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101. Factor V Leiden mutation in cerebral venous thrombosis

Author

Mathieu Zuber, Jean-Louis Mas, Pierre Toulon, and Laurence Marnet

Subjects
Cerebral veins, Adult, Male, Pathology, medicine.medical_specialty, Heterozygote, Deep vein, Gastroenterology, Risk Factors, Internal medicine, medicine, Humans, Aged, Advanced and Specialized Nursing, biology, business.industry, Factor V, Puerperal Disorders, Intracranial Embolism and Thrombosis, Middle Aged, medicine.disease, Thrombosis, Cerebral Veins, Venous thrombosis, medicine.anatomical_structure, Coagulation, Case-Control Studies, Mutation (genetic algorithm), Mutation, biology.protein, Female, Neurology (clinical), Cardiology and Cardiovascular Medicine, business, Protein C, medicine.drug, Contraceptives, Oral
Abstract

Background and Purpose Resistance to activated protein C is a common inherited risk factor for venous thrombosis, which is due to a mutation in coagulation factor V (factor V Leiden mutation). It is present in approximately 20% of unselected consecutive patients with deep vein thrombosis. The rate of resistance to activated protein C in patients with cerebral venous thrombosis (CVT) is unknown. Methods We investigated the association of factor V mutation with CVT using a case-control study. Nineteen unselected patients with CVT and 57 healthy control subjects were tested for the point mutation. Results The mutation was found in a heterozygous form in 4 of the 19 patients with CVT (21%) and in only 1 of the 57 control subjects (2%) ( P =.02, Fisher's exact test). The prevalence of the coagulation defect found in our patients with CVT was consistent with that observed in previous studies in patients with deep vein thrombosis. In 3 of the 4 patients positive for the mutation, CVT developed in the presence of an acquired prothrombotic state, including oral contraceptive use in 2 patients and puerperium in the third. Conclusions Factor V Leiden mutation is a risk factor for CVT and may be the most common inherited coagulation defect associated with this condition.

Published
1996

103. Botulinum antibodies in dystonic patients treated with type A botulinum toxin: frequency and significance

Author

P. Rondot, Mathieu Zuber, J. de Recondo, N Bathien, and M. Sebald

Subjects
Adult, Male, medicine.medical_specialty, Botulinum Toxins, Adolescent, medicine.medical_treatment, Neurological disorder, medicine.disease_cause, Gastroenterology, Internal medicine, medicine, Humans, Aged, Dystonia, Chemotherapy, biology, business.industry, Toxin, Focal dystonia, Middle Aged, medicine.disease, Botulinum toxin, Antibodies, Bacterial, Anesthesia, biology.protein, Clostridium botulinum, Female, Neurology (clinical), Antibody, business, medicine.drug
Abstract

We measured serum antibodies to botulinum toxin (ABT) in 96 patients with focal dystonia who had been treated with type A botulinum toxin. The frequency of detectable ABT was 3% (three patients). Patients with ABT had received more than 50 ng of botulinum toxin, and the shortest time between two injections was significantly less than in patients without ABT. The clinical evolution of the three patients was heterogeneous: one had decreased effectiveness with repeated injections, another had persistent improvement, and the third never responded to toxin injections.

Published
1993

104. Heparin Cofactor II (HCII) Levels and the Risk of Ischemic Stroke. No Deleterious Role of HCII Deficiency but Potential Protective Role of High Plasma Level

Author

Mathieu Zuber, Raphaël Adda, Pierre Toulon, and Jean-Louis Mas

Subjects
Heparin cofactor II, medicine.medical_specialty, business.industry, Arbitrary unit, Immunology, Antithrombin, Cell Biology, Hematology, Heparin, medicine.disease, Biochemistry, Thrombosis, Dermatan sulfate, Surgery, chemistry.chemical_compound, Thrombin, Endocrinology, chemistry, Internal medicine, Medicine, business, medicine.drug, Discovery and development of direct thrombin inhibitors
Abstract

Background: Heparin cofactor II (HCII) is a thrombin inhibitor which activity is dramatically enhanced by heparin and more specifically by dermatan sulfate, another glycosaminoglycan. Its pathophysiological role remains unknown even if cases of HCII deficiency were reported in patients with a history of venous or arterial thrombosis. Recently, it was suggested that high plasma HCII level could play a protective role against atherosclerosis in elderly individuals and protect from restenosis after femoro-popliteal or coronary artery stenting. The aim of this case-control study was to investigate the significance of plasma HCII level in the development of ischemic stroke. Methods: 81 cases (44 M and 37 F, mean age of 43 years, range: 22–63) and 80 age-and sex-matched healthy controls of the same ethnic origin. HCII activity was evaluated as antithrombin dermatan sulfate cofactor activity using a chromogenic assay. Test results were expressed in arbitrary unit per mL: 1 U/mL is the activity found in 1 mL of pooled normal human plasma. Results: Plasma HCII activity was not significantly different in cases and in controls (1.04±0.17 vs. 1.00±0.23). The same applied after stratification in males and in females. The normal range for HCII, previously defined in a large cohort of healthy individuals, was between 0.60 and 1.40 U/mL. The frequency of HCII deficiency was not significantly different in cases and in controls [n=3/81 (3.7%) vs. n=2/80, (2.5%); p=1.00] and the same applied to the frequency of HCII level above 1.40 U/mL [n=0/81 (0%) vs. n=2/80 (2.5%); p=0.25]. Interestingly, HCII activity was found above 1.30 U/mL in 7 controls and in only 1 case (p Conclusions: These results suggest that HCII deficiency is not in itself a risk factor for the development of ischemic stroke. Even if the frequency of HCII level above the normal range was not statistically different in cases and in controls, the significance of a higher proportion of controls than cases presenting with a HCII level in the high end of the normal range deserves to be further evaluated in connection with a potential protective role against ischemic stroke.

Published
2008

106. Ischemic Stroke and Activated Protein C Resistance

Author

Robin Dhote, Jean-Louis Mas, Claude Bachmeyer, Boyan Christoforov, Mathieu Zuber, and Pierre Toulon

Subjects
medicine.medical_specialty, medicine.drug_class, Thrombophilia, Internal medicine, medicine, Factor V Leiden, Humans, biology, medicine.diagnostic_test, Cerebral infarction, business.industry, Anticoagulant, Factor V, Magnetic resonance imaging, General Medicine, Blood Coagulation Disorders, medicine.disease, Surgery, Cerebrovascular Disorders, biology.protein, Cardiology, Activated protein C resistance, business, Protein C, medicine.drug
Abstract

To the Editor. —A poor anticoagulant response to activated protein C (APC) has been reported to be the most common identified coagulation defect in patients with thrombophilia. 1-3 The molecular basis of APC resistance was identified in most patients as a single G-to-A substitution at position 1691 in the factor V gene, described as factor V Leiden. 4 The resulting Arg-to-Gln mutation at position 506, the APC cleavage site in factor Va, leads to an unregulated activation of coagulation. The cause of ischemic stroke often remains unknown, despite extensive investigations. The association with hypercoagulable states has rarely been reported. 5 We report two cases of ischemic stroke associated with APC resistance. Report of Cases.—Case 1. —A 64-year-old nonsmoking woman developed sudden onset of right complete hemiplegia and aphasia. A computed tomographic scan and magnetic resonance imaging of the head disclosed a large cerebral infarction in the left middle

Published
1995

108. Subject Index Vol. 1, (suppl 1)

Author

Antoine M. Hakim, Gérard Besson, André Bès, C. Hornig, Jean-Marc Orgogozo, Bernard Saïag, Danièle Bentué-Ferrer, G. L. Lenzi, Mathieu Zuber, Werner Hacke, David Guez, M. Giroud, Derk W. Krieger, Matthias Hirschberg, R. von Kummer, Kjell Asplund, Harold P. Adams, Julien Bogousslavsky, R. Dumas, Byron F. Vandenberg, Perret J, M. Hennerici, P. Gras, Marc Hommel, Konstantin-A. Hossmann, Niels A. Lassen, José Biller, Bernard Memin, J. De Reuck, Gilles Géraud, J.L. Mas, Cesare Fieschi, Marc Fisher, Shunya Takizawa, René Decombe, José Biller, J. F. Dartigues, Jean-Claude Baron, W. Zangemeister, and Hervé Allain

Subjects
medicine.medical_specialty, Index (economics), Neurology, business.industry, Physical therapy, medicine, Subject (documents), Neurology (clinical), Cardiology and Cardiovascular Medicine, business
Published
1991

109. Implications diagnostiques et thérapeutiques des caractéristiques du thrombus intracrânien à la phase aigüe de l'infarctus cérébral

Author

Soize, Sébastien, Physiopathologie et imagerie des troubles neurologiques (PhIND), Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Normandie Université, Emmanuel Touzé, Mathieu Zuber, and STAR, ABES

Subjects
Magnetic resonance imaging, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, Stent, Cerebral infarction, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Thrombectomy
Abstract

Sufficient recanalization is achieved by thrombectomy only in 70-80% of cases and often after several attempts. Better adaptation of the treatment to the thrombus could improve this result. Current knowledge of intracranial thrombus is limited in both diagnostic and therapeutic applications. For this reason, we wished to study: 1) the variability over time of the appearance of intracranial thrombus on MRI in the acute phase of cerebral infarction; 2) the response to different thrombectomy techniques depending on the type of thrombi.The probability of observing a Susceptibility Vessel Sign (SVS) on the T2* sequence increases with the time between the onset of symptoms and MRI images acquisition, highlighting the existence of dynamic phenomena modifying the composition of the thrombus during its incubation period at the occlusion site. SVS- thrombi, corresponding to fibrin-rich thrombi, which are elastic and difficult to extract, seem to be more frequent during the early therapeutic window. These variations will be confirmed by a radio-histological correlation. On the other hand, rapid removal of the stent during thrombectomy increases the chances of complete recanalization after a single pass in both in vitro experiments with fibrin-rich thrombus (RR=4.00; 1.11-14.35; Pint=0.048) and in vivo with SVS- thrombus (RR 95%IC = 4.30 [1.80-10.24]). This technique was also effective regardless of the type of thrombus, in vitro (RR=1.83; 95%CI, 1.12-2.99) and in vivo in a large series of 320 patients (OR, 2.88 [1.81-4.59]). A randomized trial is needed to confirm these results., Une recanalisation suffisante n’est obtenue par la thrombectomie que dans 70-80% des cas et bien souvent après plusieurs tentatives. Mieux adapter le traitement au thrombus pourrait permettre d’améliorer ce résultat. Les connaissances actuelles sur le thrombus intracrânien présentent des applications limitées tant sur le versant diagnostic que thérapeutique. C’est pour cela que nous avons souhaité étudier : 1) la variabilité au cours du temps de l’aspect du thrombus intracrânien en IRM à la phase aigüe de l’infarctus cérébral ; 2) la réponse à différentes techniques de thrombectomie en fonction du type de thrombi.La probabilité d’observer un Susceptibility Vessel Sign (SVS) sur la séquence T2* augmente en fonction du temps entre le début des symptômes et la réalisation de l’IRM; mettant en évidence l’existence de phénomènes dynamiques modifiant la composition du thrombus lors de sa période d’incubation au site d’occlusion. Les thrombus SVS-, correspondant à des thrombus riches en fibrine, élastiques et difficiles à extraire semblent plus fréquents lors de la fenêtre thérapeutique précoce. Ces variations seront confirmées par une corrélation radio-histologique. D’autre part, un retrait rapide du stent lors de la thrombectomie permet d’augmenter les chances de recanalisation complète au premier passage en lors d’expériences in vitro sur thrombus riche en fibrine (RR=4.00; 1.11-14.35; Pint=0.048) comme in vivo sur thrombus SVS- (RR 95%IC = 4.30 [1.80-10.24]). Cette technique s’avère également efficace quel que soit le type de thrombus, in vitro (RR=1.83; 95%CI, 1.12-2.99) et in vivo dans une large série de 320 patients (OR, 2.88 [1.81-4.59]). Une étude randomisée est nécessaire pour confirmer ces résultats.

Published
2022

110. Impact of Lower Versus Higher LDL Cholesterol Targets on Cardiovascular Events After Ischemic Stroke in Patients With Diabetes

Author

Pierre, Amarenco, Jong S, Kim, Julien, Labreuche, Hugo, Charles, Maurice, Giroud, Byung-Chul, Lee, Philippa C, Lavallée, Marie-Hélène, Mahagne, Elena, Meseguer, Norbert, Nighoghossian, Philippe Gabriel, Steg, Éric, Vicaut, Eric, Bruckert, Jongwon, Chung, Laboratoire de Recherche Vasculaire Translationnelle (LVTS (UMR_S_1148 / U1148)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Université Sorbonne Paris Nord, Asan Medical Center [Seoul, South Korea] (AMC), Santé Publique : épidémiologie et qualité des soins (EA 2694), Université Lille 2 - Faculté de Médecine -Centre d'Etudes et de Recherche en Informatique Médicale [Lille] (CERIM), Physiopathologie et épidémiologie cérébro-cardiovasculaire [Dijon] (PEC2), Université de Bourgogne (UB)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Hallym University Sacred Heart Hospital [Anyang, South Korea] (HUS2H), Hôpital Pasteur [Nice] (CHU), Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Hospices Civils de Lyon (HCL), Hôpital Lariboisière-Fernand-Widal [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Treat Stroke to Target Investigators, Treat Stroke to Target investigators: Pierre Amarenco, Eric Bruckert, Maurice Giroud, Jong S Kim, Julien Labreuche, Byung-Chul Lee, Marie-Hélène Mahagne, Norbert Nighoghossian, Philippe Gabriel Steg, Pierre-Jean Touboul, Eric Vicaut, Didier Leys, Yannick Béjot, Philippa Lavallée, Fernando Pico, Emmanuel Touzé, Gregory Ducrocq, Jérémy Abtan, Olivier Varenne, Charles Foix, Agnes Kemmel, Fausta Syana, Manele Ledra, Tharani Nagasara, Mervette Ledjeroud, Bahous Samia, Hafirassou Hadia, Benyoub Hazare, Ikrame El Jaghouni, Nessima Yelles, Sofia Zemouri, Salim Kerai, YunJeong In, Elena Meseguer, Philippa C Lavallée, Cristina Hobeanu, Celine Guidoux, Lucie Cabrejo, Bertrand Lapergue, Candice Sabben, Jaime Gonzalez-Valcarcel, Ricardo Rigual, Gaia Sirimarco, Anna Martin-Bechet, Elena Viedma, Ioan Avram, Yves Samson, Charlotte Rosso, Sophie Crozier, Sara Leder, Anne Léger, Sandrine Deltour, Gurkan Mutlu, Marion Yger, Chiara Zavanone, Flore Baronnet, Christine Pires, Bertrand Lapergue, Adrien Wang, Serge Evrard, Maya Tchikviladze, Frédéric Bourdain, Delphine Lopez, Fernando Pico, Laetitia Bayon de la Tour, Marie-Laure Chadenat, Duc Long Duong, Solène Genty, Catherine Hirel, Chantal Nifle, Jérôme Servan, Daniela Stanciu, Veronica Sudacevschi, Mélissa Tir, Anne-Cécile Troussière, Jennifer Yeung, Anne-Céline Zeghoudi, Ikram Tidafi-Bayou, Sylvain Lachaud, Tae-Hee Cho, Laura Mechtouff, Thomas Ritzenthaller, Laurent Derex, Carlo Albanesi, Elodie Ong, Amandine Benoit, Nadia Berhoune, Sandra Felix, Maud Esteban-Mader, Igor Sibon, Annabelle Kazadi, François Rouanet, Pauline Renou, Sabrina Debruxelles, Mathilde Poli, Sharmila Sagnier, Jean-Louis Mas, Valérie Domigo, Catherine Lamy, Eric Bodiguel, Jérôme Grimaud, Valentin Bohotin, Michael Obadia, Erwan Morvan, Gilles Rodier, Wilfried Vadot, Hilde Hénon, Charlotte Cordonnier, Frédéric Dumont, Marie Bodenant, Christian Lucas, Solène Moulin, Nelly Dequatre, Sonia Alamowitch, Jean-Paul Muresan, Thomas Drouet, Magalie Gallea, Marie-Amélie Dalloz, Stephen Delorme, Marion Yger, Yannick Béjot, Philippe Loisel, Carine Bonnin, Virginie Bernigal, Guy Victor Osseby, Marie Hervieu-Bègue Marsac, Pierre Garnier, Sandrine Accassat, Magali Epinat, Jérôme Varvat, Doïna Marinescu, Aude Triquenot-Bagan, Ozlem Ozkul-Wermester, Frédéric Philippeau, Angel Olaru, Anne Vieillart, Annie Lannuzel, Alice Demoly, Valérie Wolff, Mihaela Diaconu, Marc Bataillard, Francisco Macian Montoro, Frédéric Faugeras, Laeticia Gimenez, Françoise Abdallah-Lebeau, Serge Timsit, Irina Viakhireva-Dovganyuk, Anne Tirel-Badets, François-Mathias Merrien, Philippe Goas, François Rouhart, Aurore Jourdain, Benoit Guillon, Fanny Hérissson, Mathieu Sevin-Allouet, Nathalie Nasr, Jean-Marc Olivot, Alderic Lecluse, Guillaume Marc, Marie Christine Hamon, Emmanuel Touzé, Vincent de la Sayette, Marion Apoil, Li Lin, Julien Cogez, Sophie Guettier, Olivier Godefroy, Jean-Marc Bugnicourt, Grégory Taurin, Marc Mérienne, Julien Gere, Anne-Marie Chessak, Tarik Habet, Anna Ferrier, Nathalie Bourgois, Dominique Minier, Marie Caillier-Minier, Fabienne Contégal-Callier, Philippe Vion, Yvan Vaschalde, Mohammed El Amrani, Emilie Xxx, Mathieu Zuber, Marie Bruandet, Claire Join-Lambert, Pierre-Yves Garcia, Isabelle Serre, Jean-Marc Faucheux, Fatia Radji, Elena Leca-Radu, Thomas Debroucker, Rodica Cumurcuc, Serkan Cakmak, Stéphane Peysson, Emmanuel Ellie, Patricia Bernady, Thierry Moulin, Paola Montiel, Eugeniu Revenco, Pierre Decavel, Elisabeth Medeiros, Myriam Bouveret, Pierre Louchart, Jean-Philippe Neau, Xavier Vandamme, Isabelle Meresse, Xxx Stantescu, Canan Ozsancak, Katell Beauvais, Pascal Auzou, Joséphine Amevigbe, Francis Vuillemet, Marie-Hélène Dugay-Arentz, Gabriela Carelli, Mikel Martinez, Marcel Maillet-Vioud, Jean-Pierre Escaillas, Stéphane Chapuis, Jean Tardy, Eric Manchon, Olivier Varnet, Yong-Jae Kim, Yoonkyung Chang, Tae-Jin Song, Jong Sung Kim, Jung-Hoon Han, Kyung Chul Noh, Eun-Jae Lee, Dong-Wha Kang, Sun Uck Kwon, Boseoung Kwon, Seongho Park, Dongwhane Lee, Hyuk Sung Kwon, Daeun Jeong, MinHwan Lee, Joonggoo Kim, Hanbin Lee, Hyo Jung Nam, Sang Hun Lee, Bum Joon Kim, Jae-Kwan Cha, DaeHyun Kim, Rae Young Kim, Sang Wuk Sohn, Dong-Hyun Shim, Hyungjin Lee, Hyun-Wook Nah, Sang Min Sung, Kyung Bok Lee, Jeong Yoon Lee, Jee Eun Yoon, Eung-Gyu Kim, Jung Hwa Seo, Yong-Won Kim, Yangha Hwang, Man Seok Park, Joon-Tae Kim, Kang-Ho Choi, Hyo Suk Nam, Ji Hoe Heo, Young Dae Kim, In Gun Hwang, Hyung Jong Park, Kyoung Sub Kim, Jang Hyun Baek, Dong Beom Song, Joon Sang Yoo, Jong-Moo Park, Ohyun Kwon, Woong-Woo Lee, Jung-Ju Lee, Kyusik Kang, Byung Kun Kim, Byung-Chul Lee, Jae-Sung Lim, Mi Sun Oh, Kyung-Ho Yu, Bora Hong, Mihoon Jang, Seyoung Jang, Jung Eun Jin, Jei Kim, Hye Seon Jeong, Keun Sik Hong, Hong Kyun Park, Yong Jin Cho, Oh Young Bang, Woo-Keun Seo, Jongwon Chung., Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Université Sorbonne Paris Nord, Faculté de Médecine Henri Warembourg - Université de Lille-Centre d'Etudes et de Recherche en Informatique Médicale [Lille] (CERIM), and CarMeN, laboratoire

Subjects
Male, medicine.medical_specialty, Endocrinology, Diabetes and Metabolism, [SDV]Life Sciences [q-bio], Hypercholesterolemia, Myocardial Infarction, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, Text mining, Internal medicine, Diabetes mellitus, Internal Medicine, Medicine, Humans, In patient, cardiovascular diseases, Aged, Ischemic Stroke, Ldl cholesterol, business.industry, Cholesterol, LDL, Middle Aged, medicine.disease, Ezetimibe, 3. Good health, [SDV] Life Sciences [q-bio], Treatment Outcome, Diabetes Mellitus, Type 2, Ischemic stroke, Cardiology, lipids (amino acids, peptides, and proteins), Female, Hydroxymethylglutaryl-CoA Reductase Inhibitors, business, 030217 neurology & neurosurgery
Abstract

International audience; After an ischemic stroke with evidence of atherosclerosis, lipid-lowering treatment with a target LDL cholesterol of

Published
2021

111. Early neurological deterioration following thrombolysis for minor stroke with isolated internal carotid artery occlusion

Author

N, Boulenoir, G, Turc, H, Henon, N, Laksiri, F, Mounier-Véhier, I, Girard Buttaz, D-L, Duong, J, Papassin, M, Yger, A, Triquenot, A, Lyoubi, A, Ter Schiphorst, C, Denier, J-C, Baron, P, Seners, Mylène, Masson, Institut de psychiatrie et neurosciences de Paris (IPNP - U1266 Inserm), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP), Département de Neurologie [Hôpital Sainte-Anne - APHP] (Paris CB2 2QQ), Centre Hospitalier Sainte Anne [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Troubles cognitifs dégénératifs et vasculaires - U 1171 (TCDV), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Neurologie, maladies neuro-musculaires [Hôpital de la Timone - APHM], Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Laboratoire de Neurologie [CH Lens], Centre Hospitalier de Lens, Neurologie - Centre Hospitalier de Valenciennes (CHV), Centre Hospitalier de Versailles André Mignot (CHV), Stroke Unit [CHU Grenoble], Centre Hospitalier Universitaire [Grenoble] (CHU), Service de Neurologie [CH Chambery], Université Savoie Mont Blanc (USMB [Université de Savoie] [Université de Chambéry]), Service de neurologie [Saint-Antoine], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service de neurologie [Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Service de neurologie [CH Saint Denis], Centre Hospitalier de Saint-Denis [Ile-de-France], Département de neurologie [Montpellier], Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Gui de Chauliac [Montpellier]-Université de Montpellier (UM), Service de neurologie [Le Kremlin Bicêtre], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Bicêtre, MINOR-STROKE Collaborators: Wagih Ben Hassen, Bertrand Lapergue, Chantal Lamy, Ludovic Lucas, Frédéric Philippeau, Michael Obadia, Michel Piotin, Omar Bennani, Laura Mechtouff, Frédéric Klapczynski, Olivier Detante, Caroline Arquizan, Gioia Mione, Denis Sablot, Sébastien Gazzola, Séverine Debiais, Serkan Cakmak, Valer Grigoras, Ruben Tamazyan, Cécile Preterre, Charlotte Rosso, Philippe Niclot, Pierre Garnier, Sébastien Soize, François Lun, Amélie Tuffal, Marion Boulanger, Sébastien Gazzola, Mathieu Zuber, Fernando Pico, Frédéric Clarençon, Igor Sibon, Sonia Alamowitch, Laurie Fraticelli, Anne-Evelyne Vallet, Vincent Costalat, Catherine Oppenheim, Jean-Philippe Cottier, Yves Berthezene, Hubert Desal, Pierre Agius, Claire Boutet, Nicolas Bricout, Didier Leys, Mohamed Chbicheb, Arnaud Malbranque, Laurent Spelle, Serge Bracard, Mylène Masson, Martinez Rico, Clara, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Université de Versailles Saint-Quentin-en-Yvelines - UFR Sciences de la santé Simone Veil (UVSQ Santé), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Service de Neurologie [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), Troubles cognitifs dégénératifs et vasculaires - U 1171 - EA 1046 (TCDV), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Gui de Chauliac [CHU Montpellier], and Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Université de Montpellier (UM)

Subjects
medicine.medical_specialty, medicine.medical_treatment, cerebral ischemia, Brain Ischemia, 03 medical and health sciences, 0302 clinical medicine, Fibrinolytic Agents, Internal medicine, Occlusion, medicine, Humans, Thrombolytic Therapy, 030212 general & internal medicine, Thrombus, Stroke, Retrospective Studies, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, business.industry, Incidence (epidemiology), Thrombosis, Thrombolysis, Odds ratio, medicine.disease, Confidence interval, 3. Good health, Treatment Outcome, thrombolysis, Neurology, thrombectomy, Cardiology, Neurology (clinical), Internal carotid artery occlusion, business, 030217 neurology & neurosurgery, Carotid Artery, Internal, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

International audience; Background and purpose: Better understanding the incidence, predictors and mechanisms of early neurological deterioration (END) following intravenous thrombolysis (IVT) for acute stroke with mild symptoms and isolated internal carotid artery occlusion (iICAo) may inform therapeutic decisions.Methods: From a multicenter retrospective database, we extracted all patients with both National Institutes of Health Stroke Scale (NIHSS) score

Published
2020

112. A Comparison of Two LDL Cholesterol Targets after Ischemic Stroke

Author

Amarenco P, Kim J, Labreuche J, Charles H, Abtan J, Bejot Y, Cabrejo L, Cha J, Ducrocq G, Giroud M, Guidoux C, Hobeanu C, Kim Y, Lapergue B, Lavallee P, Lee B, Lee K, Leys D, Mahagne M, Meseguer E, Nighoghossian N, Pico F, Samson Y, Sibon I, Steg P, Sung S, Touboul P, Touze E, Varenne O, Vicaut E, Yelles N, Bruckert E, Treat Stroke Target Investigators, AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Asan Medical Center [Seoul], University of Ulsan, Santé Publique : épidémiologie et qualité des soins (EA 2694), Faculté de Médecine Henri Warembourg - Université de Lille-Centre d'Etudes et de Recherche en Informatique Médicale [Lille] (CERIM), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Université de Bourgogne (UB), Service de neurologie [Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU), Catholic University of Korea, Hôpital Foch [Suresnes], Hallym University Sacred Heart Hospital [Anyang, South Korea] (HUS2H), Soonchunhyang University [Asan], CHU Lille, Hôpital Pasteur [Nice] (CHU), Hospices Civils de Lyon (HCL), Centre Hospitalier de Versailles André Mignot (CHV), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Sorbonne Université (SU), Hôpital Pellegrin, CHU Bordeaux [Bordeaux]-Groupe hospitalier Pellegrin, Pusan National University Hospital, Physiopathologie et imagerie des troubles neurologiques (PhIND), Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Neurologie [CHU Caen], Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), GIP Cyceron (Cyceron), Normandie Université (NU)-Normandie Université (NU)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Service de Cardiologie [CHU Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Laboratoire de Recherche Vasculaire Translationnelle (LVTS (UMR_S_1148 / U1148)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Université Sorbonne Paris Nord, Hôpitaux Universitaire Saint-Louis, Lariboisière, Fernand-Widal, Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases (ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Institut de Cardiométabolisme et Nutrition = Institute of Cardiometabolism and Nutrition [CHU Pitié Salpêtrière] (IHU ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-CHU Pitié-Salpêtrière [AP-HP], Laboratoire de Neurosciences Fonctionnelles et Pathologies - UR UPJV 4559 (LNFP), Université de Picardie Jules Verne (UPJV), CHU Amiens-Picardie, and Treat Stroke to Target Investigators: Pierre Amarenco, Eric Bruckert, Maurice Giroud, Jong S Kim, Julien Labreuche, Byung-Chul Lee, Marie-Hélène Mahagne, Norbert Nighoghossian, Philippe Gabriel Steg, Pierre-Jean Touboul, Eric Vicaut, Didier Leys, Philippa Lavallée, Gregory Ducrocq, Jérémy Abtan, Olivier Varenne, Agnes Kemmel, Fausta Syana, Manele Ledra, Tharani Nagasara, Mervette Ledjeroud, Bahous Samia, Hafirassou Hadia, Benyoub Hazare, Ikrame El Jaghouni, Nessima Yelles, Sofia Zemouri, Mervette Ladjeroud, Salim Kerai, YunJeong In, Elena Meseguer, Philippa C Lavallée, Cristina Hobeanu, Celine Guidoux, Lucie Cabrejo, Jaime Gonzalez-Valcarcel, Ricardo Rigual, Gaia Sirimarco, Anna Martin-Bechet, Elena Viedma, Ioan Avram, Yves Samson, Charlotte Rosso, Sophie Crozier, Sara Leder, Anne Léger, Sandrine Deltour, Chiara Zavanone, Flore Baronnet, Christine Pires, Bertrand Lapergue, Adrien Wang, Serge Evrard, Maya Tchikviladze, Frédéric Bourdain, Delphine Lopez, Fernando Pico, Laetitia Bayon de la Tour, Marie-Laure Chadenat, Duc Long Duong, Solène Genty, Catherine Hirel, Gurkan Mutlu, Chantal Nifle, Jérôme Servan, Daniela Stanciu, Veronica Sudacevschi, Mélissa Tir, Anne-Cécile Troussière, Jennifer Yeung, Anne-Céline Zeghoudi, Ikram Tidafi-Bayou, Sylvain Lachaud, Tae-Hee Cho, Laura Mechtouff, Thomas Ritzenthaller, Laurent Derex, Carlo Albanesi, Elodie Ong, Amandine Benoit, Nadia Berhoune, Sandra Felix, Maud Esteban-Mader, Igor Sibon, Annabelle Kazadi, François Rouanet, Pauline Renou, Sabrina Debruxelles, Mathilde Poli, Sharmila Sagnier, Jean-Louis Mas, Valérie Domigo, Catherine Lamy, Eric Bodiguel, Jérôme Grimaud, Valentin Bohotin, Michael Obadia, Candice Sabben, Erwan Morvan, Gilles Rodier, Wilfried Vadot, Hilde Hénon, Charlotte Cordonnier, Frédéric Dumont, Marie Bodenant, Christian Lucas, Solène Moulin, Nelly Dequatre, Sonia Alamowitch, Jean-Paul Muresan, Thomas Drouet, Magalie Gallea, Marie-Amélie Dalloz, Stephen Delorme, Marion Yger, Yannick Béjot, Philippe Loisel, Carine Bonnin, Virginie Bernigal, Guy Victor Osseby, Marie Hervieu-BègueMarsac, Pierre Garnier, Sandrine Accassat, Magali Epinat, Jérôme Varvat, Doïna Marinescu, Aude Triquenot-Bagan, Ozlem Ozkul-Wermester, Frédéric Philippeau, Angel Olaru, Anne Vieillart, Annie Lannuzel, Alice Demoly, Valérie Wolff, Mihaela Diaconu, Francisco Macian Montoro, Frédéric Faugeras, Laeticia Gimenez, Françoise Abdallah-Lebeau, Serge Timsit, Irina Viakhireva-Dovganyuk, Anne Tirel-Badets, François-Mathias Merrien, Philippe Goas, François Rouhart, Aurore Jourdain, Benoit Guillon, Fanny Hérissson, Mathieu Sevin-Allouet, Nathalie Nasr, Jean-Marc Olivot, Alderic Lecluse, Guillaume Marc, Emmanuel Touzé, Vincent de la Sayette, Marion Apoil, Li Lin, Julien Cogez, Sophie Guettier, Olivier Godefroy, Chantal Lamy, Jean-Marc Bugnicourt, Grégory Taurin, Marc Mérienne, Julien Gere, Anne-Marie Chessak, Tarik Habet, Anna Ferrier, Nathalie Bourgois, Dominique Minier, Marie Caillier-Minier, Fabienne Contégal-Callier, Philippe Vion, Yvan Vaschalde, Mohammed El Amrani, Mathieu Zuber, Marie Bruandet, Claire Join-Lambert, Pierre-Yves Garcia, Isabelle Serre, Jean-Marc Faucheux, Fatia Radji, Elena Leca-Radu, Thomas Debroucker, Rodica Cumurcuc, Serkan Cakmak, Stéphane Peysson, Emmanuel Ellie, Patricia Bernady, Thierry Moulin, Paola Montiel, Eugeniu Revenco, Pierre Decavel, Elisabeth Medeiros, Myriam Bouveret, Pierre Louchart, Claudia Vaduva, Grégory Couvreur, Eric Sartori, Adam Amer Alnajar-Carpentier, Michèle Levasseur, Pierre Louchart, Jean-Philippe Neau, Xavier Vandamme, Isabelle Meresse, Marc Bataillard, Canan Ozsancak, Katell Beauvais, Pascal Auzou, Joséphine Amevigbe, Francis Vuillemet, Marie-Hélène Dugay-Arentz, Gabriela Carelli, Mikel Martinez, Marcel Maillet-Vioud, Jean-Pierre Escaillas, Stéphane Chapuis, Jean Tardy, Eric Manchon, Olivier Varnet, Yong-Jae Kim, Yoonkyung Chang, Tae-Jin Song, Jong Sung Kim, Jung-Hoon Han, Kyung Chul Noh, Eun-Jae Lee, Dong-Wha Kang, Sun Uck Kwon, Boseoung Kwon, Seongho Park, Dongwhane Lee, Hyuk Sung Kwon, Daeun Jeong, MinHwan Lee, Joonggoo Kim, Hanbin Lee, Hyo Jung Nam, Sang Hun Lee, Bum Joon Kim, Jae-Kwan Cha, DaeHyun Kim, Rae Young Kim, Sang Wuk Sohn, Dong-Hyun Shim, Hyungjin Lee, Hyun-Wook Nah, Sang Min Sung, Kyung Bok Lee, Jeong Yoon Lee, Jee Eun Yoon, Eung-Gyu Kim, Jung Hwa Seo, Yong-Won Kim, Yangha Hwang, Man Seok Park, Joon-Tae Kim, Kang-Ho Choi, Hyo Suk Nam, Ji Hoe Heo, Young Dae Kim, In Gun Hwang, Hyung Jong Park, Kyoung Sub Kim, Jang Hyun Baek, Dong Beom Song, Joon Sang Yoo, Jong-Moo Park, Ohyun Kwon, Woong-Woo Lee, Jung-Ju Lee, Kyusik Kang, Byung Kun Kim, Jae-Sung Lim, Mi Sun Oh, Kyung-Ho Yu, Bora Hong, Mihoon Jang, Seyoung Jang, Jung Eun Jin, Jei Kim, Hye Seon Jeong, Keun Sik Hong, Hong Kyun Park, Yong Jin Cho, Oh Young Bang, Woo-Keun Seo, Jongwon Chung

Subjects
Adult, Male, medicine.medical_specialty, Statin, medicine.drug_class, [SDV]Life Sciences [q-bio], MEDLINE, Kaplan-Meier Estimate, 030204 cardiovascular system & hematology, Brain Ischemia, law.invention, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Text mining, Pharmacotherapy, Randomized controlled trial, law, Internal medicine, Humans, Medicine, cardiovascular diseases, 030212 general & internal medicine, Aged, Intention-to-treat analysis, business.industry, Cholesterol, Anticholesteremic Agents, Cholesterol, LDL, General Medicine, Middle Aged, Atherosclerosis, Ezetimibe, Intention to Treat Analysis, Stroke, chemistry, Cardiovascular Diseases, Ischemic Attack, Transient, Ischemic stroke, Drug Therapy, Combination, Female, lipids (amino acids, peptides, and proteins), Hydroxymethylglutaryl-CoA Reductase Inhibitors, business
Abstract

International audience; BACKGROUND: The use of intensive lipid-lowering therapy by means of statin medications is recommended after transient ischemic attack (TIA) and ischemic stroke of atherosclerotic origin. The target level for low-density lipoprotein (LDL) cholesterol to reduce cardiovascular events after stroke has not been well studied. METHODS: In this parallel-group trial conducted in France and South Korea, we randomly assigned patients with ischemic stroke in the previous 3 months or a TIA within the previous 15 days to a target LDL cholesterol level of less than 70 mg per deciliter (1.8 mmol per liter) (lower-target group) or to a target range of 90 mg to 110 mg per deciliter (2.3 to 2.8 mmol per liter) (higher-target group). All the patients had evidence of cerebrovascular or coronary-artery atherosclerosis and received a statin, ezetimibe, or both. The composite primary end point of major cardiovascular events included ischemic stroke, myocardial infarction, new symptoms leading to urgent coronary or carotid revascularization, or death from cardiovascular causes. RESULTS: A total of 2860 patients were enrolled and followed for a median of 3.5 years; 1430 were assigned to each LDL cholesterol target group. The mean LDL cholesterol level at baseline was 135 mg per deciliter (3.5 mmol per liter), and the mean achieved LDL cholesterol level was 65 mg per deciliter (1.7 mmol per liter) in the lower-target group and 96 mg per deciliter (2.5 mmol per liter) in the higher-target group. The trial was stopped for administrative reasons after 277 of an anticipated 385 end-point events had occurred. The composite primary end point occurred in 121 patients (8.5%) in the lower-target group and in 156 (10.9%) in the higher-target group (adjusted hazard ratio, 0.78; 95% confidence interval, 0.61 to 0.98; P = 0.04). The incidence of intracranial hemorrhage and newly diagnosed diabetes did not differ significantly between the two groups. CONCLUSIONS: After an ischemic stroke or TIA with evidence of atherosclerosis, patients who had a target LDL cholesterol level of less than 70 mg per deciliter had a lower risk of subsequent cardiovascular events than those who had a target range of 90 mg to 110 mg per deciliter. (Funded by the French Ministry of Health and others; Treat Stroke to Target ClinicalTrials.gov number, NCT01252875.).

Published
2020

113. Ecological momentary assessment and network analysis of depression, anxiety, coping and quality of life after a minor stroke

Author

Vansimaeys, Camille, Laboratoire de Psychopathologie et Processus de Santé (LPPS - EA 4057), Université Paris Descartes - Paris 5 (UPD5), Université Sorbonne Paris Cité, Catherine Bungener, and Mathieu Zuber

Subjects
Quality of life, Depression, Stratégies de coping, Qualité de vie, Dépression, [SHS.PSY]Humanities and Social Sciences/Psychology, Anxiety, Accident vasculaire cérébral, Stroke, Network analysis, Coping, Ecological momentary assessment, Anxiété, Évaluation écologique instantanée répétée, Analyses en réseau
Abstract

About 150 000 individuals are hospitalized after a stroke every year in France. Half of stroke survivors are expected to have complete neurological recovery and thus they will not suffer from any motor or cognitive impairment. Those cases are called minor strokes. Patients with minor stroke frequently experience an early hospital discharge and fitful neurological follow-ups. To date, we have few information regarding minor stroke's effect on the evolution of those patients' quality of life. Even though scientific literature is still insufficient, recent studies showed that anxiety and depression symptoms frequently occur after a minor stroke despite there being no functional impairment. Anxiety and depressive symptoms could impact patients' quality of life. Two main concerns of public health emerge from this hypothesis: screening and caring the determinants of the deterioration of minor stroke patients' quality of life. The present dissertation aims to study the evolution of quality of life after a minor stroke and to explore the role of anxiety and depression symptoms and the role of coping strategies. For this purpose, we have measured the quality of life of 68 patients at three times after the stroke: during initial hospitalization, after discharge and at four-month. We also assessed their anxiety and depression symptoms and coping strategies by combining two methods: standard ponctual assessment using classical scales and questionnaires on the one hand; and ecological momentary assessment using a smartphone application, on the other hand. Our results show a deterioration of the quality of life in numerous participants during the study. On the one hand, this deterioration is associated with the appearance of anxiety and depression symptoms after stroke. Network analysis suggests that somatic disturbance precedes the occurrence of psychological symptoms. Those results highlight the importance of paying attention and caring somatic symptoms despite the pronostic of neurophysiological recovery. On the other hand, our results suggest that coping could influence the evolution of quality of life after a minor stroke. Further studies are needed to confirm those results. Indeed, we have to understand the specificities of stress situations that individuals are facing after a minor stroke. According to this information, efficient coping could represent concrete therapeutic objectives which will be helpful to specify practice guidelines. Our work also contributes to a theoretical and methodological reflexion of psychopathology and health psychology science. On the theoretical hand, our study emphasizes the benefits of the network approach to psychopathology in somatic diseases. On the methodological hand, our study argues for the use of ecological momentary assessment methods in regard of the promising perspectives they could bring in psychological science.; Chaque année en France, 150 000 personnes sont hospitalisées suite à un Accident Vasculaire Cérébral (AVC). Il est estimé qu'environ la moitié des survivants récupéreront complètement sur le plan neurologique, et ne souffriront d'aucun déficit quant à leurs capacités fonctionnelles (motrices et cognitives notamment). On parle dans ce cas d'AVC mineurs. Le parcours de soin après un AVC mineur est caractérisé par un retour au domicile précoce et un suivi médical intermittent, et nous n'avons actuellement que très peu d'informations quant à l'impact de l'accident sur l'évolution de la qualité de vie de ces patients. La littérature spécifique à cette population est encore très peu fournie à l'heure actuelle. Cependant, il a récemment était montré que des symptômes anxio-dépressifs surviennent fréquemment après un AVC mineur, et ce en dépit de l'absence de séquelles fonctionnelles visibles. Ces symptômes pourraient donc venir dégrader la qualité de vie des patients malgré leur bon état de santé apparent. Deux enjeux majeurs de santé publique s'articulent autour de la question de l'impact subjectif d'un AVC mineur : celui du dépistage et celui de la prise en charge des facteurs associés à la dégradation de la qualité de vie. Ce travail de thèse vise à étudier l'évolution de la qualité de vie après un AVC mineur et à explorer l'implication des symptômes anxio-dépressifs, d'une part, et celle des stratégies d'adaptation (coping), d'autre part, dans cette évolution. Nous avons mis en place une étude au cours de laquelle nous avons évalué les dimensions de la qualité de vie, auprès d'un échantillon composé de 68 personnes, à différents moments après un AVC mineur : durant l'hospitalisation initiale, après le retour au domicile, et quatre mois après l'accident. En parallèle, nous avons également évalué la symptomatologie anxio-dépressive et les stratégies de coping en associant deux modalités de mesures : des évaluations ponctuelles grâce à des échelles et questionnaires standardisés et validés d'une part, et, d'autres part, des évaluations écologiques instantanées et répétées grâce à une application smartphone. Les résultats révèlent que nombre de personnes décrivent une dégradation de leur qualité de vie au cours des quatre mois. Cette dégradation est liée, d'une part, à l'apparition de symptômes anxio-dépressifs consécutifs à l'AVC. Les analyses en réseau suggèrent que l'apparition, dès l'hospitalisation initiale, de manifestations somatiques précède la survenue de symptômes psychiques. Ces résultats soulignent la nécessité de ne pas négliger l'importance de la prise en charge, dès la phase aiguë, des symptômes somatiques, indépendamment du pronostic de récupération neurophysiologique. D'autre part, nos résultats suggèrent le rôle de certaines stratégies de coping dans l'évolution de la qualité de vie. Des études complémentaires devront permettre de confirmer nos résultats. Ces études sont nécessaires afin de préciser, notamment, les caractéristiques des situations problématiques vécues par les patients en fonction du temps après un AVC mineur. Ainsi, les stratégies de coping fonctionnelles pourraient constituer, à terme, des objectifs thérapeutiques tangibles qui contribueront à préciser les recommandations de prise en charge des AVC mineurs. Notre travail apporte également des éléments qui contribuent à la réflexion théorique et méthodologique de la recherche en psychopathologie et en psychologie de la santé. Sur le plan théorique, notre étude souligne l'intérêt et l'apport de l'approche en réseau, notamment pour l'étude des processus psychopathologiques dans le cadre de la maladie somatique. Au niveau méthodologique, nos résultats encouragent à l'utilisation et au développement des méthodes d'évaluation écologiques instantanées et répétées en psychologie. Malgré les limites actuelles sur le plan technologique, les perspectives de recherches futures sont nombreuses et prometteuses.

Published
2017

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