NE], [INFO.INFO-CV]Computer Science [cs]/Computer Vision and Pattern Recognition [cs.CV], Semi-supervised Learning, [INFO.INFO-NE]Computer Science [cs]/Neural and Evolutionary Computing [cs.NE], Magnetic Resonance Imaging
Abstract

International audience; For best medical imaging application results, learning-based approaches such as deep learning necessitate specific, extensive and precise annotations. Outside well-curated public benchmarks, these are rarely available in practice, and so it becomes necessary to use less-than-perfect annotations. One way of compensating for this is the embedding of anatomical knowledge. Complementing this, there is the incremental semi-supervised learning technique, whereby a small amount of annotations can be used to derive more and superior labels.In this article, we illustrate this approach on a deep learning system to help radiologists and rheumatologists finely and interactively assess MRI scans of the sacro-iliac joint in order to correctly diagnose Axial Spondyloarthritis. Our model is trained initially on a relatively small set of images with promising results, on par with expert opinion and generalizable to new datasets.

Published
2022

3. Measurement of Trabecular Bone Score of the Spine by Low-Dose Imaging System (EOS®): A Feasibility Study

Author

J. Fechtenbaum, C. Roux, Antoine Feydy, Karine Briot, S. Kolta, Adrien Etcheto, Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Université Paris Descartes - Paris 5 (UPD5)

Subjects
0301 basic medicine, Bone mineral, business.industry, Endocrinology, Diabetes and Metabolism, [SDV]Life Sciences [q-bio], Low dose, Osteoporosis, 030209 endocrinology & metabolism, Odds ratio, medicine.disease, 03 medical and health sciences, 0302 clinical medicine, medicine.anatomical_structure, Trabecular bone score, Hip bone, medicine, Radiology, Nuclear Medicine and imaging, Orthopedics and Sports Medicine, 030101 anatomy & morphology, Densitometer, Nuclear medicine, business, Prospective cohort study
Abstract

Purpose/Introduction: Measurement of trabecular bone score (TBS®) of the lumbar spine on dual energy X-ray absorptiometry (DXA) devices improves fracture risk prediction. We conducted a proof of concept study to assess the feasibility of TBS® measured on the low-dose imaging system EOS®. Methods: TBS was assessed on both DXA and EOS® in 122 patients aged ≥ 50 yr, receiving no anti-osteoporotic treatment. The TBS® was computed on full-body EOS® images, focusing on the lumbar spine region. The patients were also scanned with a DXA bone densitometer (Hologic) and the spine and hip bone mineral density (g/cm²) were computed. Results: TBS® measurement on EOS® was not possible in 34 patients due to technical problems. It could be measured on both DXA and EOS® in 88 patients (28 with severe low-trauma fracture and 60 without fracture). TBS-EOS values were significantly lower in fractured patients compared to nonfractured patients. TBS-EOS was associated with the presence of fractures as reported by an AUC of 0.70. Odds ratio of TBS-EOS for the presence of severe low-trauma fracture was 2.00 [1.24–3.25], p = 0.005. Conclusions: This proof of concept study, based on a prototype version of the TBS-EOS, demonstrated the feasibility of the measurement of TBS® on low-dose EOS® imaging devices. Results show that the TBS-EOS was lower in patients with severe low-trauma fractures compared to nonfractured patients independently from bone mineral density. Some technical issues need to be solved before its eventual use in routine clinical settings. Additional prospective studies are still needed to define the actual contribution of this new technique.

Published
2019
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4. Spinal-pelvic orientation: potential effect on the diagnosis of spondyloarthritis

Author

Laure Gossec, Antoine Feydy, Florent Garrigues, M. Herbette, Pascal Claudepierre, Alain Saraux, A. Simon, Damien Loeuille, Thierry Marhadour, Lucile Deloire, Désirée van der Heijde, Monique Reijnierse, Guillermo Carvajal Alegria, Lymphocytes B, Autoimmunité et Immunothérapies (LBAI), Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-LabEX IGO Immunothérapie Grand Ouest, Nantes Université (Nantes Univ)-Nantes Université (Nantes Univ)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO), Département de radiologie [Brest] (DR - Brest), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Centre National de Référence CERAINO, Service de Rhumatologie (Hôpital de la Cavale Blanche), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service de neurochirurgie [Brest], Hôpital de la Cavale Blanche - CHRU Brest (CHU - BREST ), Service de Radiologie [CHU Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Department of Radiology (MVS), Leiden University Medical Center (LUMC), Service de Rhumatologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Service de rhumatologie [CHU Henri Mondor], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor, Epidemiology in Dermatology and Evaluation in Therapeutics (EpiDermE), Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), CHRU Brest - Service de Rhumatologie (CHU - BREST - Rhumato), Lymphocyte B et Auto-immunité (LBAI), Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Brestois Santé Agro Matière (IBSAM), and Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM)

Subjects
Adult, Male, sacral slope, Lordosis, Radiography, Lumbar vertebrae, sacroiliitis, 03 medical and health sciences, 0302 clinical medicine, Rheumatology, Spondylarthritis, ankylosing spondylitis, Back pain, medicine, Humans, Pharmacology (medical), Prospective Studies, Pelvic Bones, Postural Balance, Orientation, Spatial, Pelvis, health care economics and organizations, 030203 arthritis & rheumatology, Ankylosing spondylitis, Lumbar Vertebrae, business.industry, Sacroiliitis, Reproducibility of Results, lumbar lordosis, axial spondyloarthritis, Pelvimetry, medicine.disease, Magnetic Resonance Imaging, medicine.anatomical_structure, Back Pain, Lumbosacral angle, [SDV.IMM]Life Sciences [q-bio]/Immunology, Female, medicine.symptom, business, Nuclear medicine, 030217 neurology & neurosurgery
Abstract

Objective To assess associations of spinal-pelvic orientation with clinical and imaging-study findings suggesting axial SpA (axSpA) in patients with recent-onset inflammatory back pain. Methods Spinal-pelvic orientation was assessed in DESIR cohort patients with recent-onset inflammatory back pain and suspected axSpA, by using lateral lumbar-spine radiographs to categorize sacral horizontal angle ( Results Of 362 patients, 358, 356 and 357 had available sacral horizontal angle, lumbosacral angle and LL values, respectively; means were 39.3°, 14.6° and 53.0°, respectively. The prevalence of sacroiliitis on both radiographs and MRI was higher in the LL < 50° group than in the LL ⩾50° group, but the difference was not statistically significant. Clinical presentation and confidence in a diagnosis of axSpA did not differ across angle groups. No significant differences were identified for degenerative changes according to sacral horizontal angle, lumbosacral angle or LL. Conclusion Spinal-pelvic balance was not statistically associated with the clinical or imaging-study findings suggesting axSpA in patients with recent-onset inflammatory back pain.

Published
2019
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5. Do Curve Characteristics Influence Stenosis Location and Occurrence of Radicular Pain in Adult Degenerative Scoliosis?

Author

S. Zakine, L. Marie-Hardy, N. Regnard, Marc Khalifé, Emmanuelle Ferrero, C. Garreau De Loubresse, Antoine Feydy, P. Guigui, and Université Paris Descartes - Paris 5 (UPD5)

Subjects
Male, musculoskeletal diseases, medicine.medical_specialty, Spinal stenosis, [SDV]Life Sciences [q-bio], Scoliosis, 03 medical and health sciences, Spinal Stenosis, 0302 clinical medicine, Lumbar, medicine, Humans, Orthopedics and Sports Medicine, Aged, Retrospective Studies, Aged, 80 and over, 030222 orthopedics, Lumbar Vertebrae, Cobb angle, business.industry, Lumbar spinal stenosis, Middle Aged, Lumbar Curve, medicine.disease, Spondylolisthesis, 3. Good health, Back Pain, Female, Radiology, business, 030217 neurology & neurosurgery, Lumbosacral joint
Abstract

Study Design Retrospective cohort. Objective The aim of this study was to describe the various locations of spinal stenosis (LSS) in lumbar scoliosis and its related clinical symptoms. Introduction Adults with lumbar scoliosis often present with pain and disability. Association of scoliosis and stenosis is not rare, but remains sparsely explored. Consequences of scoliosis on stenosis location and treatment remain debatable. Methods Patients operated for symptomatic LSS with lumbar scoliosis (Cobb angle >20°) from 2015 to 2016 were included. All patients completed preoperative clinical and neurologic examination. Coronal and sagittal radiographic parameters, rotatory subluxation (RS), and spondylolisthesis were analyzed on full spine radiographs. Computed tomographic scan multiplanar reconstructions were performed to measure central, foraminal, and lateral recess stenosis, from T10 to the sacrum. Results A total of 76 patients were included (69 ± 9 years old, 77% female). Sixty percent had neurogenic claudication, and L5 was the most common radicular pain (41%). The mean Cobb angle was 33° ± 16°. Overall, 35 (46%) patients had coronal malalignment; in 69%, side of the coronal tilt corresponded to side of the concavity of the lumbosacral curve. Sixty patients had RS (most frequent level L3–L4). In 50% of the cohort, RS was located at the junction between the lumbar and lumbosacral curves. In 70% (n = 53) of the patients, central stenosis occurred at the junction between the lumbar and lumbosacral curves. Foraminal and lateral stenosis were most frequently observed in the concavity of the distal lumbosacral curve. L5 radicular pain was significantly more frequent in case of lumbosacral contra-curve and right coronal malalignment. Conclusion LSS is frequent in lumbar scoliosis. Relationships exist between curve characteristics and symptomatic LSS in lumbar scoliosis; especially, concavity of the lumbosacral contra-curve and the junctional level between the lumbar curve and the lumbosacral contra-curve. Therefore, accurate analysis of stenosis in ASD seems mandatory, to at least perform decompression because perfect planned treatment for stenosis and scoliosis correction might not always be possible because of the patient's general health status. Level of Evidence Level 4.

Published
2019
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6. Associations of Lumbar Scoliosis with Presentation of Suspected Early Axial Spondyloarthritis

Author

Thierry Marhadour, Alain Saraux, Antoine Feydy, Pascal Claudepierre, A. Simon, M. Voirin-Hertz, Damien Loeuille, Guillermo Carvajal Alegria, Monique Reijnierse, Désirée van der Heijde, Florent Garrigues, CCSD, Accord Elsevier, CHRU Brest - Service de Rhumatologie (CHU - BREST - Rhumato), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Lymphocytes B, Autoimmunité et Immunothérapies (LBAI), Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-LabEX IGO Immunothérapie Grand Ouest, Nantes Université (Nantes Univ)-Nantes Université (Nantes Univ)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO), Département de radiologie [Brest] (DR - Brest), Service de neurochirurgie [Brest], Hôpital de la Cavale Blanche - CHRU Brest (CHU - BREST ), Service de radiologie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5), Department of Radiology (MVS), Leiden University Medical Center (LUMC), Service de Rhumatologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Service de rhumatologie [CHU Henri Mondor], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor, Lymphocyte B et Auto-immunité (LBAI), and Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Brestois Santé Agro Matière (IBSAM)

Subjects
Adult, Male, musculoskeletal diseases, medicine.medical_specialty, Adolescent, [SDV.IMM] Life Sciences [q-bio]/Immunology, Radiography, Lumbar scoliosis, Scoliosis, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Degenerative disease, Lumbar, Rheumatology, Sacral slope, Spondylarthritis, medicine, Humans, 030212 general & internal medicine, Sacroiliitis, Axial spondyloarthritis, Lumbar lordosis, Pelvis, ComputingMilieux_MISCELLANEOUS, 030203 arthritis & rheumatology, Ankylosing spondylitis, Lumbar Vertebrae, business.industry, Middle Aged, medicine.disease, Magnetic Resonance Imaging, 3. Good health, Anesthesiology and Pain Medicine, medicine.anatomical_structure, Lumbosacral angle, [SDV.IMM]Life Sciences [q-bio]/Immunology, Female, Radiology, business, Low Back Pain
Abstract

Objective: Scoliosis may impact the mechanical loading and cause secondary changes of the sacroiliac joints and lumbar spine. Our goal was to look how lumbar scoliosis modify the clinical and imaging-study in patients with recent-onset inflammatory back pain (IBP) suggesting axial spondyloarthritis (axSpA).Methods: Baseline weight-bearing lumbar-spine radiographs obtained in the DESIR cohort of patients aged 18-50 years and having IBP for at least 3 months but less than 3 years suggesting axSpA were studied. After training on scoliosis detection based on Cobb's angle>10 degrees plus Nash-Moe grade >= 1, readers blinded to patient data measured spine lumbar scoliosis, sacral horizontal angle, lumbosacral angle and lumbar lordosis on the radiograph of the lumbar and scored sacroiliitis on the radiograph of the pelvis. Baseline MRIs T1 and STIR of the lumbar spine and sacroiliac joints were evaluated for respectively degenerative changes and signs of axSpA.Results: Of the 360 patients (50.8% females) 88.7% had lumbar pain and 69.3% met ASAS criteria for axSpA. Mean Cobb's angle was 3.2 degrees +/- 5.0 degrees and 28 (7.7%) patients had lumbar scoliosis. No statistical differences were observed for radiographic sacroiliitis, MRI sacroiliitis, modified Stoke Ankylosing Spondylitis Spinal Score, Pfirmmann score, high-intensity zone, protrusion, extrusion, MODIC score between patients with and without scoliosis. In both groups, degenerative changes by MRI were rare and predominated at L4-L5 and L5-S1.Conclusion: In patients with early IBP suggesting axSpA, lumbar scoliosis was not associated with inflammatory or degenerative changes. (C) 2019 Elsevier Inc. All rights reserved.

Published
2019
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7. Which scoring method depicts spinal radiographic damage in early axial spondyloarthritis best? Five-year results from the DESIR cohort

Author

Maria Antonietta D'Agostino, Alexandre Sepriano, Sofia Ramiro, Maxime Dougados, Damien Loeuille, Antoine Feydy, Anna Molto, Pascal Claudepierre, Désirée van der Heijde, Miranda van Lunteren, Monique Reijnierse, Leiden University Medical Center (LUMC), Service de rhumatologie [CHU Henri Mondor], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor, NOVA Medical School - Faculdade de Ciências Médicas (NMS), Universidade Nova de Lisboa = NOVA University Lisbon (NOVA), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA), Service de rhumatologie [CHU Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital Cochin [AP-HP], Université Paris Descartes - Paris 5 (UPD5), Hôpital Ambroise Paré [AP-HP], Infection et inflammation (2I), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Rhumatologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Ingénierie Moléculaire et Physiopathologie Articulaire (IMoPA), Université de Lorraine (UL)-Centre National de la Recherche Scientifique (CNRS), CIC Brest, Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital de la Cavale Blanche, Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Henri Mondor, Universidade Nova de Lisboa (NOVA), Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Cochin [AP-HP], CHU Cochin [AP-HP], Hôpital Ambroise Paré, Infection et inflammation chronique (2I), and CHU Cochin [AP-HP]-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)

Subjects
0301 basic medicine, Adult, Male, Thoracic spine, Radiography, [SDV]Life Sciences [q-bio], Severity of Illness Index, 03 medical and health sciences, outcome measures, 0302 clinical medicine, Rheumatology, Severity of illness, Spondylarthritis, medicine, Humans, Pharmacology (medical), Axial spondyloarthritis, ComputingMilieux_MISCELLANEOUS, 030203 arthritis & rheumatology, Ankylosing spondylitis, business.industry, Desir cohort, Reproducibility of Results, Middle Aged, spondyloarthritis, medicine.disease, Explained variation, Spine, radiology, 030104 developmental biology, [SDV.MHEP.RSOA]Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, Disease Progression, Female, epidemiology, sense organs, Analysis of variance, business, Nuclear medicine, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

Objective To compare the performance of different spinal radiographic damage scoring methods in patients with early axial spondyloarthritis (axSpA). Methods Five-year spinal radiographs from the DESIR cohort were scored by three readers (averaged) for the calculation of the Stoke AS Spine Score (SASSS), modified Stoke Ankylosing Spondylitis Spine Score (mSASSS), Radiographic AS Spinal Score (RASSS), BASRI-spine and BASRI-total, and following the OMERACT filter, scores were compared according to truth, discrimination (reliability and sensitivity to change) and feasibility. The proportion of patients with a net change > smallest detectable change and >1 was calculated. The proportion of total variance explained by the patient (true variance) was calculated for the change scores as a measure of reliability, using analysis of variance. Results In total 699 patients were included. Five-year net changes > smallest detectable change (>1) were: RASSS 17% (17%), mSASSS 12% (12%), BASRI-spine and BASRI-total 12% (9%), SASSS 11% (11%). The mSASSS and the RASSS performed the best in terms of capturing the signal (positive change) related to noise (negative change). The proportion of variance explained by the patient was highest for the mSASSS and RASSS (85% for both 5-year progression scores vs 50-55% for other methods). The proportion of patient variance in the thoracic segment of the RASSS was unsatisfactory (46% for progression). Conclusion The existing scoring methods to assess spinal radiographic damage performed well in early phases of axSpA. The mSASSS and RASSS captured most change. There was no clear gain in additionally scoring the thoracic spine for the RASSS. The mSASSS remains the most sensitive and valid scoring method in axSpA, including early phases of the disease.

Published
2018
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8. The yield of a positive MRI of the spine as imaging criterion in the ASAS classification criteria for axial spondyloarthritis: results from the SPACE and DESIR cohorts

Author

Monique Reijnierse, F. Thévenin, Lennart T. H. Jacobsson, Grégory Lenczner, Z. Ez-Zaitouni, Rosaline van den Berg, Miranda van Lunteren, P. Bakker, Karen Minde Fagerli, Manouk de Hooge, Floris A. van Gaalen, Jean-Baptiste Pialat, Alain Saraux, Robert Landewé, Désirée van der Heijde, Antoine Feydy, Roberta Ramonda, Leiden University Medical Center (LUMC), Department of Rheumatology (LEIDEN - Rhumato), Universita degli Studi di Padova, Lymphocyte B et Auto-immunité (LBAI), Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO), CIC Brest, Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital de la Cavale Blanche, Department of Radiology (Clinique Hartmann - Radio), Clinique Hartmann, CHU Cochin [AP-HP], Service de Radiologie [CHU Cochin], CHU Cochin [AP-HP]-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Université Paris Descartes - Paris 5 (UPD5), Clinique Hartmann [Neuilly-sur-Seine], Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], AII - Inflammatory diseases, Clinical Immunology and Rheumatology, and Amsterdam institute for Infection and Immunity

Subjects
Male, Genetics and Molecular Biology (all), Entire spine, [SDV]Life Sciences [q-bio], Biochemistry, 030218 nuclear medicine & medical imaging, Cohort Studies, 0302 clinical medicine, Symptom duration, Back pain, Immunology and Allergy, Axial spondyloarthritis, ComputingMilieux_MISCELLANEOUS, ankylosing spondylitis, axial spondyloarthritis, classification criteria, magnetic resonance imaging, Adult, Back Pain, Chronic Pain, Female, Humans, Observer Variation, Radiography, Sacroiliac Joint, Sacroiliitis, Spine, Spondylarthropathies, Young Adult, Magnetic Resonance Imaging, Rheumatology, Immunology, Biochemistry, Genetics and Molecular Biology (all), [SDV.MHEP.RSOA]Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, Cohort, Radiology, medicine.symptom, musculoskeletal diseases, medicine.medical_specialty, General Biochemistry, Genetics and Molecular Biology, 03 medical and health sciences, medicine, In patient, 030203 arthritis & rheumatology, business.industry, medicine.disease, Surgery, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

Objectives To assess the prevalence of spinal inflammation on MRI in patients with chronic back pain (CBP) of maximally 3 years duration and to evaluate the yield of adding a positive MRI-spine as imaging criterion to the Assessment of SpondyloArthritis international Society (ASAS) classification criteria for axial spondyloarthritis (axSpA). Methods Baseline imaging of the sacroiliac joints (X-SI), MRI of the sacroiliac joints (MRI-SI) and MRI-spine were scored by ≥2 experienced central readers per modality in the SPondyloArthritis Caught Early (SPACE) and DEvenir des Spondylarthropathies Indifferenciees Recentes (DESIR) cohorts. Inflammation suggestive of axSpA was assessed in the entire spine. A positive MRI-spine was defined by the presence of ≥5 inflammatory lesions. Alternative less strict definitions were also tested. Results In this study, 541 and 650 patients with CBP from the SPACE and DESIR cohorts were included. Sacroiliitis on X-SI and MRI-SI was found in 40/541 (7%) and 76/541 (14%) patients in SPACE, and in DESIR in 134/650 (21%) and 231/650 (36%) patients, respectively. In SPACE and DESIR, a positive MRI-spine was seen in 4/541 (1%) and 48/650 (7%) patients. Of the patients without sacroiliitis on imaging, 3/447 (1%) (SPACE) and 8/382 (2%) (DESIR) patients had a positive MRI-spine. Adding positive MRI-spine as imaging criterion led to new classification in only one patient in each cohort, as the other patients already fulfilled the clinical arm. Other definitions of a positive MRI-spine yielded similar results. Conclusion In two cohorts of patients with CBP with a maximum symptom duration of 3 years, a positive MRI-spine was rare in patients without sacroiliitis on MRI-SI and X-SI. Addition of MRI-spine as imaging criterion to the ASAS axSpA criteria had a low yield of newly classified patients and is therefore not recommended.

Published
2017

9. Clinical presentation of patients suffering from recent onset chronic inflammatory back pain suggestive of spondyloarthritis: The DESIR cohort

Author

Maxime, Dougados, Adrien, Etcheto, Anna, Molto, Sandrine, Alonso, Sophie, Bouvet, Jean-Pierre, Daurès, Paul, Landais, Maria-Antonietta, d'Agostino, Francis, Berenbaum, Maxime, Breban, Pascal, Claudepierre, Bernard, Combe, Bruno, Fautrel, Antoine, Feydy, Philippe, Goupille, Pascal, Richette, Thao, Pham, Christian, Roux, Jean-Marc, Treluyer, Alain, Saraux, Désirée, van der Heijde, Daniel, Wendling, Alain, Cantagrel, Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de rhumatologie [CHU Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), BESPIM, Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Aide à la Décision pour une Médecine Personnalisé - Laboratoire de Biostatistique, Epidémiologie et Recherche Clinique - EA 2415 (AIDMP), Université Montpellier 1 (UM1)-Université de Montpellier (UM), Service de Rhumatologie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Ambroise Paré [AP-HP], Service de rhumatologie [CHU Saint-Antoine], CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service de rhumatologie [CHU Henri Mondor], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor, Département de Rhumatologie[Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Lapeyronie, Institut de Génétique Moléculaire de Montpellier (IGMM), Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM), Service de rhumatologie [CHU Pitié Salpêtrière] (GRC-08 EEMOIS), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Hôpital Cochin [AP-HP], Centre Hospitalier Régional Universitaire de Tours (CHRU TOURS), Service de Rhumatologie [CHU Lariboisière], Hôpital Lariboisière-Fernand-Widal [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Rhumatologie [Sainte- Marguerite - APHM] ( Hôpitaux Sud), Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital Sainte-Marguerite [CHU - APHM] (Hôpitaux Sud ), CHRU Brest - Service de Rhumatologie (CHU - BREST - Rhumato), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Lymphocyte B et Auto-immunité (LBAI), Université de Brest (UBO)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM), CIC Brest, Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital de la Cavale Blanche, Leiden University Medical Center (LUMC), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Département de Biostatistique, Epidémiologie, Santé Publique et Informatique Médicale (BESPIM), Centre Hospitalier Universitaire de Nîmes (CHU de Nîmes), Centre Hospitalier Régional Universitaire de Nîmes (CHRU Nîmes), Hôpital Ambroise Paré, Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Centre de Recherche Saint-Antoine (CR Saint-Antoine), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Ambroise Paré, Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Henri Mondor, Université Pierre et Marie Curie - Paris 6 - UFR de Médecine Pierre et Marie Curie (UPMC), Université Pierre et Marie Curie - Paris 6 (UPMC), CHU Cochin [AP-HP], Génétique, immunothérapie, chimie et cancer (GICC), UMR 7292 CNRS [2012-2017] (GICC UMR 7292 CNRS), Université de Tours-Centre National de la Recherche Scientifique (CNRS), Hôpital Lariboisière, Laboratoire d'Economie de Dauphine (LEDa), Université Paris Dauphine-PSL, Laboratoire de Traitement de l'Information Medicale (LaTIM), Université européenne de Bretagne - European University of Brittany (UEB)-Télécom Bretagne-Centre Hospitalier Régional Universitaire de Brest (CHRU Brest)-Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Mines-Télécom [Paris] (IMT), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Cochin [AP-HP], Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO), Centre Hospitalier Régional Universitaire [Besançon] (CHRU Besançon), Université de Montpellier (UM)-Université Montpellier 1 (UM1), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Pierre et Marie Curie - Paris 6 (UPMC), Université Paris Descartes - Paris 5 (UPD5), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Saint-Antoine [APHP], Service de Rhumatologie [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Pitié-Salpêtrière [APHP], Centre Hospitalier Régional Universitaire [Besançon] (CHRU Besançon)-Hôpital Jean Minjoz, CHU Cochin [AP-HP]-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), and Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)

Subjects
Adult, Male, medicine.medical_specialty, Settore MED/16 - REUMATOLOGIA, Adolescent, Epidemiology, Classification criteria, [SDV]Life Sciences [q-bio], Dactylitis, Young Adult, Rheumatology, Psoriasis, Internal medicine, Spondylarthritis, Spondyloarthritis, medicine, Humans, Prospective Studies, Age of Onset, BASDAI, ComputingMilieux_MISCELLANEOUS, business.industry, Incidence, Gold standard, Enthesitis, Cohort, Middle Aged, medicine.disease, 3. Good health, [SDV.MHEP.RSOA]Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, Back Pain, Physical therapy, Female, France, medicine.symptom, BASFI, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Follow-Up Studies, Forecasting
Abstract

Objectives DESIR is a prospective longitudinal multicentric French cohort of patients with inflammatory back pain suggestive of spondyloarthritis, with a 10-year-follow-up. The purpose is to evaluate the performances of the different sets of classification criteria for axial spondyloarthritis, and to describe the frequency and characteristics of the clinical features of axial spondyloarthritis. Methods Demographic data and items allowing classification and indices calculation were collected, as well as biologic and imaging data. Baseline data are analyzed. The performance of the several classification criteria sets was evaluated (likelihood ratio) with the physician's diagnosis as external gold standard. For the clinical presentation of axial spondyloarthritis, a descriptive analysis was conducted. Results Seven hundred and eight patients are included. Ninety-two percent of them satisfy at least one set of classification criteria: mNY 26%, Amor 79%, ESSG 78%, ASAS 70%; physician's confidence level 6.8 ± 2.7. 81 and 83% of patients fulfil modified (including MRI) Amor or ESSG criteria. Axial involvement is present in 100% of the cases. NSAIDs are taken by 90%, with an NSAID sore of 50 ± 46. BASDAI over 40 is noted in 60% and elevated CRP in 30% of the cases. HLA-B27 is present in 58%. According to ASDAS CRP levels, 12.7% are in inactive disease, 63% in high disease activity; mean BASFI was 30. Peripheral involvement is present in 57%, with arthritis in 37% of these. Enthesitis is noted in 49% of the patients, and first symptom in 22.5%; anterior chest wall involvement is noted in 44.6%, and dactylitis in 13%. For extra articular manifestations, psoriasis is recorded in 16%, uveitis in 8.5% and IBD in 5.1%. Smoking is present in 36.3% and hypertension in 5.1% of the cases. Conclusion These data represent the base of evaluation of the follow-up of this cohort, allowing future specific studies.

Published
2015
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10. Increase in Dickkopf-1 Serum Level in Recent Spondyloarthritis. Data from the DESIR Cohort

Author

Joanne Nithitham, Gaetane Nocturne, Karine Briot, Christian Roux, Kimberly E. Taylor, Lindsey A. Criswell, Francis Berenbaum, Xavier Mariette, Antoine Feydy, Maxime Dougados, Pascal Claudepierre, Corinne Miceli-Richard, Floris A. van Gaalen, Philippe Goupille, Philippe Chanson, Saida Boudaoud, Raphaèle Seror, Stephan Pavy, Philippe Dieudé, Désirée van der Heijde, Immunologie des Maladies Virales et Autoimmunes (IMVA - U1184), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Sud - Paris 11 (UP11)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA), Service de rhumatologie, AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), Université Francois Rabelais [Tours], Service d'endocrinologie, Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Bicêtre, Universiteit Leiden [Leiden], CHU Saint-Antoine [APHP], Service de rhumatologie B, Université Paris Descartes - Paris 5 (UPD5), Service de radiologie, CHU Cochin [AP-HP], Service de rhumatologie [CHU Henri Mondor], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Henri Mondor, Service de rhumatologie [Bichat], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-AP-HP - Hôpital Bichat - Claude Bernard [Paris]-Université Paris Diderot - Paris 7 (UPD7), University of California [San Francisco] (UCSF), University of California, Université Paris-Sud - Paris 11 (UP11)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Bicêtre, CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7), Universiteit Leiden, University of California [San Francisco] (UC San Francisco), University of California (UC), Immunologie des Maladies Virales et Autoimmunes ( IMVA - U1184 ), Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université Paris-Sud - Paris 11 ( UP11 ) -Commissariat à l'énergie atomique et aux énergies alternatives ( CEA ), Université Paris-Sud - Paris 11 ( UP11 ) -Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Bicêtre, Université Pierre et Marie Curie - Paris 6 ( UPMC ) -APHP-CHU Saint-Antoine [APHP], Université Paris Descartes - Paris 5 ( UPD5 ), Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Henri Mondor, Assistance publique - Hôpitaux de Paris (AP-HP)-AP-HP - Hôpital Bichat - Claude Bernard [Paris]-Université Paris Diderot - Paris 7 ( UPD7 ), and University of California [San Francisco] ( UCSF )

Subjects
Adult, Genetic Markers, Male, medicine.medical_specialty, Multivariate analysis, Genotype, Cross-sectional study, lcsh:Medicine, Single-nucleotide polymorphism, Gastroenterology, Polymorphism, Single Nucleotide, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, [ SDV.MHEP ] Life Sciences [q-bio]/Human health and pathology, Internal medicine, Spondylarthritis, medicine, Humans, lcsh:Science, Wnt Signaling Pathway, 030304 developmental biology, Adaptor Proteins, Signal Transducing, 030203 arthritis & rheumatology, 0303 health sciences, Ankylosing spondylitis, Multidisciplinary, business.industry, lcsh:R, Desir cohort, Sacroiliitis, medicine.disease, 3. Good health, Cross-Sectional Studies, Back Pain, Cohort, Immunology, Bone Morphogenetic Proteins, Intercellular Signaling Peptides and Proteins, lcsh:Q, Female, France, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Cohort study, Research Article
Abstract

International audience; Objectives : To investigate DKK-1 and SOST serum levels among patients with recent inflammatory back pain (IBP) fulfilling ASAS criteria for SpA and associated factors.Methods : The DESIR cohort is a prospective, multicenter French cohort of 708 patients with early IBP (duration >3 months and

Published
2015
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11. fMRI study of problem-solving after severe traumatic brain injury

Author

Mélanie Pélégrini-Issac, Antoine Feydy, Romain Valabregue, Laurent Pierot, Fabienne Cazalis, Philippe Azouvi, Plasticité cérébrale et adaptations des fonctions visuelles et motrices, Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Laboratoire d'Imagerie Fonctionnelle ( LIF ), Université Pierre et Marie Curie - Paris 6 ( UPMC ) -IFR14-IFR49-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Institut d'imagerie neurofonctionnelle ( IIN ), Institut National de la Santé et de la Recherche Médicale ( INSERM ) -ENST-Assistance publique - Hôpitaux de Paris (AP-HP)-Commissariat à l'énergie atomique et aux énergies alternatives ( CEA ) -École des hautes études en sciences sociales ( EHESS ) -Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Université Paris-Sud - Paris 11 ( UP11 ) -Centre National de la Recherche Scientifique ( CNRS ), Université de Reims Champagne-Ardenne ( URCA ), Service de réeducation fonctionnelle [Raymond Poincaré], Assistance publique - Hôpitaux de Paris (AP-HP)-AP-HP Hôpital Raymond Poincaré [Garches], Physiologie et physiopathologie de la motricité chez l'homme, Université Pierre et Marie Curie - Paris 6 ( UPMC ) -IFR70-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire d'Imagerie Fonctionnelle (LIF), Université Pierre et Marie Curie - Paris 6 (UPMC)-IFR14-IFR49-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut d'imagerie neurofonctionnelle (IIN), Institut National de la Santé et de la Recherche Médicale (INSERM)-Ecole Nationale Supérieure des Télécommunications (ENST)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-École des hautes études en sciences sociales (EHESS)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Université Paris-Sud - Paris 11 (UP11)-Centre National de la Recherche Scientifique (CNRS), Université de Reims Champagne-Ardenne (URCA), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Raymond Poincaré [AP-HP], Université Pierre et Marie Curie - Paris 6 (UPMC)-IFR70-Institut National de la Santé et de la Recherche Médicale (INSERM), and Université Paris-Sud - Paris 11 (UP11)-Université Pierre et Marie Curie - Paris 6 (UPMC)-École des hautes études en sciences sociales (EHESS)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Ecole Nationale Supérieure des Télécommunications (ENST)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)

Subjects
Male, MESH : Brain Mapping, Neuropsychological Tests, Audiology, MESH : Prefrontal Cortex, MESH: Magnetic Resonance Imaging, 0302 clinical medicine, Cortex (anatomy), Image Processing, Computer-Assisted, Developmental and Educational Psychology, MESH : Female, MESH : Gyrus Cinguli, Problem Solving, MESH: Brain Mapping, Dysexecutive syndrome, Brain Mapping, MESH : Brain Injuries, 05 social sciences, Healthy subjects, MESH: Neuropsychological Tests, MESH : Adult, Magnetic Resonance Imaging, MESH: Case-Control Studies, MESH: Image Processing, Computer-Assisted, MESH : Neuropsychological Tests, medicine.anatomical_structure, Female, Psychology, psychological phenomena and processes, MESH : Image Processing, Computer-Assisted, MESH: Problem Solving, Adult, Brain activation, medicine.medical_specialty, MESH : Case-Control Studies, Adolescent, Traumatic brain injury, MESH : Male, Neuroscience (miscellaneous), Prefrontal Cortex, Gyrus Cinguli, behavioral disciplines and activities, 050105 experimental psychology, 03 medical and health sciences, MESH : Cognition Disorders, MESH: Gyrus Cinguli, MESH : Adolescent, MESH : Magnetic Resonance Imaging, MESH : Problem Solving, Reaction Time, medicine, Humans, 0501 psychology and cognitive sciences, Anterior cingulate cortex, MESH: Adolescent, MESH: Humans, [SDV.BA.MVSA]Life Sciences [q-bio]/Animal biology/Veterinary medicine and animal Health, MESH : Humans, MESH: Adult, medicine.disease, MESH: Male, MESH: Reaction Time, MESH: Cognition Disorders, nervous system, Brain Injuries, Case-Control Studies, MESH : Reaction Time, MESH: Brain Injuries, MESH: Prefrontal Cortex, Neurology (clinical), [ SDV.BA.MVSA ] Life Sciences [q-bio]/Animal biology/Veterinary medicine and animal Health, Cognition Disorders, Neuroscience, MESH: Female, 030217 neurology & neurosurgery
Abstract

International audience; OBJECTIVE: To assess the cerebral correlates of the dysexecutive syndrome after diffuse severe traumatic brain injury (TBI). METHODS: Ten patients with sub-acute/chronic severe TBI without detectable focal cortical contusion and 11 matched healthy subjects were included in a parametric fMRI study using a planning task, the Tower of London. RESULTS: Brain activation in the left Dorsolateral Pre-frontal Cortex (DLPFC) and the Anterior Cingulate Cortex (ACC) was closely related to performance. Patients with TBI who performed the task efficiently showed, like healthy controls who obtained a similar pattern of performance, a large activation in the left DLPFC and a small activation in the ACC. In contrast, poor performance was associated with a reduced activation in these both regions. CONCLUSION: Problem-solving deficits after severe diffuse TBI could be related to an impaired activation of the DLPFC and of the ACC.

Published
2006
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12. Mesure de hauteur discale du rachis lombaire : comparaison entre radiographie standard et un système radiographique à balayage EOS®

Author

Regnard, Nor-Eddine, Université Paris Descartes - Faculté de Médecine (UPD5 Médecine), Université Paris Descartes - Paris 5 (UPD5), and Antoine Feydy

Subjects
MESH: EOS, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, Radiographie, EOS, MESH: Reproducibility of results, Mesure de hauteur discale, Acquisition à balayage biplan, Rachis lombaire, MESH: Radiography, MESH: Spine, Reproductibilité, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, MESH: Lumbar
Abstract

Background context:Chronic low-back pain (LBP) is a major public health problem. Conventional radiography (CR) of Lumbar Spine is the first imaging technique recommended for LBP, particularly to assess discal height (DH) measurement. No study assessed DH measurement with Low-Dose Biplanar radiographic System (LDBS)Purpose: To compare lumbar DH measurements between CR and a LDBS on vertebras ex-vivo and in-vivo in a chronic LBP population.Patient sample: Patient sample included consecutively and prospectively those diagnosed in our institution with chronic LBP from April to October 2011.Outcome measures: There were based on DH values (in millimeters) and reproducibility measurements for the last 3 lumbar discs levels on CR and LDBS. Image quality score were assessed on a numerical scale /10 (Visual Analogic Scale).Methods:50 consecutive patients with chronic low back pain (LBP) were included in this monocentric study. All received a lateral lumbar spine radiograph by both CR and LDBS. One radiologist and one rheumatologist measured the DH for the last 3 lumbar disc levels and assessed image quality. Radiographs of the vertebras ex vivo were acquired via LDBS and CR at 5 different DH, fixed and known. We measured inter-observer reproducibility and repeatability for CR and LDBS in vivo and ex vivo.Results:For L3-L4, the DH was 9.5+/-2mm by CR and 7mm+/-1.5mm by LDBS. For L4-L5, the DH was 10.2mm+/-2.4mm by CR and 7.3mm +/- 1.6 mm by LDBS. For L5-S1, the DH was 8.9 mm+/-2mm by CR and 6.3mm+/-2.4mm by LDBS. The real ex-vivo DH measurement was closer to the LDBS measurement. Reproducibility and repeatability were consistent for the 2 systems. Image quality scores were similar.Conclusion:DH measurements using LDBS were closer to real measurements than using CR. LDBS measurements were accurate and reproducible. The image quality was similar.; Objectif:Les objectifs principaux sont de comparer les mesures des hauteurs discales (HD) du rachis lombaire entre radiographie conventionnelle (CR) et le système radiographique à balayage EOS chez des patients lombalgiques chroniques (étude in-vivo) ainsi que les mesures de HD avec les 2 systèmes radiographiques aux HD réelles sur des vertèbres sèches ex-vivoMatériels et Méthodes:50 patients atteints de lombalgie chronique ont été inclus de manière consécutive, prospective, dans cette étude monocentrique. Tous avaient des acquisitions radiographique de rachis lombaire de profil en radiographie standard et avec le système EOS. Un radiologue et un rhumatologue sénior ont mesuré les HD aux 3 derniers étages lombaires et évalué la qualité d’image. Des radiographies des vertèbres ex-vivo à un niveau ont été acquises avec EOS et CR à 5 hauteurs fixées et connues. Les mesures sur les images CR et EOS étaient faites par un radiologue senior et un interne de radiologie. Nous avons mesuré la reproductibilité et la répétabilité des mesures in-vivo et ex-vivo et nous avons comparé les scores de qualité image.Résultats:En L3-L4 la hauteur discale était de 9.5 mm +/- 2mm en CR et 7 mm +/- 1.5 mm en EOS. En L4-L5, elle était de 10.2 mm +/- 2.4 mm en CR et 7.3 mm +/- 1.6 mm en EOS. En L5-S1, elle était de 8.9 mm+/-2 mm en CR et 6.3 mm+/-2.4 mm en EOS. Les mesures réelles des hauteurs discales des vertèbres ex-vivo étaient plus proches en EOS qu’en CR. Les coefficients d’agrandissement entre CR et EOS étaient de 33% pour les mesures ex-vivo et 36% pour les mesures in-vivo. Les reproductibilités et répétabilités étaient bonnes pour les 2 systèmes avec des coefficients de Corrélation Intra-Classe > 0.8. Les scores de qualité image étaient similaires pour les images EOS et CR.Conclusion:Les mesures de hauteurs discales avec EOS sont plus proches des mesures réelles que la radiographie conventionnelle. Les mesures EOS sont fiables et reproductibles. La qualité d’image est similaire.

Published
2015

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