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1. Quantitative brain imaging analysis of neurological syndromes associated with anti-GAD antibodies

Author

Maëlle Dade, Marine Giry, Giulia Berzero, Marion Benazra, Gilles Huberfeld, Delphine Leclercq, Vincent Navarro, Jean-Yves Delattre, Dimitri Psimaras, and Agusti Alentorn

Subjects
Glutamic acid decarboxylase, GAD65 autoimmunity, Volumetry, Cortical thickness, Radiomic data, Neuronal antibodies, Computer applications to medicine. Medical informatics, R858-859.7, Neurology. Diseases of the nervous system, RC346-429
Abstract

Neurological disorders associated with anti-glutamic acid decarboxylase (GAD) autoimmunity are rare and include a variety of neurological syndromes: stiff-person syndrome, cerebellar ataxia or limbic encephalitis. The diagnosis remains challenging due to the variety of symptoms and normal brain imaging.The morphological MRI of 26 patients (T1-weighted and Fluid-attenuated inversion recovery (FLAIR)-weighted images) was analyzed at the initial stage of diagnosis, matched by age and sex to 26 healthy subjects. We performed a vertex-wise analysis using a generalized linear model, adjusting by age, to compare the brain cortical thickness of both populations. In addition, we used a voxel-based morphometry of cerebellum thickness obtained by CEREbellum Segmentation (CERES), as well as the hippocampus volumetry comparison using HIPpocampus subfield Segmentation (HIPS). Finally, we extracted 62 radiomics features using LifeX to assess the classification performance using a random forest model to identify an anti-GAD related MRI.The results suggest a peculiar profile of atrophy in patients with anti-GAD, with a significant atrophy in the temporal and frontal lobes (adjusted p-value

Published
2021
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2. Late-onset vascular complications of radiotherapy for primary brain tumors: a case–control and cross-sectional analysis

Author

María-José Ibáñez-Juliá, Alberto Picca, Delphine Leclercq, Giulia Berzero, Julian Jacob, Loïc Feuvret, Charlotte Rosso, Cristina Birzu, Agusti Alentorn, Marc Sanson, Camille Tafani, Flavie Bompaire, Luis Bataller, Khê Hoang-Xuan, Jean-Yves Delattre, Dimitri Psimaras, and Damien Ricard

Subjects
Oncology, Oncology (nursing)
Abstract

Purpose Radiotherapy (RT) is a recognized risk factor for cerebrovascular (CV) disease in children and in adults with head and neck cancer. We aimed to investigate whether cerebral RT increases the risk of CV disease in adults with primary brain tumors (PBT). Methods We retrospectively identified adults with a supratentorial PBT diagnosed between 1975 and 2006 and with at least 10 years follow-up after treatment. We analyzed demographic, clinical, and radiological features with special attention to CV events. We also described CV events, vascular risk factors, and intracranial artery modifications in a cross-sectional study of irradiated patients alive at the time of the study. Results A total of 116 patients, treated with RT (exposed group), and 85 non-irradiated patients (unexposed group) were enrolled. Stroke was more frequent in irradiated PBT patients than in the unexposed group (42/116 (36%) vs 7/85 (8%); p p = 0.004) and hemorrhagic (12/116 (10%) vs 1/85 (1%); p = 0.02) stroke. In the irradiated group, patients with tumors near the Willis Polygon were more likely to experience stroke (p Conclusions Stroke prevalence is increased in long-surviving PBT patients treated with cranial RT. Implications for cancer survivors CV events are frequent in long survivors of PBT treated with cerebral RT. We propose a check list to guide management of late CV complications in adults treated with RT for PBT.

Published
2023

3. Data from Safety and Feasibility of Repeated and Transient Blood–Brain Barrier Disruption by Pulsed Ultrasound in Patients with Recurrent Glioblastoma

Author

Alexandre Carpentier, Jean-Yves Delattre, Jean-Yves Chapelon, Cyril Lafon, Arthur André, Bertrand Mathon, Florence Laigle-Donadey, Caroline Houillier, Caroline Dehais, Khe Hoang-Xuan, Marc Sanson, Laurent Capelle, Clementine Trosch, Yann De Rycke, Anne Bissery, Delphine Leclercq, Bruno Law-Ye, Nicolas Asquier, Guillaume Bouchoux, Alexandre Vignot, Carole Desseaux, Lisa Belin, Michael Canney, and Ahmed Idbaih

Abstract

Purpose:The blood–brain barrier (BBB) limits the efficacy of drug therapies for glioblastoma (GBM). Preclinical data indicate that low-intensity pulsed ultrasound (LIPU) can transiently disrupt the BBB and increase intracerebral drug concentrations.Patients and Methods:A first-in-man, single-arm, single-center trial (NCT02253212) was initiated to investigate the transient disruption of the BBB in patients with recurrent GBM. Patients were implanted with a 1-MHz, 11.5-mm diameter cranial ultrasound device (SonoCloud-1, CarThera). The device was activated monthly to transiently disrupt the BBB before intravenous carboplatin chemotherapy.Results:Between 2014 and 2016, 21 patients were registered for the study and implanted with the SonoCloud-1; 19 patients received at least one sonication. In 65 ultrasound sessions, BBB disruption was visible on T1w MRI for 52 sonications. Treatment-related adverse events observed were transient and manageable: a transient edema at H1 and at D15. No carboplatin-related neurotoxicity was observed. Patients with no or poor BBB disruption (n = 8) visible on MRI had a median progression-free survival (PFS) of 2.73 months, and a median overall survival (OS) of 8.64 months. Patients with clear BBB disruption (n = 11) had a median PFS of 4.11 months, and a median OS of 12.94 months.Conclusions:SonoCloud-1 treatments were well tolerated and may increase the effectiveness of systemic drug therapies, such as carboplatin, in the brain without inducing neurotoxicity.See related commentary by Sonabend and Stupp, p. 3750

Published
2023

4. Supplementary Tables from Safety and Feasibility of Repeated and Transient Blood–Brain Barrier Disruption by Pulsed Ultrasound in Patients with Recurrent Glioblastoma

Author

Alexandre Carpentier, Jean-Yves Delattre, Jean-Yves Chapelon, Cyril Lafon, Arthur André, Bertrand Mathon, Florence Laigle-Donadey, Caroline Houillier, Caroline Dehais, Khe Hoang-Xuan, Marc Sanson, Laurent Capelle, Clementine Trosch, Yann De Rycke, Anne Bissery, Delphine Leclercq, Bruno Law-Ye, Nicolas Asquier, Guillaume Bouchoux, Alexandre Vignot, Carole Desseaux, Lisa Belin, Michael Canney, and Ahmed Idbaih

Abstract

Supplementary Table 1. The acoustic pressure levels are determined by a calibration of the implants in water prior to implantation in patients. The 95% confidence interval given in the table denotes the measurement uncertainty inherent to this process. Acoustic pressure levels reported previously (19) were re-evaluated using enhanced acoustic calibration methods with reduced uncertainty. The former values are given in the pold column to ease comparison with our previous publication. Supplementary Table 2. BBB disruption grade and acoustic pressure. Data are n (%). Supplementary Table 3. The secondary outcomes of the trial were calculated based on the grading assigned to post-contrast MR images evaluating the level of BBB disruption. Greater amounts of post-sonication BBB disruption resulted in a trend towards longer PFS and OS.

Published
2023

5. Cerebrovascular Ischemic Events in Patients With Takayasu Arteritis

Author

Adrien, Mirouse, Sandrine, Deltour, Delphine, Leclercq, Pierre-Alexandre, Squara, Clara, Pouchelon, Cloé, Comarmond, Jean-Emmanuel, Kahn, Ygal, Benhamou, Tristan, Mirault, Arsène, Mekinian, Marc, Lambert, Laurent, Chiche, Fabien, Koskas, Philippe, Cluzel, Alban, Redheuil, Patrice, Cacoub, Lucie, Biard, David, Saadoun, CACOUB, Patrice, CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Immunologie - Immunopathologie - Immunothérapie [CHU Pitié Salpêtrière] (I3), CHU Charles Foix [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)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Hôpital Raymond Poincaré [Garches], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hopital Saint-Louis [AP-HP] (AP-HP), Épidémiologie et statistiques cliniques pour les évaluations tumorales, respiratoires et de réanimation (ECSTRRA), Centre of Research in Epidemiology and StatisticS (CRESS), Hôpital Lariboisière-Fernand-Widal [APHP], Hôpital Ambroise Paré [AP-HP], CHU Rouen, Normandie Université (NU), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), CHU Saint-Antoine [AP-HP], and CHU Lille

Subjects
Male, Advanced and Specialized Nursing, [SDV.IMM] Life Sciences [q-bio]/Immunology, Aspirin, Constriction, Pathologic, Takayasu Arteritis, vasculitis, United States, Stroke, transient, Ischemic Attack, Transient, middle aged, arteritis, [SDV.IMM]Life Sciences [q-bio]/Immunology, Humans, Female, cardiovascular diseases, Neurology (clinical), ischemic attack, Cardiology and Cardiovascular Medicine
Abstract

Background: Takayasu arteritis (TA) is a large vessel vasculitis that may complicate with cerebrovascular ischemic events. The objective was to describe clinical and vascular features of TA patients with cerebrovascular ischemic events and to identify risk factors for these events. Methods: We analyzed the prevalence and type of stroke/transient ischemic attack (TIA), factors associated with cerebrovascular ischemic events, and stroke-free survival in a large cohort fulfilling the American College of Rheumatology or Ishikawa criteria of TA. Results: Among 320 patients with TA (median age at diagnosis, 36 [25–47] years; 261 [86%] women), 63 (20%) had a stroke (n=41; 65%) or TIA (n=22; 35%). Ischemic event localized in the carotid territory for 55 (87%) patients and the vertebral artery territory in 8 (13%) patients. Multiple stenosis were observed in 33 (52%) patients with a median number of stenosis of 2 (minimum, 0 to maximum, 11), and aneurysms were observed in 10 (16%) patients. A history of stroke or TIA before TA diagnosis (hazard ratio [HR], 4.50 [2.45–8.17]; P P =0.05), myocardial infarction history (HR, 0.21 [0.05–0.89]; P =0.039), thoracic aorta involvement (HR, 2.05 [1.30–3.75]; P =0.023), time from first symptoms to diagnosis >1 year (HR, 2.22 [1.30–3.80]; P =0.005), and aspirin treatment (HR, 1.82 [1.04–3.19]; P =0.035) were associated with cerebrovascular ischemic event. In multivariate analysis, time from first symptoms to TA diagnosis >1 year (HR, 2.16 [1.27–3.70]; P =0.007) was independently associated with cerebrovascular ischemic events in patients with TA. The HR for cerebrovascular ischemic event in patients who already experienced a stroke/TIA was 5.11 (2.91–8.99; P Conclusions: Carotid stroke/TIA is frequent in TA. We identified factors associated with cerebrovascular ischemic events.

Published
2022

6. Teaching NeuroImages: Burkitt dural lymphoma mimicking a subacute subdural hematoma

Author

Matthieu Faillot, Karima Mokhtari, Didier Dormont, Philippe Cornu, Hussa Alshehhi, Chiara Villa, Bertrand Mathon, Delphine Leclercq, Aurélien Nouet, Service de Neurochirurgie [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [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), Institut de psychiatrie et neurosciences (U894 / UMS 1266), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Hôpital Foch [Suresnes], Algorithms, models and methods for images and signals of the human brain (ARAMIS), Inria Paris-Rocquencourt, Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut du Cerveau et de la Moëlle Epinière = Brain and Spine Institute (ICM), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [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)-Centre National de la Recherche Scientifique (CNRS)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [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)-Centre National de la Recherche Scientifique (CNRS), Centre de Recherche de l'Institut du Cerveau et de la Moelle épinière (CRICM), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Pitié-Salpêtrière [APHP], Centre de Psychiatrie et Neurosciences ( CPN - U894 ), Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Service de Neuropathologie, CHU Pitié-Salpêtrière [APHP], Algorithms, models and methods for images and signals of the human brain ( ARAMIS ), Institut National de Recherche en Informatique et en Automatique ( Inria ) -Institut National de Recherche en Informatique et en Automatique ( Inria ) -Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Institut du Cerveau et de la Moëlle Epinière = Brain and Spine Institute ( ICM ), Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -CHU Pitié-Salpêtrière [APHP]-Centre National de la Recherche Scientifique ( CNRS ) -Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -CHU Pitié-Salpêtrière [APHP]-Centre National de la Recherche Scientifique ( CNRS ), Centre de Recherche de l'Institut du Cerveau et de la Moelle épinière ( CRICM ), Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre National de la Recherche Scientifique ( CNRS ), Colliot, Olivier, Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-CHU Pitié-Salpêtrière [AP-HP], Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Pierre et Marie Curie - Paris 6 (UPMC), and Centre de Psychiatrie et Neurosciences (U894)

Subjects
Weakness, medicine.medical_specialty, [ INFO.INFO-TS ] Computer Science [cs]/Signal and Image Processing, [INFO.INFO-TS] Computer Science [cs]/Signal and Image Processing, Neuroimaging, Computed tomography, [ SPI.SIGNAL ] Engineering Sciences [physics]/Signal and Image processing, Diagnosis, Differential, 03 medical and health sciences, 0302 clinical medicine, Hematoma, [INFO.INFO-TS]Computer Science [cs]/Signal and Image Processing, 030225 pediatrics, Biopsy, Meningeal Neoplasms, Humans, Medicine, [SPI.SIGNAL] Engineering Sciences [physics]/Signal and Image processing, medicine.diagnostic_test, business.industry, Middle Aged, medicine.disease, Burkitt Lymphoma, Magnetic Resonance Imaging, Lymphoma, Surgery, Hematoma, Subdural, Homogeneous, Female, Dura Mater, Neurosurgery, Neurology (clinical), Headaches, medicine.symptom, Tomography, X-Ray Computed, business, [SPI.SIGNAL]Engineering Sciences [physics]/Signal and Image processing, 030217 neurology & neurosurgery
Abstract

International audience; A 59-year-old woman with no history of trauma presented with severe headaches and right-sided weakness. A CT scan showed a left hemispheric isodense subdural collection thought to be consistent with a subacute subdural hematoma (figure 1A). The patient underwent a single parietal burr hole for evacuation, but the neurosurgeon found subdural fleshy tissue and performed a biopsy. Immediate postoperative MRI showed a homogeneous hypercellular subdural mass (figure 1, B–F).1 Pathology was consistent with Burkitt lymphoma (figure 2). Retrospectively, the homogeneous density of the collection argued against hematoma. In nonemergent situations, an atypical radiologic appearance of a subdural hematoma may suggest the need for further radiologic investigations before surgical evacuation.2

Published
2023

10. Le scanner de mort encéphalique

Author

Didier Dormont, N. Sourour, Delphine Leclercq, Stéphanie Lenck, Kevin Premat, Damien Galanaud, Vincent Degos, Eimad Shotar, and Frédéric Clarençon

Subjects
03 medical and health sciences, 0302 clinical medicine, 030220 oncology & carcinogenesis, 030218 nuclear medicine & medical imaging
Abstract

Resume La mort encephalique est definie comme une cessation complete et definitive d’activite du cerveau et du tronc cerebral, y compris du systeme nerveux autonome. Les examens de reference pour confirmer l’etat de mort encephalique, l’electroencephalogramme, les potentiels evoques et le « Bispectral index » (BIS), peuvent etre pris en defaut dans certaines situations. Dans ces cas, le scanner de mort encephalique peut permettre la confirmation du diagnostic de mort encephalique. Dans cet article, nous definirons precisement les criteres techniques de bonne realisation d’un angioscanner de mort encephalique. Puis, nous detaillerons les criteres d’imagerie permettant de confirmer definitivement le diagnostic de mort encephalique.

Published
2020

13. Quantitative brain imaging analysis of neurological syndromes associated with anti-GAD antibodies

Author

Vincent Navarro, Jean-Yves Delattre, Maëlle Dade, Marion Benazra, Agusti Alentorn, Marine Giry, Giulia Berzero, Gilles Huberfeld, Delphine Leclercq, Dimitri Psimaras, Sorbonne Université - Département de neurologie 2 - Mazarin, Sorbonne Université (SU)-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), Institut du Cerveau et de la Moëlle Epinière = Brain and Spine Institute (ICM), Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [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)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), Centre interdisciplinaire de recherche en biologie (CIRB), Labex MemoLife, École normale supérieure - Paris (ENS Paris), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Collège de France (CdF (institution))-Ecole Superieure de Physique et de Chimie Industrielles de la Ville de Paris (ESPCI Paris), Université Paris sciences et lettres (PSL)-École normale supérieure - Paris (ENS Paris), Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Service de Neuroradiologie [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [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), Unité fonctionnelle d'épilepsie [CHU Pitié-Salpêtrière], Service de Neurologie [CHU Pitié-Salpêtrière], IFR70-CHU Pitié-Salpêtrière [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)-IFR70-CHU Pitié-Salpêtrière [AP-HP], Service d'Onco-neurologie = Département de neurologie 2 [CHU Pitié Salpêtrière], Institut du Cerveau = Paris Brain Institute (ICM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), École normale supérieure - Paris (ENS-PSL), Université Paris sciences et lettres (PSL)-École normale supérieure - Paris (ENS-PSL), Gestionnaire, HAL Sorbonne Université 5, Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Ecole Superieure de Physique et de Chimie Industrielles de la Ville de Paris (ESPCI Paris), Université Paris sciences et lettres (PSL)-Collège de France (CdF (institution))-École normale supérieure - Paris (ENS Paris), Université Paris sciences et lettres (PSL)-Collège de France (CdF (institution))-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-IFR70-CHU Pitié-Salpêtrière [AP-HP], Dade, M., Giry, M., Berzero, G., Benazra, M., Huberfeld, G., Leclercq, D., Navarro, V., Delattre, J. -Y., Psimaras, D., and Alentorn, A.

Subjects
Cerebellum, Pathology, Radiomic data, endocrine system diseases, Hippocampus, Fluid-attenuated inversion recovery, 0302 clinical medicine, Volumetry, Autoimmune epilepsy, Cerebellar ataxia, Neuronal antibodies, 0303 health sciences, Glutamate Decarboxylase, Limbic encephalitis, Brain, Regular Article, 3. Good health, medicine.anatomical_structure, Neurology, Cerebellar atrophy, [SDV.NEU]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC], medicine.symptom, endocrine system, medicine.medical_specialty, Cognitive Neuroscience, Paraneoplastic neurological syndromes, Computer applications to medicine. Medical informatics, R858-859.7, Neuroimaging, Stiff-Person Syndrome, Cortical thickness, 03 medical and health sciences, Atrophy, medicine, Humans, Radiology, Nuclear Medicine and imaging, Stiff-person syndrome, [SDV.NEU] Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC], RC346-429, Autoantibodies, 030304 developmental biology, Glutamic acid decarboxylase, business.industry, nutritional and metabolic diseases, medicine.disease, GAD65 autoimmunity, Neurology. Diseases of the nervous system, Neurology (clinical), business, 030217 neurology & neurosurgery
Abstract

Highlights • The pattern of cortical atrophy is present throughout all anti-GAD phenotypes. • The radiomic features correctly classify anti-GAD patients versus healthy subjects. • The different neurological anti-GAD phenotypes should be considered as a continuum., Neurological disorders associated with anti-glutamic acid decarboxylase (GAD) autoimmunity are rare and include a variety of neurological syndromes: stiff-person syndrome, cerebellar ataxia or limbic encephalitis. The diagnosis remains challenging due to the variety of symptoms and normal brain imaging. The morphological MRI of 26 patients (T1-weighted and Fluid-attenuated inversion recovery (FLAIR)-weighted images) was analyzed at the initial stage of diagnosis, matched by age and sex to 26 healthy subjects. We performed a vertex-wise analysis using a generalized linear model, adjusting by age, to compare the brain cortical thickness of both populations. In addition, we used a voxel-based morphometry of cerebellum thickness obtained by CEREbellum Segmentation (CERES), as well as the hippocampus volumetry comparison using HIPpocampus subfield Segmentation (HIPS). Finally, we extracted 62 radiomics features using LifeX to assess the classification performance using a random forest model to identify an anti-GAD related MRI. The results suggest a peculiar profile of atrophy in patients with anti-GAD, with a significant atrophy in the temporal and frontal lobes (adjusted p-value

Published
2021

15. Brain MRI features and scoring of leukodystrophy in adult-onset Krabbe disease

Author

Bruno Law-Ye, Nadya Pyatigorskaya, Fausto Viader, Roseline Froissart, Raili Raininko, Antonio Federico, Seung H. Kim, Louis Cousyn, Kiyotaka Nakamagoe, Monique Piraud, Cornelia Laule, Alfonso Cerase, Xavier Ayrignac, Robert Henderson, Simona Salvatore, Delphine Leclercq, Hiroshi Adachi, Yuwei Da, Karol Jastrzębski, Maria Carmo Macário, Sandra Sirrs, João Durães, Rabab Debs, Ludger Schols, Yann Nadjar, Bertrand Audoin, Roberta La Piana, CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service de Biochimie et Biologie Moléculaire Grand Est Unité Médicale Pathologies Métaboliques, Erythrocytaires et Dépistage Périnatal, Centre de Biologie et de Pathologie Est, Hospices Civils de Lyon, Bron, Laboratoire de Biologie Tissulaire et d'ingénierie Thérapeutique UMR 5305 (LBTI), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS), Università degli Studi di Siena = University of Siena (UNISI), Neuroradiology Unit, Azienda Ospedaliera Universitaria Senese, Siena, Department of Neurology, Coimbra Hospital and University Centre, Department of Neurology, College of Medicine, Hanyang University, Seoul, Division of Neurology, Hyogo Prefectural Amagasaki General Medical Center, Hyogo, Department of Neurology, La Timone Hospital, Aix-Marseille University, Centre de résonance magnétique biologique et médicale (CRMBM), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Centre National de la Recherche Scientifique (CNRS), Centre d'Exploration Métabolique par Résonance Magnétique [Hôpital de la Timone - APHM] (CEMEREM), Hôpital de la Timone [CHU - APHM] (TIMONE)-Centre de résonance magnétique biologique et médicale (CRMBM), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Centre National de la Recherche Scientifique (CNRS)-Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Centre National de la Recherche Scientifique (CNRS), Department of Neurology, University Hospital of Montpellier, Department of Neurology, Xuan Wu Hospital, Capital Medical University, Beijing, Department of Neurology, Royal Brisbane Hospital, Brisbane, Laboratory of Neurogenetics of Motion and Department of Neuroradiology, Montréal Neurological Institute and Hospital, McGill University, Montréal, University of British Columbia (UBC), International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, Department of Neurology, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, Ibaraki, Uppsala University, Department of Neurology and Hertie-Institute for Clinical Brain Research, Eberhard-Karls-University, German Center of Neurodegenerative Diseases (DZNE), Tübingen, Department of Neurology, Caen-Normandie University Hospital, Caen, Inserm U1077, EPHE, Caen-Normandie University, Caen, and Department of Neurology and Stroke, Medical University of Lodz

Subjects
Male, 0301 basic medicine, Internal capsule, pathology [Pyramidal Tracts], Pyramidal Tracts, 030105 genetics & heredity, Corpus callosum, Corpus Callosum, methods [Magnetic Resonance Imaging], 0302 clinical medicine, Internal Capsule, pathology [White Matter], Age of Onset, Child, Brain, Middle Aged, Magnetic Resonance Imaging, White Matter, pathology [Corpus Callosum], pathology [Internal Capsule], Female, pathology [Leukodystrophy, Globoid Cell], Radiology, Adult, medicine.medical_specialty, Adolescent, diagnostic imaging [Leukodystrophy, Globoid Cell], Young Adult, 03 medical and health sciences, Corona radiata, medicine, Humans, ddc:610, diagnostic imaging [Brain], Aged, business.industry, Leukodystrophy, Precentral gyrus, medicine.disease, Hyperintensity, Leukodystrophy, Globoid Cell, Corticospinal tract, Krabbe disease, Neurology (clinical), pathology [Demyelinating Diseases], business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, 030217 neurology & neurosurgery, Demyelinating Diseases
Abstract

ObjectiveTo perform a systematic analysis and scoring of brain MRI white matter hyperintensities (WMH) in adult-onset Krabbe disease.MethodsWe retrospectively collected basic clinical data and the first available brain MRI from patients with confirmed Krabbe disease with first clinical manifestations beyond 10 years of age. Data were obtained from our reference center for lysosomal diseases (n = 6) and from contacted authors of published articles describing patients with adult-onset Krabbe disease (n = 15). T2-weighted fluid-attenuated inversion recovery images of each patient were analyzed and scored using a radiologic score of WMH in a single center.ResultsThe corticospinal tract was always affected by WMH (100% of patients), however, with some distinctions along the tract: the precentral gyrus (100%), corona radiata (95%), and posterior internal capsule (81%) were highly abnormal, whereas the mesencephalon (57%), pons (52%), and medulla oblongata (5%) were less affected. WMH were also frequently present in the posterior lateral periventricular white matter (95%), optic radiations (86%), postcentral gyrus (71%), medial lemniscus (62%), and corpus callosum, especially in the isthmus (71%), whereas the genu was always normal. A few patients did not have the classical MRI pattern but extensive hyperintensities (n = 3), or patchy distribution of hyperintensities mimicking an acquired etiology (n = 2), or very subtle hyperintensities of the corticospinal tract (n = 1).ConclusionsWe specified the main locations of WMH, which were observed in the earliest stages of the disease and were also present in patients with atypical MRI pattern, highlighting the importance of radiologic features to guide the diagnosis.

Published
2019

16. Leukoencephalopathy with transient splenial lesions related to 5-fluorouracil or capecitabine

Author

Julien Mahé, Kevin Bihan, Caroline Houillier, Damien Ricard, Dimitri Psimaras, Giulia Berzero, Valentine Perrain, Sandrine Combret, Flavie Bompaire, Delphine Leclercq, Fanny Jomier, Perrain, V., Bihan, K., Bompaire, F., Houillier, C., Jomier, F., Leclercq, D., Combret, S., Mahe, J., Ricard, D., Berzero, G., and Psimaras, D.

Subjects
Adult, medicine.medical_specialty, Antimetabolites, Antineoplastic, Splenium, Fluid-attenuated inversion recovery, Gastroenterology, corpus callosum, Leukoencephalopathy, Capecitabine, 03 medical and health sciences, Dihydropyrimidine dehydrogenase deficiency, 0302 clinical medicine, Leukoencephalopathies, Internal medicine, neurotoxicity, medicine, Humans, 5-fluorouracil, toxic leukoencephalopathy, 030212 general & internal medicine, Retrospective Studies, business.industry, capecitabine, medicine.disease, Hyperintensity, Toxic leukoencephalopathy, Neurology, Neurology (clinical), Fluorouracil, business, Splenial, 030217 neurology & neurosurgery, medicine.drug
Abstract

Background: 5-Fluorouracil (5-FU) and its oral prodrug capecitabine have been rarely but consistently associated with acute central nervous system toxicity, including transient leukoencephalopathies involving the splenium of the corpus callosum. Methods: We performed a retrospective search in the French Pharmacovigilance database (FPDB) (January 1985−July 2020) for adult patients affected by solid cancers who developed acute toxic leukoencephalopathies with splenial lesions following treatment with 5-FU or capecitabine. A comprehensive review of the literature helped to circumstantiate our findings. Results: Our research in the FPDB identified six patients who, within 3days from their first cycle of 5-FU or capecitabine, developed acute neurological symptoms, including gait ataxia (n=4), dysarthria (n=3), dysmetria (n=2), headache (n=2), and confusion (n=2). Brain magnetic resonance imaging (MRI) showed T2/FLAIR (fluid-attenuated inversion recovery) hyperintensities in the corpus callosum, with diffusion restriction and no contrast enhancement, generally accompanied by additional alterations in the bilateral supratentorial white matter (n=5). All patients discontinued the agent supposedly responsible for the toxicity and experienced full recovery after a median of 8.5days from symptom onset. Control MRI showed a progressive normalization of acute MRI abnormalities. Literature review identified 26 cases with similar clinical and paraclinical characteristics. A single patient from the literature resumed 5-FU at a lower dose, with no recurrent toxicity. Conclusions: 5-FU and capecitabine might be responsible for acute leukoencephalopathies with transient splenial lesions that are generally reversible upon drug discontinuation. Resuming the agent responsible for toxicity might be feasible in selected cases, after having excluded dihydropyrimidine dehydrogenase deficiency, if expected benefits outweigh the risks.

Published
2021

17. Longitudinally Extensive Myelitis Associated With Immune Checkpoint Inhibitors

Author

Julie Perrin, Kevin Bihan, Marc Coustans, Giulia Berzero, Pablo Berlanga, Marion Benazra, Vincent Jachiet, Delphine Leclercq, Cécile Cauquil, Samy Ammari, Perrine Devic, Flavie Bompaire, Jean-Marie Michot, François Ducray, Alberto Picca, Bethsabée Garel, Nora Kramkimel, Dimitri Psimaras, Edouard Januel, Picca, A., Berzero, G., Bihan, K., Jachiet, V., Januel, E., Coustans, M., Cauquil, C., Perrin, J., Berlanga, P., Kramkimel, N., Garel, B., Devic, P., Ducray, F., Benazra, M., Bompaire, F., Leclercq, D., Michot, J. -M., Ammari, S., Psimaras, D., Università di Pavia, CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), Institut Gustave Roussy (IGR), Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL), Institut du Cerveau et de la Moëlle Epinière = Brain and Spine Institute (ICM), Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Département d'hématologie [Gustave Roussy], Département d'imagerie médicale [Gustave Roussy], Università degli Studi di Pavia = University of Pavia (UNIPV), Institut du Cerveau = Paris Brain Institute (ICM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), and HAL-SU, Gestionnaire

Subjects
Adult, Male, medicine.medical_specialty, Ataxia, Adolescent, Immune checkpoint inhibitors, [SDV.NEU.NB]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]/Neurobiology, Myelitis, [SDV.CAN]Life Sciences [q-bio]/Cancer, Article, 03 medical and health sciences, 0302 clinical medicine, [SDV.CAN] Life Sciences [q-bio]/Cancer, Internal medicine, Neoplasms, Pharmacovigilance, medicine, Humans, Glucocorticoids, Immune Checkpoint Inhibitors, Severe complication, Aged, Retrospective Studies, business.industry, [SDV.NEU.NB] Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]/Neurobiology, [SDV.IMM.IMM]Life Sciences [q-bio]/Immunology/Immunotherapy, Middle Aged, medicine.disease, Magnetic Resonance Imaging, 3. Good health, Discontinuation, medicine.anatomical_structure, Neurology, 030220 oncology & carcinogenesis, Concomitant, Sphincter, Female, Neurology (clinical), Immunotherapy, [SDV.IMM.IMM] Life Sciences [q-bio]/Immunology/Immunotherapy, medicine.symptom, business, 030217 neurology & neurosurgery
Abstract

ObjectiveTo define the characteristics and the outcome of myelitis associated with immune checkpoint inhibitors (ICIs).MethodsWe performed a retrospective research in the databases of the French Pharmacovigilance Agency and the OncoNeuroTox network for patients who developed myelitis following treatment with ICIs (2011–2020). A systematic review of the literature was performed to identify similar cases.ResultsWe identified 7 patients who developed myelitis after treatment with ICIs (anti-PD1 [n = 6], anti-PD1 + anti-CTLA4 [n = 1]). Neurologic symptoms included paraparesis (100%), sphincter dysfunction (86%), tactile/thermic sensory disturbances (71%), and proprioceptive ataxia (43%). At the peak of symptom severity, all patients were nonambulatory. MRI typically showed longitudinally extensive lesions, with patchy contrast enhancement. CSF invariably showed inflammatory findings. Five patients (71%) had clinical and/or paraclinical evidence of concomitant cerebral, meningeal, caudal roots, and/or peripheral nerve involvement. Despite the prompt discontinuation of ICIs and administration of high-dose glucocorticoids (n = 7), most patients needed second-line immune therapies (n = 5) because of poor recovery or early relapses. At last follow-up, only 3 patients had regained an ambulatory status (43%). Literature review identified 13 previously reported cases, showing similar clinical and paraclinical features. All patients discontinued ICIs and received high-dose glucocorticoids, with the addition of other immune therapies in 8. Clinical improvement was reported for 10 patients.ConclusionMyelitis is a rare but severe complication of ICIs that shows limited response to glucocorticoids. Considering the poor functional outcome associated with longitudinally extensive myelitis, strong and protracted immune therapy combinations are probably needed upfront to improve patient outcome and prevent early relapses.

Published
2021

18. Retrospective Observational Study of Brain MRI Findings in Patients with Acute SARS-CoV-2 Infection and Neurologic Manifestations

Author

Lydia, Chougar, Natalia, Shor, Nicolas, Weiss, Damien, Galanaud, Delphine, Leclercq, Bertrand, Mathon, Samia, Belkacem, Sebastian, Ströer, Sonia, Burrel, David, Boutolleau, Alexandre, Demoule, Charlotte, Rosso, Cécile, Delorme, Danielle, Seilhean, Didier, Dormont, Elise, Morawiec, Mathieu, Raux, Sophie, Demeret, Sophie, Gerber, Stéphanie, Trunet, Thomas, Similowski, Vincent, Degos, Pierre, Rufat, Jean-Christophe, Corvol, Stéphane, Lehéricy, Nadya, Pyatigorskaya, Safia, Said, Institut du Cerveau et de la Moëlle Epinière = Brain and Spine Institute (ICM), Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), Centre de Neuro-Imagerie de Recherche (CENIR), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service de Neuroradiologie [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Sorbonne Université - Faculté de Médecine (SU FM), Sorbonne Université (SU), Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de Recherche Saint-Antoine (CR Saint-Antoine), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-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), Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Institute of cardiometabolism and nutrition (ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Centre d'investigation clinique Neurosciences [CHU Pitié Salpêtrière] (CIC Neurosciences), Algorithms, models and methods for images and signals of the human brain (ARAMIS), Sorbonne Université (SU)-Inria de Paris, Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)-Institut du Cerveau et de la Moëlle Epinière = Brain and Spine Institute (ICM), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), Maladies neurodéveloppementales et neurovasculaires (NeuroDiderot (UMR_S_1141 / U1141)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP), Ecole Supérieure Privée d'Ingénierie et de Technologies (ESPRIT), This project was funded by the Paris Brain Institute (ICM). ICM was supported by an unrestricted donation from the Fédération Internationale d’Automobile (https://www.fia.com/fia), a non-profit making association. The research was also supported by funding from the program 'Investissements d’avenir' ANR-10- IAIHU-06., ANR-10-IAHU-0006,IHU-A-ICM,Institut de Neurosciences Translationnelles de Paris(2010), Institut du Cerveau = Paris Brain Institute (ICM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), Center for NeuroImaging Research-Human MRI Neuroimaging core facility for clinical research [ICM Paris] (CENIR), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), 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], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Neurophysiologie Respiratoire Expérimentale et Clinique (UMRS 1158), Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)-Institut du Cerveau = Paris Brain Institute (ICM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), Groupe de recherche clinique Biomarqueurs d’urgence et de réanimation (GRC 14 - BIOSFAST), Supported by the Paris Brain Institute, ICM was supported by an unrestricted donation from the Fédération Internationale d’Automobile, and Investissements d’avenir (ANR-10-IAIHU-06)., Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [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)-Centre National de la Recherche Scientifique (CNRS), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre de Recherche Saint-Antoine (CRSA), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases [IHU ICAN], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPC)

Subjects
Adult, Male, medicine.medical_specialty, Cross-sectional study, [SDV]Life Sciences [q-bio], Pneumonia, Viral, Imaging patterns, Corpus callosum, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, Betacoronavirus, 0302 clinical medicine, Cerebrospinal fluid, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Internal medicine, Intensive care, medicine, Humans, Radiology, Nuclear Medicine and imaging, 10. No inequality, Pandemics, Aged, Retrospective Studies, Original Research, Aged, 80 and over, [SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases, business.industry, SARS-CoV-2, Brain, COVID-19, Retrospective cohort study, Middle Aged, medicine.disease, Magnetic Resonance Imaging, 3. Good health, Venous thrombosis, Pneumonia, Cerebrovascular Disorders, Cross-Sectional Studies, Brain MRI, 030220 oncology & carcinogenesis, Acute Disease, Neurological manifestations, Female, [SDV.NEU]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC], [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, Coronavirus Infections, Perfusion
Abstract

International audience; Background This study provides a detailed imaging assessment in a large series of patients infected with coronavirus disease 2019 (COVID-19) and presenting with neurologic manifestations. Purpose To review the MRI findings associated with acute neurologic manifestations in patients with COVID-19. Materials and Methods This was a cross-sectional study conducted between March 23 and May 7, 2020, at the Pitié-Salpêtrière Hospital, a reference center for COVID-19 in the Paris area. Adult patients were included if they had a diagnosis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection with acute neurologic manifestations and referral for brain MRI. Patients with a prior history of neurologic disease were excluded. The characteristics and frequency of different MRI features were investigated. The findings were analyzed separately in patients in intensive care units (ICUs) and other departments (non-ICU). Results During the inclusion period, 1176 patients suspected of having COVID-19 were hospitalized. Of 308 patients with acute neurologic symptoms, 73 met the inclusion criteria and were included (23.7%): thirty-five patients were in the ICU (47.9%) and 38 were not (52.1%). The mean age was 58.5 years ± 15.6 [standard deviation], with a male predominance (65.8% vs 34.2%). Forty-three patients had abnormal MRI findings 2-4 weeks after symptom onset (58.9%), including 17 with acute ischemic infarct (23.3%), one with a deep venous thrombosis (1.4%), eight with multiple microhemorrhages (11.3%), 22 with perfusion abnormalities (47.7%), and three with restricted diffusion foci within the corpus callosum consistent with cytotoxic lesions of the corpus callosum (4.1%). Multifocal white matter-enhancing lesions were seen in four patients in the ICU (5%). Basal ganglia abnormalities were seen in four other patients (5%). Cerebrospinal fluid analyses were negative for SARS-CoV-2 in all patients tested (n = 39). Conclusion In addition to cerebrovascular lesions, perfusion abnormalities, cytotoxic lesions of the corpus callosum, and intensive care unit-related complications, we identified two patterns including white matter-enhancing lesions and basal ganglia abnormalities that could be related to severe acute respiratory syndrome coronavirus 2 infection. © RSNA, 2020 Online supplemental material is available for this article.

Published
2020

19. Pseudo-continuous arterial spin labelling shows high diagnostic performance in the detection of postoperative residual lesion in hyper-vascularised adult brain tumours

Author

Marc Sanson, Bruno Law-Ye, Nadya Pyatigorskaya, Delphine Leclercq, Didier Dormont, Clara Cohen, Laurent Capelle, Damien Galanaud, Centre Hospitalier Régional Universitaire de Tours (CHRU TOURS), CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Algorithms, models and methods for images and signals of the human brain (ARAMIS), Sorbonne Université (SU)-Inria de Paris, Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)-Institut du Cerveau et de la Moëlle Epinière = Brain and Spine Institute (ICM), Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), Sorbonne Université (SU), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)-Institut du Cerveau = Paris Brain Institute (ICM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), 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)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS)

Subjects
Male, Neoplasm, Residual, [SDV.IB.IMA]Life Sciences [q-bio]/Bioengineering/Imaging, [SDV.NEU.NB]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]/Neurobiology, Contrast Media, Perfusion scanning, Neurosurgical Procedures, 030218 nuclear medicine & medical imaging, MESH: Magnetic Resonance Imaging, 0302 clinical medicine, MESH: Postoperative Period, Medicine, Postoperative Period, Prospective Studies, Neuroradiology, MESH: Middle Aged, medicine.diagnostic_test, Brain Neoplasms, Ultrasound, General Medicine, MESH: Cerebrovascular Circulation, Middle Aged, Perfusion imaging, Postoperative procedures, Cerebral blood flow, Cerebrovascular Circulation, 030220 oncology & carcinogenesis, [INFO.INFO-TI]Computer Science [cs]/Image Processing [eess.IV], MESH: Brain Neoplasms, Disease Progression, Female, MESH: Disease Progression, Radiology, medicine.symptom, [SPI.SIGNAL]Engineering Sciences [physics]/Signal and Image processing, Adult, medicine.medical_specialty, education, Lesion, Residual tumour, 03 medical and health sciences, McNemar's test, Magnetic resonance imaging, MESH: Contrast Media, [INFO.INFO-IM]Computer Science [cs]/Medical Imaging, Humans, Radiology, Nuclear Medicine and imaging, MESH: Neoplasm, Residual, MESH: Humans, business.industry, Brain tumours, [INFO.INFO-CV]Computer Science [cs]/Computer Vision and Pattern Recognition [cs.CV], MESH: Adult, MESH: Neurosurgical Procedures, Perioperative, MESH: Male, MESH: Prospective Studies, business, MESH: Female
Abstract

Our aim was to evaluate the contribution of pseudo-continuous arterial spin labelling (pCASL) in the detection of a postoperative residual lesion in adult brain tumours. Seventy-five patients were prospectively included. Following the results of preoperative DSC-PWI assessment, intra-axial lesions, including high-grade gliomas (n = 43) and certain metastases (n = 14), were classified as hyper-vascular (HV+ group, n = 57); other lesions, including low-grade gliomas and certain metastases, were classified as non-hyper-vascular (HV− group, n = 18). To confirm the absence/presence of a residual lesion or disease progression, postoperative MRI including pCASL sequence and follow-up-MRI were performed within 72 h and 1–6 months after the resection, respectively. Two raters evaluated the images. Mean and maximal ASL cerebral blood flow (CBF) values were measured in the perioperative region and normalised to the contralateral tissue. The pCASL-CBF maps and post-contrast T1WI were visually assessed for residual lesion. Quantitative data were analysed with unpaired Student t and Mann-Whitney U tests and the visual diagnostic performance with the McNemar test. In the HV+ group, the mean normalised CBF was 1.97 ± 0.59 and 0.97 ± 0.29 (p < 0.0001, AUC = 0.964, cut-off = 1.27) for patients with or without residual tumours, respectively. The mean normalised CBF was not discriminative for assessing residual tumours in the HV− group (p = 0.454). Visual CBF evaluation allowed 92.98% patients belonging to the HV+ group to be correctly classified (sensitivity 93.02%, specificity 92.86%, p < 0.001). Visual evaluation was correlated with contrast enhancement evaluation and with the mean normalised CBF values (r = 0.505, p < 0.0001 and 0.838, p < 0.0001, respectively). Qualitative and quantitative ASL evaluation shows high diagnostic performance in postoperative assessment of hyper-perfused tumours. In this case, postoperative pCASL may be useful, especially if contrast injection cannot be performed or when contrast enhancement is doubtful. • Evaluation of postoperative residual lesion in the case of brain tumours is an imaging challenge. • This prospective monocentric study showed that increased normalised cerebral blood flow assessed by pseudo-continuous arterial spin labelling (pCASL) correlates well with the presence of a residual tumour in the case of hyper-vascular tumour diagnosed on preoperative MRI. • Qualitative and quantitative pCASL is an informative sequence for hyper-vascular residual tumour, especially if acquired more than 48 h after brain tumour surgery, when contrast enhancement can give ambiguous results due to blood-brain barrier disruption.

Published
2020

20. Safety and Feasibility of Repeated and Transient Blood–Brain Barrier Disruption by Pulsed Ultrasound in Patients with Recurrent Glioblastoma

Author

Alexandre Carpentier, Marc Sanson, Caroline Houillier, Bruno Law-Ye, Anne Bissery, Alexandre Vignot, Khê Hoang-Xuan, Bertrand Mathon, Jean-Yves Delattre, Jean-Yves Chapelon, Cyril Lafon, Nicolas Asquier, Arthur André, Carole Desseaux, Ahmed Idbaih, Clementine Trosch, Guillaume Bouchoux, Caroline Dehais, Delphine Leclercq, Michael Canney, Laurent Capelle, Lisa Belin, Yann De Rycke, and Florence Laigle-Donadey

Subjects
Drug, Cancer Research, medicine.medical_specialty, medicine.medical_treatment, media_common.quotation_subject, Urology, Blood–brain barrier, Article, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Humans, Medicine, In patient, Adverse effect, media_common, Chemotherapy, medicine.diagnostic_test, business.industry, Neurotoxicity, Magnetic resonance imaging, medicine.disease, Magnetic Resonance Imaging, Carboplatin, 3. Good health, medicine.anatomical_structure, Ultrasonic Waves, Oncology, chemistry, Blood-Brain Barrier, 030220 oncology & carcinogenesis, Feasibility Studies, Neoplasm Recurrence, Local, Glioblastoma, business, 030217 neurology & neurosurgery
Abstract

Purpose: The blood–brain barrier (BBB) limits the efficacy of drug therapies for glioblastoma (GBM). Preclinical data indicate that low-intensity pulsed ultrasound (LIPU) can transiently disrupt the BBB and increase intracerebral drug concentrations. Patients and Methods: A first-in-man, single-arm, single-center trial (NCT02253212) was initiated to investigate the transient disruption of the BBB in patients with recurrent GBM. Patients were implanted with a 1-MHz, 11.5-mm diameter cranial ultrasound device (SonoCloud-1, CarThera). The device was activated monthly to transiently disrupt the BBB before intravenous carboplatin chemotherapy. Results: Between 2014 and 2016, 21 patients were registered for the study and implanted with the SonoCloud-1; 19 patients received at least one sonication. In 65 ultrasound sessions, BBB disruption was visible on T1w MRI for 52 sonications. Treatment-related adverse events observed were transient and manageable: a transient edema at H1 and at D15. No carboplatin-related neurotoxicity was observed. Patients with no or poor BBB disruption (n = 8) visible on MRI had a median progression-free survival (PFS) of 2.73 months, and a median overall survival (OS) of 8.64 months. Patients with clear BBB disruption (n = 11) had a median PFS of 4.11 months, and a median OS of 12.94 months. Conclusions: SonoCloud-1 treatments were well tolerated and may increase the effectiveness of systemic drug therapies, such as carboplatin, in the brain without inducing neurotoxicity. See related commentary by Sonabend and Stupp, p. 3750

Published
2019
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21. Erratum to 'Specificities of Arterial Spin Labeling (ASL) Abnormalities in Acute Seizure' [J Neuroradiol 47 (2020) 20–26]

Author

Mathieu Schertz, Bruno Law-Ye, Didier Dormont, Nadya Pyatigorskaya, Clément Cholet, Samia Belkacem, Vincent Navarro, Melika Sahli-Amor, Delphine Leclercq, and Joseph Benzakoun

Subjects
Nuclear magnetic resonance, Radiological and Ultrasound Technology, business.industry, Arterial spin labeling, Medicine, Radiology, Nuclear Medicine and imaging, Neurology (clinical), business
Published
2020

22. Blood-brain barrier disruption in humans using an implantable ultrasound device: quantification with MR images and correlation with local acoustic pressure

Author

Delphine Leclercq, Alexandre Carpentier, Ahmed Idbaih, Guillaume Bouchoux, Nicolas Asquier, Cyril Martin, Cyril Lafon, Michael Canney, Bruno Law-Ye, and Jean-Yves Chapelon

Subjects
Receiver operating characteristic, business.industry, Ultrasound, Image processing, computer.software_genre, White matter, 03 medical and health sciences, 0302 clinical medicine, medicine.anatomical_structure, Voxel, Region of interest, 030220 oncology & carcinogenesis, Medicine, business, Sound pressure, computer, 030217 neurology & neurosurgery, Biomedical engineering, Parametric statistics
Abstract

OBJECTIVEOne of the goals in this study was to set up a semiautomatic method to estimate blood-brain barrier disruption obtained in patients with glioblastoma by using an implantable, unfocused, ultrasound device. Another goal was to correlate the probability of significant ultrasound-induced signal enhancement (SUISE) with local acoustic pressure in the brain.METHODSGd-enhanced MR images acquired before and after ultrasound treatments were analyzed prospectively. The image sets were segmented, normalized, and coregistered to evaluate contrast enhancement. The volume of SUISE was calculated with voxels labeled as gray or white matter, in a cylindrical region of interest, and with enhancement above a given threshold. To validate the method, the resulting volumes of SUISE were compared to qualitative grades previously assigned by 3 clinicians for 40 ultrasound treatments in 15 patients. A parametric study was performed to optimize the algorithm prediction of the qualitative grades. The 3D acoustic field in the brain was estimated from measurements in water combined with simulations accounting for ultrasound attenuation in brain and overlaid on each MR image to correlate local acoustic pressure with the probability of SUISE (defined as enhancement > 10%).RESULTSThe algorithm predicted grade 2 or 3 and grade 3 openings with areas under the receiver operating characteristic curve of 0.831 and 0.995, respectively. The probability of SUISE was correlated with local acoustic pressure (R2 = 0.98) and was 3.33 times higher for gray matter than for white matter.CONCLUSIONSAn algorithm for evaluating blood-brain barrier disruption was validated and can be used for future clinical trials to further understand and quantify this technique in humans.Clinical trial registration no.: NCT02253212 (clinicaltrials.gov)

Published
2018

23. Progressive white-matter demyelination in delayed CO poisoning encephalopathy

Author

Bruno Law-Ye, Didier Dormont, Nadya Pyatigorskaya, S. Trunet, Pauline Dodet, Bertrand Hermann, Delphine Leclercq, CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service de Neuroradiologie [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Algorithms, models and methods for images and signals of the human brain (ARAMIS), Sorbonne Université (SU)-Inria de Paris, Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)-Institut du Cerveau et de la Moëlle Epinière = Brain and Spine Institute (ICM), Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [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)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [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)-Centre National de la Recherche Scientifique (CNRS), Institut du Cerveau et de la Moëlle Epinière = Brain and Spine Institute (ICM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)-Institut du Cerveau = Paris Brain Institute (ICM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), Institut du Cerveau = Paris Brain Institute (ICM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), 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), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS)

Subjects
Pathology, medicine.medical_specialty, [SDV.IB.IMA]Life Sciences [q-bio]/Bioengineering/Imaging, [SDV.NEU.NB]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]/Neurobiology, Encephalopathy, 030218 nuclear medicine & medical imaging, White matter, 03 medical and health sciences, 0302 clinical medicine, White matter pathology, [INFO.INFO-IM]Computer Science [cs]/Medical Imaging, Medicine, Radiology, Nuclear Medicine and imaging, ComputingMilieux_MISCELLANEOUS, Radiological and Ultrasound Technology, medicine.diagnostic_test, business.industry, Disease progression, [INFO.INFO-CV]Computer Science [cs]/Computer Vision and Pattern Recognition [cs.CV], Magnetic resonance imaging, CO poisoning, medicine.disease, medicine.anatomical_structure, [INFO.INFO-TI]Computer Science [cs]/Image Processing [eess.IV], Neurology (clinical), business, [SPI.SIGNAL]Engineering Sciences [physics]/Signal and Image processing, 030217 neurology & neurosurgery
Abstract

International audience

Published
2018

24. Performances Diagnostiques de la Séquence ASL pour Évaluer le Reliquat Post-Opératoire Immédiat des Tumeurs Cérébrales Primitives et Secondaires

Author

Didier Dormont, C. Cohen, Damien Galanaud, Bruno Law-Ye, Nadya Pyatigorskaya, Laurent Capelle, Marc Sanson, and Delphine Leclercq

Subjects
03 medical and health sciences, 0302 clinical medicine, Radiological and Ultrasound Technology, Radiology, Nuclear Medicine and imaging, Neurology (clinical), 030217 neurology & neurosurgery, 030218 nuclear medicine & medical imaging
Abstract

Introduction L’evaluation de l’exerese chirurgicale des tumeurs cerebrales sur l’IRM post-operatoire est un defi. Notre objectif etait d’evaluer la contribution de l’arterial-spin-labelling pseudocontinu (pCASL) dans la recherche d’une lesion residuelle post-operatoire. Materiel et methode L’etude prospective a inclus 64 adultes avec tumeur cerebrale primitive ou secondaire. L’imagerie de perfusion dynamique injectee pre-operatoire a permis d’etablir deux groupes : groupe hyperperfusion (HP+, n = 49), comprenant gliomes de haut-grade (31), certaines metastases (11), meningiomes (4), autres (3) ; et groupe sans hyperperfusion (HP-, n = 15) comprenant gliomes de bas-grade (10), certaines metastases (2), autres (3). Pour confirmer l’absence/presence d’un residu ou progression lesionnelle, IRM post-operatoire comprenant pCASL et IRM de suivi ont ete realisees respectivement dans les 48 heures et 1-6mois apres la resection. Les IRM ont ete analysees par deux lecteurs, qualitativement et quantitativement. Le debit sanguin cerebral (DSC), obtenu en placant le ROI dans la region peri-operatoire, a distance des artefacts, a ete normalise par le parenchyme cerebral controlateral sain. Les cartographies de DSC en pCASL et le rehaussement ont ete analyses visuellement. Resultats Dans le groupe HP+, le DSC moyen normalise etait 2,21 ± 1,03 ou 0,99 ± 0,31 (p Fig. 1 , Fig. 2 ) pour les patients avec ou sans tumeur residuelle, respectivement. Le DSC moyen normalise n’etait pas discriminant pour evaluer la tumeur residuelle dans le groupe HP- (p = 0,639). L’evaluation visuelle du DSC a permis de classer correctement 94,1 % des patients du groupe HP+ (sensibilite 94,12 %, specificite 86,67 %, p Conclusion L’evaluation qualitative et quantitative de l’ASL a une haute performance diagnostique dans l’analyse post-operatoire des tumeurs hyperperfusees. Dans cette situation, le pCASL post-operatoire pourrait etre une sequence utile, en particulier en cas de contre-indication a l’injection de gadolinium ou lorsque le rehaussement est douteux dans la zone peri-operatoire [1] , [2] , [3] , [4] , [5] .

Published
2019

25. Neurologic Complications of Radiation Therapy

Author

Damien Ricard, Delphine Leclercq, Dimitri Psimaras, Arnault Tauziède-Espariat, and Thomas Durand

Subjects
Nervous system, medicine.medical_specialty, Chemotherapy, business.industry, medicine.medical_treatment, Central nervous system, Cancer, medicine.disease, Radiosurgery, Leukoencephalopathy, Radiation therapy, 03 medical and health sciences, 0302 clinical medicine, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Peripheral nervous system, medicine, Intensive care medicine, business, 030217 neurology & neurosurgery
Abstract

Radiation-induced nervous system toxicity remains a cause of morbidity in patients with cancer. Real advances in the design of safer radiation procedures have been counterbalanced by a wider use of combined radiotherapy-chemotherapy regimens, the development of radiosurgery, and the increasing number of long-term survivors. While classic radionecrosis have become less common, more subtle changes such as progressive cognitive dysfunction are increasingly reported after cranial radiotherapy (radiation-induced leukoencephalopathy) administered alone or in combination with chemotherapy. The most important and controversial complications of radiotherapy and combined treatments in the central nervous system and peripheral nervous system are reviewed here, including new diagnostic tools, practical management, and prevention.

Published
2017

26. Characterization of Skull Base Lesions Using Pseudo-Continuous Arterial Spin Labeling

Author

Bruno Law-Ye, Nadya Pyatigorskaya, B. Geerts, Delphine Leclercq, S. Tezenas du Montcel, Damien Galanaud, Didier Dormont, D. Bernardeschi, S. Gerber, CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Synchrotron SOLEIL (SSOLEIL), Centre National de la Recherche Scientifique (CNRS), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Institut du Cerveau = Paris Brain Institute (ICM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), Algorithms, models and methods for images and signals of the human brain (ARAMIS), Sorbonne Université (SU)-Inria de Paris, Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)-Institut du Cerveau = Paris Brain Institute (ICM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut du Cerveau et de la Moëlle Epinière = Brain and Spine Institute (ICM), Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)-Institut du Cerveau et de la Moëlle Epinière = Brain and Spine Institute (ICM), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), Service de Neuroradiologie [CHU Pitié-Salpêtrière], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-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)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [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)-Centre National de la Recherche Scientifique (CNRS), and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)

Subjects
Male, Arterial spin labeling, [SDV.IB.IMA]Life Sciences [q-bio]/Bioengineering/Imaging, [SDV.NEU.NB]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]/Neurobiology, Contrast Media, Schwannoma, 030218 nuclear medicine & medical imaging, 0302 clinical medicine, Paraganglioma, Meningeal Neoplasms, Neuroradiology, medicine.diagnostic_test, Neuroma, Acoustic, Middle Aged, Perfusion, medicine.anatomical_structure, [INFO.INFO-TI]Computer Science [cs]/Image Processing [eess.IV], Female, Radiology, medicine.symptom, Meningioma, [SPI.SIGNAL]Engineering Sciences [physics]/Signal and Image processing, Neurilemmoma, Adenoma, Adult, medicine.medical_specialty, Skull base lesions, Skull Base Neoplasms, Lesion, Diagnosis, Differential, 03 medical and health sciences, Magnetic resonance imaging, medicine, [INFO.INFO-IM]Computer Science [cs]/Medical Imaging, Humans, Radiology, Nuclear Medicine and imaging, Pituitary Neoplasms, Aged, Retrospective Studies, business.industry, Temporal Bone, [INFO.INFO-CV]Computer Science [cs]/Computer Vision and Pattern Recognition [cs.CV], Blood flow, medicine.disease, Skull, Orbital Neoplasms, Spin Labels, Neurology (clinical), business, 030217 neurology & neurosurgery
Abstract

Pseudo-continuous arterial spin labeling (pCASL) is a non-invasive magnetic resonance (MR) perfusion technique. Our study aimed at estimating the diagnostic performance of the pCASL sequence in assessing the perfusion of skull base lesions both qualitatively and quantitatively and at providing cut-off values for differentiation of specific skull base lesions. In this study 99 patients with histopathologically confirmed skull base lesions were retrospectively enrolled. Based on a pathological analysis, the lesions were classified as hypervascular and non-hypervascular. Patients were divided into two subgroups according to the anatomical origin of each lesion. The MRI study included pCASL and 3D T1-weighted fat-saturated post-contrast sequences. Of the patients seven were excluded due to technical difficulties or patient movement. The lesions were classified by two raters, blinded to the diagnosis as either hyperperfused or non-hyperperfused, based on the pCASL sequence. The normalized tumor blood flow (nTBF) of each lesion was determined. Qualitative and quantitative characteristics of hypervascular and non-hypervascular lesions were compared. Visual assessment enabled correct classification of 98% of the lesions to be performed. Quantitatively, we found significant differences between the nTBF values for hypervascular and non-hypervascular lesions (p < 0.001) and provided cut-off values, allowing meningioma and schwannoma to be distinguished from meningioma and adenoma. Significant differences were also found within the hypervascular group, namely, paraganglioma was more hyperperfused than meningioma (p = 0.003) or metastases (p = 0.009). The present study demonstrates the high diagnostic performance of pCASL in characterizing skull base lesions by either visual assessment or nTBF quantification. Adding the pCASL sequence to the conventional protocol of skull base assessment can be recommended.

Published
2017

27. Capecitabine-induced acute toxic leukoencephalopathy

Author

Johanna Wasserman, Dimitri Psimaras, Damien Galanaud, M. Obadia, Didier Dormont, Bruno Law-Ye, Delphine Leclercq, Nadya Pyatigorskaya, M. Sahli-Amor, CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Algorithms, models and methods for images and signals of the human brain (ARAMIS), Sorbonne Université (SU)-Inria de Paris, Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)-Institut du Cerveau et de la Moëlle Epinière = Brain and Spine Institute (ICM), Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), Institut du Cerveau et de la Moëlle Epinière = Brain and Spine Institute (ICM), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), Service de Neuroradiologie [CHU Pitié-Salpêtrière], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (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)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [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)-Centre National de la Recherche Scientifique (CNRS), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)

Subjects
medicine.medical_specialty, Pathology, Antimetabolites, Antineoplastic, Nausea, [SDV.IB.IMA]Life Sciences [q-bio]/Bioengineering/Imaging, medicine.medical_treatment, [SDV.NEU.NB]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]/Neurobiology, Pyramidal Tracts, Breast Neoplasms, Fluid-attenuated inversion recovery, Toxicology, Gastroenterology, Bone and Bones, Leukoencephalopathy, Capecitabine, 03 medical and health sciences, 0302 clinical medicine, Breast cancer, Leukoencephalopathies, Internal medicine, medicine, [INFO.INFO-IM]Computer Science [cs]/Medical Imaging, Humans, 5-fluorouracil, Chemotherapy, business.industry, General Neuroscience, [INFO.INFO-CV]Computer Science [cs]/Computer Vision and Pattern Recognition [cs.CV], Middle Aged, medicine.disease, Acute leukoencephalopathy, Toxic, Magnetic Resonance Imaging, 3. Good health, Toxic leukoencephalopathy, 030220 oncology & carcinogenesis, [INFO.INFO-TI]Computer Science [cs]/Image Processing [eess.IV], Female, Diffusion-weighted imaging, medicine.symptom, Headaches, Demyelination, business, [SPI.SIGNAL]Engineering Sciences [physics]/Signal and Image processing, 030217 neurology & neurosurgery, medicine.drug
Abstract

International audience; A 45-year-old woman was treated by Capecitabine (Xeloda®) during 6 days for breast cancer with metastatic bone lesions when she presented with nausea, headaches, muscle cramps, dysarthria and swallowing disorders. A stroke was first suspected. Brain CT was normal. MRI showed bilateral and symmetric high signal intensities of deep white matter, corpus callosum and corticospinal tracts on diffusion-weighted imaging and T2 fluid-attenuated inversion recovery (FLAIR) sequence, similar to 5-FU acute leukoencephalopathy. An acute toxic leukoencephalopathy was diagnosed prompting to discontinue capecitabine, which allowed a regression of the symptoms. Though acute toxic leukoencephalopathies with pseudo-stroke presentation have been reported with other chemotherapy agents such as methotrexate or 5-fluorouracil (5-FU), cases of leukoencephalopathy induced by capecitabine are less reported and less well known. This oral precursor of 5-FU is commonly used to treat colorectal, stomach or breast cancers. Neurotoxicity of other 5-FU derivates like cormafur and tergafur have rarely been depicted as well.Although 5-FU-induced leukoencephalopathy is known, the potential toxicity of its precursor should be acknowledged as well. Early detection of chemotherapy-induced toxicity by MRI is crucial as symptoms may be reversible to the condition that chemotherapy is immediately discontinued.

Published
2017

28. CLIPPERS mimickers: relapsing brainstem encephalitis associated with anti-MOG antibodies

Author

Julien Savatovsky, Romain Marignier, Giulia Berzero, Dimitri Psimaras, Guillaume Taieb, Delphine Leclercq, N. Younan, Berzero, G., Taieb, G., Marignier, R., Younan, N., Savatovsky, J., Leclercq, D., and Psimaras, D.

Subjects
0301 basic medicine, biology, relapsing, business.industry, autoimmune brainstem encephalitis, anti-MOG antibodies, Steroid responsive, steroid-responsive, Brainstem encephalitis, 03 medical and health sciences, 030104 developmental biology, 0302 clinical medicine, Neurology, Immunology, CLIPPERS, biology.protein, Medicine, Neurology (clinical), Antibody, business, 030217 neurology & neurosurgery
Published
2017

29. First Depiction of Flow Voids to Differentiate Pituicytomas from Giant Adenomas

Author

Bruno Law-Ye, Delphine Leclercq, and Clément Cholet

Subjects
Adenoma, Adult, Male, Pathology, medicine.medical_specialty, Normal tissue, 030209 endocrinology & metabolism, Astrocytoma, Diagnosis, Differential, 03 medical and health sciences, 0302 clinical medicine, medicine, Humans, Pituitary Neoplasms, medicine.diagnostic_test, business.industry, Magnetic resonance imaging, medicine.disease, Magnetic Resonance Imaging, Hemorrhagic complication, Pituitary Gland, Surgery, Neurology (clinical), business, 030217 neurology & neurosurgery, Pituicytoma
Abstract

Pituicytomas are rare low-grade glial lesions of neurohypophysis or adenohypophysis. They are often misdiagnosed as adenomas due to their similar morphology. Previous reports have underlined their nonspecific aspect. In our experience, presence of flow voids on magnetic resonance, which usually indicate hypervascularized tumors with strong arterial supply, may be a useful sign to identify pituicytomas. Unlike adenomas, pituicytomas are highly vascularized tumors. Second, we emphasize the strong enhancement of these tumors when compared with normal hypophysis, which may be another sign of their hypervascularization. Indeed, adenomas, on the opposite side, present less enhancement than normal hypophysis. This observation is corroborated by previous histologic studies that showed adenomas present less vascular density than normal pituitary glands. However, in large tumors, the normal hypophysis can sometimes not be individualized and thus the enhancement gradient between the tumor and normal tissue cannot be properly assessed. Due to their rarity, no previous reports had ever emphasized the specific signs that could allow us to differentiate pituicytomas from adenomas; however, it seems crucial due to the potential hemorrhagic complications of pituicytoma surgery.

Published
2017

30. Human Herpesvirus 6 (HHV-6) necrotizing encephalitis, a rare condition in immunocompromised patients: The importance of brain biopsy associated with HHV-6 testing

Author

Damien Roos-Weil, Henri Agut, Karima Mokhtari, Dorian Chauvet, Pascale Bonnafous, Agnès Gautheret-Dejean, Julien Mayaux, S. Demeret, Nina Dupuis, Loïc Le Guennec, Sylvain Choquet, Nicolas Weiss, Delphine Leclercq, Stéphane Auvin, Dimitri Psimaras, CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Division of Genetics and Epidemiology, Institute of Cancer Research (ICR), Institut du Cerveau et de la Moëlle Epinière = Brain and Spine Institute (ICM), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [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)-Centre National de la Recherche Scientifique (CNRS), Centre National de la Recherche Scientifique (CNRS), Sorbonne Université (SU), Université Pierre et Marie Curie - Paris 6 (UPMC), Fondation Ophtalmologique Adolphe de Rotschild, Université Sorbonne Paris Cité (USPC), Neuroprotection du Cerveau en Développement / Promoting Research Oriented Towards Early Cns Therapies (PROTECT), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Robert Debré-Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hématopoïèse normale et pathologique (U1170 Inserm), Université Paris-Sud - Paris 11 (UP11)-Institut Gustave Roussy (IGR)-Institut National de la Santé et de la Recherche Médicale (INSERM), 'Personal Protection Against Vectors' working group (PPAV), PPAV working group, Centre d'Immunologie et des Maladies Infectieuses (CIMI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), Centre d'investigation clinique Paris Est [CHU Pitié Salpêtrière] (CIC Paris-Est), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU)

Subjects
0301 basic medicine, Pathology, medicine.medical_specialty, Human Herpesvirus-6 Necrotizing encephalitis Blood brain-barrier Brain biopsy Microbiological diagnosis, biology, medicine.diagnostic_test, business.industry, Brain biopsy, [SDV]Life Sciences [q-bio], biology.organism_classification, medicine.disease, Blood–brain barrier, Virology, 03 medical and health sciences, 030104 developmental biology, 0302 clinical medicine, medicine.anatomical_structure, Neurology, medicine, Human herpesvirus 6, 030212 general & internal medicine, Neurology (clinical), business, Encephalitis
Published
2017

31. Brain volumetric analysis and cortical thickness in adults with saccadic intrusions (ocular flutter or opsoclonus-myoclonus syndrome)

Author

Dimitri Psimaras, Agusti Alentorn, Charlotte Hautefort, Bertrand Gaymard, Khê Hoang-Xuan, Jean-Yves Delattre, Evangelia Pappa, Delphine Leclercq, Caroline Tilikete, and Maria-José Ibáñez-Juliá

Subjects
Adult, Male, Cerebellum, Pathology, medicine.medical_specialty, Ocular flutter, 03 medical and health sciences, 0302 clinical medicine, Atrophy, Ocular Motility Disorders, 030225 pediatrics, Opsoclonus myoclonus syndrome, medicine, Saccades, Humans, Prospective Studies, Gray Matter, Opsoclonus-Myoclonus Syndrome, medicine.diagnostic_test, business.industry, Magnetic resonance imaging, General Medicine, Opsoclonus, Middle Aged, medicine.disease, Subcortical gray matter, Magnetic Resonance Imaging, medicine.anatomical_structure, Surgery, Cerebellar atrophy, Female, Neurology (clinical), business, 030217 neurology & neurosurgery
Abstract

Objectives Ocular flutter (OF) and opsoclonus are considered a continuum with a similar pathogenesis. Due to the rarity of this disease in the adult population, little is known about the brain morphological changes in the chronic phase of the disease. Patients and methods Six magnetic resonance imaging from adults with previous history of OF/Opsoclonus and 12 healthy patients (paired by age and sex) were analyzed in order to identify the long term cortical thickness pattern in this rare disease by using Freesurfer. Results Patients with OF/Opsoclonus showed reduced cerebellum cortical volume with a subsequent diminution in total cerebellar volume. White mater cerebellum volume was not modified. In addition, we have also identified a significant supratentorial gray matter volume decrease in OF/Opsoclonus patients, involving both the cortical and the subcortical gray matter. Conclusions OF/Opsoclonus in adults may be associated with cortical and subcortical gray matter atrophy, as well as decreased cerebellar cortical volume. Further larger prospective studies are necessary to confirm these results.

Published
2017

32. Arterial Spin Labeling Hypoperfusion in Migraine Aura

Author

Bruno, Law-Ye, Guillaume, Fargeot, and Delphine, Leclercq

Subjects
Diagnosis, Differential, Male, Adolescent, Cerebrovascular Circulation, Migraine with Aura, Aphasia, Brain, Humans, Magnetic Resonance Imaging, Magnetic Resonance Angiography, Cerebral Angiography
Published
2017

33. Considerations on the Relevance of Cerebral Fusiform Aneurysms Observed During HIV Infection

Author

Pierre de Truchis, Flore Viry, Bruno Law-Ye, Frédéric Clarençon, Claire Jourdan, Didier Dormont, Raphaël Blanc, Robert-Yves Carlier, Raphaël Richard, Delphine Leclercq, HAL-UPMC, Gestionnaire, Université Pierre et Marie Curie - Paris 6 - UFR de Médecine Pierre et Marie Curie (UPMC), Université Pierre et Marie Curie - Paris 6 (UPMC), Service de Neuroradiologie [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [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), Hôpital Raymond Poincaré [AP-HP], Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Laboratoire de recherches cliniques et en santé publique sur les handicaps psychique, cognitif et moteur (HANDIReSP), Fondation Ophtalmologique Adolphe de Rotschild, Service de médecine physique et réadaptation [CHU Raymond-Poincaré], Service des Maladies Infectieuses et Tropicales [CHU Raymond Poincaré], Service de Radiologie [CHU Saint-Antoine], 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)-Sorbonne Université (SU), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), CHU Saint-Antoine [AP-HP], Université Pierre et Marie Curie - Paris 6 - UFR de Médecine Pierre et Marie Curie ( UPMC ), Université Pierre et Marie Curie - Paris 6 ( UPMC ), Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Pitié-Salpêtrière [APHP], AP-HP Hôpital Raymond Poincaré [Garches], Université de Versailles Saint-Quentin-en-Yvelines ( UVSQ ), Unité des troubles du sommeil et de l’éveil [AP-HP hôpital Raymond-Poincaré] ( CIC 1429 ), Université de Versailles Saint-Quentin-en-Yvelines ( UVSQ ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) - AP-HP Hôpital Raymond Poincaré [Garches], CHU Raymond Poincaré, and Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Saint-Antoine [APHP]

Subjects
Adult, Male, Pathology, medicine.medical_specialty, Cerebral vasculitis, Fusiform Aneurysm, HIV Infections, Magnetic resonance angiography, 03 medical and health sciences, Young Adult, 0302 clinical medicine, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, medicine.artery, medicine, Humans, Radiology, Nuclear Medicine and imaging, 030212 general & internal medicine, cardiovascular diseases, Neuroradiology, Retrospective Studies, medicine.diagnostic_test, business.industry, Human immunodeficiency virus, Angiography, Digital Subtraction, Intracranial Aneurysm, Digital subtraction angiography, Middle Aged, medicine.disease, 3. Good health, Cerebral Angiography, Acquired immunodeficiency syndrome, [ SDV.MHEP.MI ] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Angiography, Fusiform aneurysm, cardiovascular system, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Circle of Willis, Female, Neurology (clinical), Radiology, Vasculitis, business, Tomography, X-Ray Computed, 030217 neurology & neurosurgery
Abstract

International audience; Human immunodeficiency virus (HIV)-associated ectatic cerebral vasculitis (HIV-AECV) is a rare form of vasculitis with diffuse fusiform aneurysms. Its pathophysiology remains poorly understood. Although extensively described in children, it is still incompletely studied in adults. Our objective was to present five adult cases with emphasis on imaging findings and long-term evolution. From 2006 to 2014, we included 5 HIV-infected patients presenting with fusiform cerebral aneurysms. Vessels abnormalities were assessed with brain computed tomography (CT) angiography, magnetic resonance angiography (MRA) and/or digital subtraction angiography (DSA). All patients had MR assessment of the brain. Clinical and biological data were analyzed. Fusiform aneurysms of carotid terminations extending to middle and anterior cerebral arteries were bilateral in three patients and unilateral in one. More distal fusiform aneurysms were observed in four patients and saccular aneurysms in two patients, two patients suffered from ischemic lesions while none experienced hemorrhage. Unlike recent reviews, our study underlines the low hemorrhagic potential of HIV-AECV and long-term follow-up suggests a monophasic evolution under antiretroviral medication.

Published
2017

34. Transdifferentiation of Neuroendocrine Cells: Gangliocytoma Associated With Two Pituitary Adenomas of Different Lineage in MEN1

Author

Christel Jublanc, Delphine Leclercq, Anne Laure Boch, Camille Sergeant, Adrian Daly, Gérald Raverot, Chiara Villa, Franck Bielle, and Jacqueline Trouillas

Subjects
Adenoma, Male, endocrine system, Lineage (genetic), Cell, 030209 endocrinology & metabolism, Histogenesis, Biology, Pathology and Forensic Medicine, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Neuroendocrine Cells, medicine, Multiple Endocrine Neoplasia Type 1, Humans, MEN1, Pituitary Neoplasms, Prolactinoma, Gangliocytoma, Patient affected, Transdifferentiation, Ganglioneuroma, medicine.disease, medicine.anatomical_structure, Cell Transdifferentiation, Cancer research, Surgery, Anatomy, 030217 neurology & neurosurgery
Abstract

Gangliocytomas are rare and benign neuronal cell tumors, mostly found in the hypothalamic and sellar regions. Their histogenesis is still the subject of discussions. Herein we present a unique case of a pituitary gangliocytoma associated with a prolactinoma and a corticotroph adenoma in a patient affected by MEN1. The histologic study revealed shared features between adenomatous and neuronal cells, supporting the etiological hypothesis of a common origin or a phenomenon of transdifferentiation. Furthermore, gangliocytoma could be a new tumor related to MEN1. The clinical and histologic observations are discussed and the literature on the topic is reviewed.

Published
2017

35. Paraneoplastic cerebellar degeneration associated with Anti-ITPR1 antibodies

Author

Bruno Buecher, Lars Komorowski, Dimitri Psimaras, Delphine Leclercq, Jérôme Honnorat, Caroline Dehais, Giulia Berzero, Jean-Yves Delattre, Francesc Graus, Virginie Fourchotte, Madeleine Scharf, Yael Hacohen, Berzero, G., Hacohen, Y., Komorowski, L., Scharf, M., Dehais, C., Leclercq, D., Fourchotte, V., Buecher, B., Honnorat, J., Graus, F., Delattre, J. -Y., and Psimaras, D.

Subjects
0301 basic medicine, Pathology, medicine.medical_specialty, biology, business.industry, Paraneoplastic cerebellar degeneration, medicine.disease, 03 medical and health sciences, 030104 developmental biology, 0302 clinical medicine, Text mining, Neurology, biology.protein, Medicine, Neurology (clinical), Antibody, business, Clinical/Scientific Notes, 030217 neurology & neurosurgery
Published
2017

36. Cerebral tumor or pseudotumor?

Author

S. Trunet, Anne Bertrand, Didier Dormont, Damien Galanaud, Stéphane Lehéricy, Aurélie Drier, Delphine Leclercq, CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Institut du Cerveau et de la Moëlle Epinière = Brain and Spine Institute (ICM), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [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)-Centre National de la Recherche Scientifique (CNRS), Algorithms, models and methods for images and signals of the human brain (ARAMIS), Inria Paris-Rocquencourt, Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut du Cerveau et de la Moëlle Epinière = Brain and Spine Institute (ICM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Institut d’Électronique, de Microélectronique et de Nanotechnologie - UMR 8520 (IEMN), Centrale Lille-Institut supérieur de l'électronique et du numérique (ISEN)-Université de Valenciennes et du Hainaut-Cambrésis (UVHC)-Université de Lille-Centre National de la Recherche Scientifique (CNRS)-Université Polytechnique Hauts-de-France (UPHF), Service de Neuroradiologie [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-CHU Pitié-Salpêtrière [AP-HP], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-CHU Pitié-Salpêtrière [AP-HP]

Subjects
Pathology, medicine.medical_specialty, Sarcoidosis, [SDV.IB.IMA]Life Sciences [q-bio]/Bioengineering/Imaging, [SDV.NEU.NB]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]/Neurobiology, MESH: Brain Diseases, Sensitivity and Specificity, MESH: Prognosis, 030218 nuclear medicine & medical imaging, MESH: Magnetic Resonance Imaging, Lesion, Diagnosis, Differential, 03 medical and health sciences, MESH: Brain, 0302 clinical medicine, MESH: Diagnosis, Differential, Image Interpretation, Computer-Assisted, medicine, Cerebral Tumor, Humans, Radiology, Nuclear Medicine and imaging, Mri scan, Brain Diseases, MESH: Humans, Radiological and Ultrasound Technology, Behçet, business.industry, Brain Neoplasms, Brain, food and beverages, General Medicine, medicine.disease, Image Enhancement, Prognosis, Magnetic Resonance Imaging, MESH: Sensitivity and Specificity, 3. Good health, Histiocytosis, Infectious disease (medical specialty), MESH: Brain Neoplasms, Intracranial lesions, medicine.symptom, Tumour, MESH: Image Enhancement, Vasculitis, business, MESH: Image Interpretation, Computer-Assisted, 030217 neurology & neurosurgery
Abstract

International audience; Pseudotumoral lesions are uncommon but important to identity lesions. They can occur during inflammatory diseases (systemic diseases, vasculitis, demyelinating diseases), infectious, and vascular diseases. Also, in a patient with a treated tumor, pseudo-progression and radionecrosis must be differentiated from the tumoral development. Diagnosis can be difficult on an MRI scan, but some MRI aspects in conventional sequences, diffusion, perfusion and spectroscopy can suggest the pseudotumoral origin of a lesion. Imaging must be interpreted according to the context, the clinic and the biology. The presence of associated intracranial lesions can orientate towards a systemic or infectious disease. A T2 hyposignal lesion suggests granulomatosis or histiocytosis, especially if a meningeal or hypothalamic-pituitary involvement is associated. Non-tumoral lesions are generally not hyperperfused. In the absence of a definitive diagnosis, the evolution of these lesions, whether under treatment or spontaneous, is fundamental.

Published
2014
Full Text
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37. Patterns of response and relapse in primary CNS lymphomas after first-line chemotherapy: imaging analysis of the ANOCEF-GOELAMS prospective randomized trial

Author

Olivier Chinot, Pierre Soubeyran, Marie-Laure Tanguy, Carole Soussain, Hervé Ghesquières, Khê Hoang-Xuan, Emmanuel Gyan, Agusti Alentorn, Antonio Omuro, Marie Blonski, Delphine Leclercq, D. Larrieu, Caroline Houillier, Nadine Martin-Duverneuil, Sylvain Choquet, Remy Gressin, Roch Houot, Emeline Tabouret, and Luc Taillandier

Subjects
Oncology, Cancer Research, medicine.medical_specialty, Pathology, medicine.medical_treatment, Clinical Investigations, Phases of clinical research, Fluid-attenuated inversion recovery, law.invention, Central Nervous System Neoplasms, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, Internal medicine, Antineoplastic Combined Chemotherapy Protocols, medicine, Humans, Progression-free survival, Prospective Studies, Neoplasm Staging, Chemotherapy, medicine.diagnostic_test, business.industry, Lymphoma, Non-Hodgkin, Primary central nervous system lymphoma, Magnetic resonance imaging, medicine.disease, Prognosis, Chemotherapy regimen, Magnetic Resonance Imaging, Survival Rate, Editorial, 030220 oncology & carcinogenesis, Neurology (clinical), Neoplasm Recurrence, Local, business, 030217 neurology & neurosurgery, Follow-Up Studies
Abstract

Our aim was to review MRI characteristics of patients with primary CNS lymphoma (PCNSL) enrolled in a randomized phase II trial and to evaluate their potential prognostic value and patterns of relapse, including T2 fluid attenuated inversion recovery (FLAIR) MRI abnormalities.Neuroimaging findings in 85 patients with PCNSL enrolled in a prospective trial were reviewed blinded to outcomes. MRI characteristics and responses according to International PCNSL Collaborative Group (IPCG) criteria were correlated with progression-free survival (PFS) and overall survival (OS).Multivariate analysis showed that objective response at 2 months (P.001) and at end of treatment (P = .015) were predictors of prolonged OS. Infratentorial location (P = .008) and large (11.4 cm3) enhancing tumor volume (P = .006) were associated with poor OS and PFS, respectively. Ratio of change in product of largest diameters at early MRI evaluation but not timing of complete response achievement (early vs delayed) was prognostic for OS. Sixty-nine patients relapsed. Relapse in the brain (n = 52) involved an initial enhancing site, a different site, or both in 46%, 40%, and 14% of patients, respectively. At baseline, non-enhancing T2-FLAIR hypersignal lesions distant from the enhancing tumor site were detected in 18 patients. These lesions markedly decreased (50%) in 16 patients after chemotherapy, supporting their neoplastic nature. Of these patients, 10/18 relapsed, half (n = 5) in the initially non-enhancing T2-FLAIR lesions.Baseline tumor size and infratentorial localization are of prognostic value in PCNSL. Our findings provide evidence that non-enhancing FLAIR abnormalities may add to overall tumor burden, suggesting that response criteria should be refined to incorporate evaluation of T2-weighted/FLAIR sequences.

Published
2016

38. Neuroimaging features in Posterior Reversible Encephalopathy Syndrome: A Pictorial Review

Author

Frédéric Clarençon, Anne Bertrand, Fanny Domont, Sophie Gerber, S. Trunet, Didier Dormont, Sandrine Deltour, Delphine Leclercq, Morgan Ollivier, CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Département de radiologie [Brest] (DR - Brest), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Algorithms, models and methods for images and signals of the human brain (ARAMIS), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut du Cerveau et de la Moëlle Epinière = Brain and Spine Institute (ICM), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [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)-Centre National de la Recherche Scientifique (CNRS)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [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)-Centre National de la Recherche Scientifique (CNRS)-Inria de Paris, Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria), Institut du Cerveau et de la Moëlle Epinière = Brain and Spine Institute (ICM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), Immunologie - Immunopathologie - Immunothérapie (I3), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Service de Neuroradiologie [CHU Pitié-Salpêtrière], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Inria de Paris, Service des Urgences Cérébro-Vasculaires [CHU Pitié-Salpétriêre], Service d'Immunologie [CHU Pitié-Salpétrière], Service de médecine interne [CHU Pitié-Salpétrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), 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 d'Urgences Cérébro-Vasculaires [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), and bertrand, anne

Subjects
medicine.medical_specialty, Perfusion scanning, Neuroimaging, Hemorrhage, 030218 nuclear medicine & medical imaging, Perfusion Imaging, White matter, Diagnosis, Differential, 03 medical and health sciences, 0302 clinical medicine, medicine, Humans, [SDV.MHEP.OS]Life Sciences [q-bio]/Human health and pathology/Sensory Organs, Eclampsia, medicine.diagnostic_test, business.industry, Brain, Magnetic resonance imaging, Posterior reversible encephalopathy syndrome, medicine.disease, Magnetic Resonance Imaging, 3. Good health, medicine.anatomical_structure, Diffusion Magnetic Resonance Imaging, Neurology, Posterior Leukoencephalopathy Syndrome, [SDV.MHEP.OS] Life Sciences [q-bio]/Human health and pathology/Sensory Organs, Angiography, Arterial Spin-Labeling, Neurology (clinical), Radiology, business, 030217 neurology & neurosurgery
Abstract

International audience; Posterior reversible encephalopathy syndrome (PRES) is a radioclinical entity associating nonspecific neurological symptoms (headache, seizures, impairment of alertness, visual disturbances...) occurring in evocative clinical condition (hypertension, eclampsia, immunosuppressor agents, systemic lupus erythematosus...). In the acute stage, the typical imaging finding is a vasogenic edema predominant in the subcortical parietal-occipital white matter.The purpose of this pictorial review is to illustrate the different neuroimaging features of PRES and present key radiological elements to assert diagnosis. In this overview, we examine the following points: the distributions of vasogenic edema, hemorrhage, the varying patterns in diffusion and perfusion, the different types of enhancement encountered and the vascular modifications demonstrated by angiography. The cause of PRES is still unknown. Nevertheless, catheter angiography, MR angiography and MR perfusion features in PRES render further insight into its pathophysiology.Follow-up imaging shows evidence of radiologic improvement in the very large majority of cases in 1 or 2 weeks, sometimes in up to 1 month. Recurrent PRES attacks are uncommon.Atypical imaging presentation should not reject the diagnosis of PRES in a compatible clinical situation.

Published
2016

39. Extraforaminal Discal Cyst as Cause of Radiculopathy

Author

Bertrand Mathon, Peggy Bienvenot, and Delphine Leclercq

Subjects
Male, medicine.medical_specialty, Nerve root, Arthrodesis, medicine.medical_treatment, 030218 nuclear medicine & medical imaging, Resection, 03 medical and health sciences, 0302 clinical medicine, Lumbar, parasitic diseases, Humans, Medicine, Cyst, Favorable outcome, Intervertebral Disc, Radiculopathy, Lumbar Vertebrae, Cysts, business.industry, Laminectomy, Middle Aged, medicine.disease, Low back pain, Discal cyst, Surgery, Spinal Fusion, Spinal Diseases, Neurology (clinical), Radiology, medicine.symptom, Tomography, X-Ray Computed, business, 030217 neurology & neurosurgery
Abstract

We report the first extraforaminal location of a lumbar discal cyst. The patient was treated by hemilaminectomy, arthrectomy, cyst resection, and unilateral arthrodesis, achieving complete release of the nerve root. Extraforaminal lumbar discal cyst may represent an unexpected cause of sciatic pain with favorable outcome after surgical resection.

Published
2018

40. Crossing the line: Brainstem lesion in a patient with glioblastoma

Author

Clément Cholet, Delphine Leclercq, and Bruno Law-Ye

Subjects
Pathology, medicine.medical_specialty, business.industry, General Medicine, Brainstem lesion, medicine.disease, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, Neurology, 030220 oncology & carcinogenesis, Physiology (medical), medicine, Surgery, Neurology (clinical), Line (text file), business, Neuroscience, 030217 neurology & neurosurgery, Glioblastoma
Published
2017

41. 5th International Symposium on Focused Ultrasound

Author

Menashe Zaaroor, Alon Sinai, Dorit Goldsher, Ayelet Eran, Maria Nassar, Ilana Schlesinger, Jonathon Parker, Vinod Ravikumar, Pejman Ghanouni, Sherman Stein, Casey Halpern, Vibhor Krishna, Amelia Hargrove, Punit Agrawal, Barbara Changizi, Eric Bourekas, Michael Knopp, Ali Rezai, Brian Mead, Namho Kim, Panagiotis Mastorakos, Jung Soo Suk, Wilson Miller, Alexander Klibanov, Justin Hanes, Richard Price, Shutao Wang, Oluyemi Olumolade, Tara Kugelman, Vernice Jackson-Lewis, Maria Eleni Karakatsani, Yang Han, Serge Przedborski, Elisa Konofagou, Kullervo Hynynen, Isabelle Aubert, Gerhard Leinenga, Rebecca Nisbet, Robert Hatch, Anneke Van der Jeugd, Harrison Evans, Jürgen Götz, Ann Van der Jeugd, Paul Fishman, Paul Yarowsky, Victor Frenkel, Shen Wei-Bin, Ben Nguyen, Carlos Sierra Sanchez, Camilo Acosta, Cherry Chen, Shih-Ying Wu, Muna Aryal, Iason T. Papademetriou, Yong-Zhi Zhang, Chanikarn Power, Nathan McDannold, Tyrone Porter, Zsofia Kovacs, Saejeong Kim, Neekita Jikaria, Farhan Qureshi, Michele Bresler, Joseph Frank, Henrik Odéen, George Chiou, John Snell, Nick Todd, Bruno Madore, Dennis Parker, Kim Butts Pauly, Mike Marx, Sumeeth Jonathan, William Grissom, Costas Arvanitis, Gregory Clement, Joshua de Bever, Allison Payne, Douglas Christensen, Guillaume Maimbourg, Mathieu David Santin, Alexandre Houdouin, Stéphane Lehericy, Mickael Tanter, Jean Francois Aubry, Christian Federau, Beat Werner, Dong-Guk Paeng, Zhiyuan Xu, Anders Quigg, Matt Eames, Changzhu Jin, Ashli Everstine, Jason Sheehan, M. Beatriz Lopes, Neal Kassell, James Drake, Karl Price, Lior Lustgarten, Vivian Sin, Charles Mougenot, Elizabeth Donner, Emily Tam, Mojgan Hodaie, Adam Waspe, Thomas Looi, Samuel Pichardo, Wonhye Lee, Yong An Chung, Yujin Jung, In-Uk Song, Seung-Schik Yoo, Hyun-Chul Kim, Jong-Hwan Lee, Charles Caskey, Wolf Zinke, Josh Cosman, Jillian Shuman, Jeffrey Schall, Christian Aurup, Hong Chen, Hermes Kamimura, Antonio Carneiro, Tao Sun, Navid Nazai, Sam Patz, Margaret Livingstone, Todd Mainprize, Yuexi Huang, Ryan Alkins, Martin Chapman, James Perry, Nir Lipsman, Allison Bethune, Arjun Sahgal, Maureen Trudeau, Hao-Li Liu, Po-Hung Hsu, Kuo-Chen Wei, Jonathan Sutton, Phillip Alexander, Eric Miller, Thiele Kobus, Alexandre Carpentier, Michael Canney, Alexandre Vignot, Kevin Beccaria, Delphine Leclercq, Cyril Lafon, Jean Yves Chapelon, Khe Hoang-Xuan, Jean-Yves Delattre, Ahmed Idbaih, David Moore, Alexis Xu, Paul Schmitt, Jessica Foley, Jonathan Sukovich, Charles Cain, Aditya Pandey, Neeraj Chaudhary, Sandra Camelo-Piragua, Steven Allen, Jon Cannata, Dejan Teofilovic, Jim Bertolina, Timothy Hall, Zhen Xu, Julien Grondin, Vincent Ferrera, Gail ter Haar, Petros Mouratidis, Elizabeth Repasky, Kelsie Timbie, Lena Badr, Benjamin Campbell, John McMichael, Andrew Buckner, Jessica Prince, Aaron Stevens, Timothy Bullock, Karin Skalina, Chandan Guha, Franco Orsi, Guido Bonomo, Paolo Della Vigna, Giovanni Mauri, Gianluca Varano, George Schade, Yak-Nam Wang, Venu Pillarisetty, Joo Ha Hwang, Vera Khokhlova, Michael Bailey, Tatiana Khokhlova, Ilya Sinilshchikov, Petr Yuldashev, Yulia Andriyakhina, Wayne Kreider, Adam Maxwell, Oleg Sapozhnikov, Ari Partanen, Jonathan Lundt, Tobias Preusser, Sabrina Haase, Mario Bezzi, Jürgen Jenne, Thomas Langø, Massimo Midiri, Michael Mueller, Giora Sat, Christine Tanner, Stephan Zangos, Matthias Guenther, Andreas Melzer, Arianna Menciassi, Selene Tognarelli, Andrea Cafarelli, Alessandro Diodato, Gastone Ciuti, Sven Rothluebbers, Julia Schwaab, Jan Strehlow, Senay Mihcin, Steffen Tretbar, Thomas Payen, Carmine Palermo, Steve Sastra, Kenneth Olive, Matthew Adams, Vasant Salgaonkar, Serena Scott, Graham Sommer, Chris Diederich, Joan Vidal-Jove, Eloi Perich, Antonio Ruiz, Manuela Velat, David Melodelima, Aurelien Dupre, Jeremy Vincenot, Chen Yao, David Perol, Michel Rivoire, Samantha Tucci, Lisa Mahakian, Brett Fite, Elizabeth Ingham, Sarah Tam, Chang-il Hwang, David Tuveson, Katherine Ferrara, Stephen Scionti, Lili Chen, Dusica Cvetkovic, Xiaoming Chen, Roohi Gupta, Bin Wang, Charlie Ma, Kenneth Bader, Kevin Haworth, Christy Holland, Narendra Sanghvi, Roy Carlson, Wohsing Chen, Christian Chaussy, Stefan Thueroff, Claudio Cesana, Carlo Bellorofonte, Qingguo Wang, Han Wang, Shengping Wang, Junhai Zhang, Alberto Bazzocchi, Alessandro Napoli, Robert Staruch, Chenchen Bing, Sumbul Shaikh, Joris Nofiele, Debra Szczepanski, Michelle Wodzak Staruch, Noelle Williams, Theodore Laetsch, Rajiv Chopra, Jarrett Rosenberg, Rachelle Bitton, Suzanne LeBlang, Joshua Meyer, Mark Hurwitz, Pavel Yarmolenko, Haydar Celik, Avinash Eranki, Viktoriya Beskin, Domiciano Santos, Janish Patel, Matthew Oetgen, AeRang Kim, Peter Kim, Karun Sharma, Alexander Chisholm, Dionne Aleman, Roberto Scipione, Michael Temple, Joao Guilherme Amaral, Ruby Endre, Maria Lamberti-Pasculli, Joost de Ruiter, Fiona Campbell, Jennifer Stimec, Samit Gupta, Manoj Singh, Sevan Hopyan, Gregory Czarnota, David Brenin, Carrie Rochman, Roussanka Kovatcheva, Jordan Vlahov, Katja Zaletel, Julian Stoinov, Matthew Bucknor, Viola Rieke, Jenny Shim, Korgun Koral, Brian Lang, Carlos Wong, Heather Lam, Alexander Shinkov, Jim Hu, Xi Zhang, Jonathan Macoskey, Kimberly Ives, Gabe Owens, Hitinder Gurm, Jiaqi Shi, Matthew Pizzuto, Christopher Dillon, Ivy Christofferson, Elaine Hilas, Jill Shea, Paul Greillier, Bénédicte Ankou, Francis Bessière, Ali Zorgani, Mathieu Pioche, Wojciech Kwiecinski, Julie Magat, Sandrine Melot-Dusseau, Romain Lacoste, Bruno Quesson, Mathieu Pernot, Stefan Catheline, Philippe Chevalier, Fabrice Marquet, Pierre Bour, Fanny Vaillant, Sana Amraoui, Rémi Dubois, Philippe Ritter, Michel Haïssaguerre, Mélèze Hocini, Olivier Bernus, Pamela Tebebi, Scott Burks, Blerta Milo, Michael Gertner, Jimin Zhang, Andrew Wong, Yu Liu, Azadeh Kheirolomoom, Jai Seo, Katherine Watson, Hua Zhang, Josquin Foiret, Alexander Borowsky, Doudou Xu, Maya Thanou, Miguell Centelles, Mike Wright, Maral Amrahli, Po-Wah So, Wladyslaw Gedroyc, Esther Kneepkens, Edwin Heijman, Jochen Keupp, Steffen Weiss, Klaas Nicolay, Holger Grüll, Matthew Nagle, Anastasia V. Nikolaeva, Marina E. Terzi, Sergey A. Tsysar, Bryan Cunitz, Pierre Mourad, Matthew Downs, Georgiana Yang, Qi Wang, Johnny Chen, Justin Farry, Adam Dixon, Zhongmin Du, Ali Dhanaliwala, John Hossack, Ashish Ranjan, Danny Maples, Rachel Wardlow, Jerry Malayer, Akhilesh Ramachandran, Hirofumi Namba, Motohiro Kawasaki, Masashi Izumi, Katsuhito Kiyasu, Ryuichi Takemasa, Masahiko Ikeuchi, Takahiro Ushida, Calum Crake, Satya V. V. N. Kothapalli, Wan Leighton, Zhaorui Wang, H. Michael Gach, William Straube, Michael Altman, Young-sun Kim, Hyo Keun Lim, Hyunchul Rhim, Johanna van Breugel, Manon Braat, Chrit Moonen, Maurice van den Bosch, Mario Ries, Cristina Marrocchio, Susan Dababou, Jae Young Lee, Hyun Hoon Chung, Soo Yeon Kang, Kook Jin Kang, Keon Ho Son, Dandan Zhang, Juan Plata, Peter Jones, Aurea Pascal-Tenorio, Donna Bouley, Aaron Bond, Robert Dallapiazza, Diane Huss, Amy Warren, Scott Sperling, Ryder Gwinn, Binit Shah, W. Jeff Elias, Colleen Curley, Ying Zhang, Karina Negron, Roger Abounader, Gesthimani Samiotaki, Tsang-Wei Tu, Georgios Papadakis, Dima Hammoud, Matthew Silvestrini, Frank Wolfram, Daniel Güllmar, Juergen Reichenbach, Denis Hofmann, Joachim Böttcher, Harald Schubert, Thomas G. Lesser, Scott Almquist, Francisco Camarena, Sergio Jiménez-Gambín, Noé Jiménez, Jin Woo Chang, Vandiver Chaplin, Rebekah Griesenauer, Michael Miga, Nicholas Ellens, Raag Airan, Alfredo Quinones-Hinojosa, Keyvan Farahani, Xue Feng, Samuel Fielden, Li Zhao, Max Wintermark, Craig Meyer, Sijia Guo, Xin Lu, Jiachen Zhuo, Su Xu, Rao Gullapalli, Dheeraj Gandhi, Omer Brokman, Hongchae Baek, Hyungmin Kim, Steven Leung, Taylor Webb, Natalia Vykhodtseva, Thai-Son Nguyen, Chang Kyu Park, Sang Man Park, Na Young Jung, Min Soo Kim, Won Seok Chang, Hyun Ho Jung, Michael Plaksin, Yoni Weissler, Shy Shoham, Eitan Kimmel, Pavel B. Rosnitskiy, Steve Krupa, Eilon Hazan, Omer Naor, Yoav Levy, Noam Maimon, Inbar Brosh, Itamar Kahn, Jessica Cahill, Elodie Constanciel Colas, Adrian Wydra, Roman Maev, Amirah Aly, Ozge Sesenoglu-Laird, Linas Padegimas, Mark Cooper, Barbara Waszczak, Seruz Tehrani, Craig Slingluff, James Larner, Kumari Andarawewa, Eugene Ozhinsky, Rutwik Shah, Roland Krug, Roel Deckers, Sabine Linn, Britt Suelmann, Arjen Witkamp, Paul Vaessen, Paul van Diest, Lambertus W. Bartels, Clemens Bos, Nicolas Borys, Gert Storm, Elsken Van der Wall, Navid Farr, Moez Alnazeer, Prateek Katti, Bradford Wood, Alexis Farrer, Cyril Ferrer, Baudouin Denis de Senneville, Marijn van Stralen, Jingfei Liu, J. Kent Leach, Stephan Zidowitz, Hsin-Lun Lee, Fang-Chi Hsu, Chia-Chun Kuo, Shiu-Chen Jeng, Tung-Ho Chen, Nai-Yi Yang, Jeng-Fong Chiou, Yi-tzu Kao, Chia-Hsin Pan, Jing-Fu Wu, Yi-Chieh Tsai, Sara Johnson, Dawei Li, Ye He, Ioannis Karakitsios, Michael Schwenke, Daniel Demedts, Xu Xiao, Ian Cavin, Emilee Minalga, Robb Merrill, Rock Hadley, Pascal Ramaekers, Martijn de Greef, Kian Shahriari, Mohammad Hossein Parvizi, Kiana Asadnia, Marzieh Chamanara, Seyed Kamran Kamrava, Hamid Reza Chabok, Ruben Stein, Sébastien Muller, Jeremy Tan, Cornel Zachiu, Hans-Peter Erasmus, Glen Van Arsdell, Lee Benson, Kee W. Jang, Mary Angstadt, Bobbi Lewis, Hailey McLean, Martijn Hoogenboom, Dylan Eikelenboom, Martijn den Brok, Pieter Wesseling, Arend Heerschap, Jurgen Fütterer, Gosse Adema, Kevin Wang, Pei Zhong, Joyce Joy, Helen McLeod, Harry Kim, Matthew Lewis, Arda Ozilgen, Peter Zahos, Dezba Coughlin, Xinyan Tang, Jeff Lotz, Kathleen Jedruszczuk, Amitabh Gulati, Stephen Solomon, Elena Kaye, John Mugler, Gaetano Barbato, Gian Luca Scoarughi, Cristiano Corso, Alessandro Gorgone, Ilaria Giuseppina Migliore, Zachary Larrabee, Arik Hananel, Jean-Francois Aubry, Ayele Negussie, Emmanuel Wilson, Reza Seifabadi, Hyungwon Moon, Jeeun Kang, Changbeom Sim, Jin Ho Chang, Hyuncheol Kim, Hak Jong Lee, Noboru Sasaki, Mitsuyoshi Takiguchi, Lukas Sebeke, Xi Luo, Bram de Jager, Maurice Heemels, Christopher Abraham, Laura Curiel, Rémi Berriet, Margit Janát-Amsbury, Joseph Corea, Patrick Peiyong Ye, Ana Clauda Arias, Micheal Lustig, and Bryant Svedin

Subjects
Pathology, medicine.medical_specialty, business.industry, Blood–brain barrier, Focused ultrasound, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, Disease therapy, 0302 clinical medicine, medicine.anatomical_structure, medicine, Radiology, Nuclear Medicine and imaging, business, 030217 neurology & neurosurgery
Published
2016

42. Pituitary Apoplexy Mimicking Bacterial Meningitis with Intracranial Hypertension

Author

Bruno Law-Ye, Nadya Pyatigorskaya, and Delphine Leclercq

Subjects
Adult, medicine.medical_specialty, law.invention, Meningitis, Bacterial, Diagnosis, Differential, 03 medical and health sciences, 0302 clinical medicine, Pituitary adenoma, law, Osmotherapy, Medicine, Humans, Pituitary Neoplasms, medicine.diagnostic_test, business.industry, Lumbar puncture, Pituitary apoplexy, Meningoencephalitis, 030208 emergency & critical care medicine, medicine.disease, Intensive care unit, Surgery, medicine.anatomical_structure, Anesthesia, Neurology (clinical), Subarachnoid space, Intracranial Hypertension, business, Meningitis, Pituitary Apoplexy, 030217 neurology & neurosurgery
Abstract

Case Description A 29-year-old patient experienced a violent headache during bodybuilding exercises. Brain magnetic resonance imaging revealed diffuse meningitis and a 38-mm necrotic pituitary adenoma. Meningoencephalitis was suspected but was ruled out by lumbar puncture. Rapid deterioration of the patient's condition led to coma and oxygen desaturation secondary to intracranial hypertension. Intense treatment for intracranial hypertension included profound sedation with respiratory assistance, osmotherapy, hypothermia, and external ventricular drainage. After 4 weeks in the intensive care unit, the patient fully recovered and was discharged with hormonal supplementation. Conclusions The few reported cases of pituitary apoplexy mimicking bacterial meningoencephalitis may have resulted from blood leakage or necrosis into the subarachnoid space.

Published
2016

43. Clinical trial of blood-brain barrier disruption by pulsed ultrasound

Author

Khê Hoang-Xuan, Delphine Leclercq, Laurent Capelle, Cyril Lafon, Catherine Horodyckid, Marc Sanson, Jean-Yves Chapelon, Philippe Cornu, Alexandre Vignot, Kevin Beccaria, Ahmed Idbaih, Vincent Reina, Carine Karachi, Alexandre Carpentier, Michael Canney, and Jean-Yves Delattre

Subjects
0301 basic medicine, Drug, Male, medicine.medical_specialty, Pathology, media_common.quotation_subject, medicine.medical_treatment, Carboplatin, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, medicine, Humans, Adverse effect, media_common, Chemotherapy, Microbubbles, medicine.diagnostic_test, business.industry, Ultrasound, Brain, Magnetic resonance imaging, General Medicine, Magnetic Resonance Imaging, Clinical trial, 030104 developmental biology, chemistry, Ultrasonic Waves, Blood-Brain Barrier, Female, Radiology, business, Glioblastoma, 030217 neurology & neurosurgery
Abstract

The blood-brain barrier (BBB) limits the delivery of systemically administered drugs to the brain. Methods to circumvent the BBB have been developed, but none are used in standard clinical practice. The lack of adoption of existing methods is due to procedural invasiveness, serious adverse effects, and the complications associated with performing such techniques coincident with repeated drug administration, which is customary in chemotherapeutic protocols. Pulsed ultrasound, a method for disrupting the BBB, was shown to effectively increase drug concentrations and to slow tumor growth in preclinical studies. We now report the interim results of an ultrasound dose-escalating phase 1/2a clinical trial using an implantable ultrasound device system, SonoCloud, before treatment with carboplatin in patients with recurrent glioblastoma (GBM). The BBB of each patient was disrupted monthly using pulsed ultrasound in combination with systemically injected microbubbles. Contrast-enhanced magnetic resonance imaging (MRI) indicated that the BBB was disrupted at acoustic pressure levels up to 1.1 megapascals without detectable adverse effects on radiologic (MRI) or clinical examination. Our preliminary findings indicate that repeated opening of the BBB using our pulsed ultrasound system, in combination with systemic microbubble injection, is safe and well tolerated in patients with recurrent GBM and has the potential to optimize chemotherapy delivery in the brain.

Published
2016

44. Social Cognition and Emotional Assessment (SEA) is a Marker of Medial and Orbital Frontal Functions: A Voxel-Based Morphometry Study in Behavioral Variant of Frontotemporal Degeneration

Author

Emmanuelle Volle, Maxime Bertoux, Delphine Leclercq, Aurélie Funkiewiez, Leonardo Cruz de Souza, and Bruno Dubois

Subjects
Male, Statistics as Topic, Theory of Mind, Neuropsychological Tests, behavioral disciplines and activities, Imaging, Three-Dimensional, Theory of mind, Avoidance Learning, medicine, Humans, Apathy, Affective Symptoms, Social Behavior, Prefrontal cortex, Aged, Aged, 80 and over, Psychiatric Status Rating Scales, General Neuroscience, Recognition, Psychology, Frontotemporal lobar degeneration, Voxel-based morphometry, Middle Aged, medicine.disease, Magnetic Resonance Imaging, Frontal Lobe, Psychiatry and Mental health, Clinical Psychology, nervous system, Frontal lobe, Female, Neurology (clinical), Frontotemporal Lobar Degeneration, medicine.symptom, Cognition Disorders, Psychology, Neuroscience, Frontotemporal dementia, Brodmann area
Abstract

The aim of this study was to explore the cerebral correlates of functional deficits that occur in behavioral variant frontotemporal dementia (bvFTD). A specific neuropsychological battery, the Social cognition & Emotional Assessment (SEA; Funkiewiez et al., 2012), was used to assess impaired social and emotional functions in 20 bvFTD patients who also underwent structural MRI scanning. The SEA subscores of theory of mind, reversal-learning tests, facial emotion identification, and apathy evaluation were entered as covariates in a voxel-based morphometry analysis. The results revealed that the gray matter volume in the rostral part of the medial prefrontal cortex [mPFC, Brodmann area (BA) 10] was associated with scores on the theory of mind subtest, while gray matter volume within the orbitofrontal (OFC) and ventral mPFC (BA 11 and 47) was related to the scores observed in the reversal-learning subtest. Gray matter volume within BA 9 in the mPFC was correlated with scores on the emotion recognition subtest, and the severity of apathetic symptoms in the Apathy scale covaried with gray matter volume in the lateral PFC (BA 44/45). Among these regions, the mPFC and OFC cortices have been shown to be atrophied in the early stages of bvFTD. In addition, SEA and its abbreviated version (mini-SEA) have been demonstrated to be sensitive to early impairments in bvFTD (Bertoux et al., 2012). Taken together, these results suggest a differential involvement of orbital and medial prefrontal subregions in SEA subscores and support the use of the SEA to evaluate the integrity of these regions in the early stages of bvFTD. (JINS, 2012, 18, 972–985)

Published
2012

45. EpiBrainRad An epidemiologic study of the neurotoxicity induced by radiotherapy in high grade glioma patients

Author

Jean-Yves Delattre, Delphine Leclercq, Radia Tamarat, Hassen Douzane, Thomas Durand, Georges Noël, Nicolas Vayatis, Fabien Milliat, Amithys Rahimian, Bruno Brochet, Damien Ricard, Sophie Jacob, Marc Benderitter, Khê Hoang-Xuan, Loïc Feuvret, Laura Lebouil, Philippe Lestaevel, Dimitri Psimaras, Marie-Odile Bernier, Cognition and Action Group (COGNAC-G - UMR 8257), Centre National de la Recherche Scientifique (CNRS)-Université de Paris (UP), Laboratoire de Radiopathologie et Thérapies Expérimentales [IRSN, Fontenay-aux-Roses] (PRP-HOM - SRBE), Institut de Radioprotection et de Sûreté Nucléaire (IRSN), PRP-HOM/SRBE/LRTOX, Institut du Cerveau et de la Moëlle Epinière = Brain and Spine Institute (ICM), Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), Groupe hospitalier Pellegrin, Centre de Mathématiques et de Leurs Applications (CMLA), and École normale supérieure - Cachan (ENS Cachan)-Centre National de la Recherche Scientifique (CNRS)

Subjects
Adult, Male, Oncology, medicine.medical_specialty, medicine.medical_treatment, [SDV]Life Sciences [q-bio], Population, Clinical Neurology, Leukoencephalopathy, Study Protocol, 03 medical and health sciences, 0302 clinical medicine, Leukoencephalopathies, Internal medicine, Temozolomide, Neurotoxicity, medicine, Humans, Prospective Studies, Cognitive skill, Prospective cohort study, education, Antineoplastic Agents, Alkylating, education.field_of_study, Radiotherapy, Brain Neoplasms, business.industry, Cognition, Glioma, General Medicine, medicine.disease, 3. Good health, Cognitive test, Surgery, Dacarbazine, Radiation therapy, Early Diagnosis, Chemotherapy, Adjuvant, 030220 oncology & carcinogenesis, Female, Quality-of-life, Neurology (clinical), Neurosurgery, Cognition Disorders, business, Cognitive impairments, 030217 neurology & neurosurgery, Follow-Up Studies
Abstract

International audience; Background Radiotherapy is one of the most important treatments of primary and metastatic brain tumors. Unfortunately, it can involve moderate to severe complications among which leukoencephalopathy is very frequent and implies cognitive deficits such as memory, attention and executive dysfunctions. However, the incidence of this complication is not well established and the risk factors and process are poorly understood. The main objective of the study is to improve knowledge on radio-induced leukoencephalopathy based on pluridisciplinar approaches combining cognitive, biologic, imagery and dosimetric investigations. Method/Design The EpiBrainRad study is a prospective cohort study including newly diagnosed high grade gliomas patients treated by radiotherapy and concomitant-adjuvant temozolomide chemotherapy. Patients are included between their surgery and first day of radio-chemotherapy, and the follow-up lasts for 3 years after treatment. Cognitive functioning assessments, specific blood biomarkers measures and magnetic resonance imagery are performed at different moment during the follow-up, and a specific dosimetric assessment of organs involved in the beam fields is performed. Firstly, leukoencephalopathy incidence rate will be estimated in this population. Secondly, correlations between cognitive impairments and dosimetry, biomarkers ranges and anomalies on imagery will be analyzed in order to better understand the onset and evolution of cognitive decrement associated with radiotherapy. Furthermore, a new cognitive test, quickly and easily performed, will be studied to determine its sensibility to detect leukoencephalopathy decrement. Discussion With an original multidisciplinary approach, the EpiBrainRad study aims to improve knowledge on radio-induced leukoencephalopathy in order to improve its early diagnosis and prevention. The main challenge is to preserve quality-of-life after cancer treatments which imply to study the incidence of radiation-induced complications and their associated risk factors. Trial Registration NCT02544178 © 2015 Durand et al.

Published
2015

46. Letter to the Editor: Can Vagus Nerve Schwannoma Masquerade as a Carotid Chemodectoma?

Author

Didier Dormont, Joseph Benzakoun, Clément Cholet, S. Trunet, Delphine Leclercq, Bruno Law-Ye, and Nadya Pyatigorskaya

Subjects
medicine.medical_specialty, Letter to the editor, business.industry, General surgery, 030206 dentistry, Schwannoma, medicine.disease, 030218 nuclear medicine & medical imaging, Vagus nerve, 03 medical and health sciences, Plastic surgery, 0302 clinical medicine, Otorhinolaryngology, medicine, Oral and maxillofacial surgery, Surgery, Oral Surgery, Chemodectoma, business, Letter to the Editor
Published
2017

47. Arterial Spin Labeling Hypoperfusion in Migraine Aura

Author

Delphine Leclercq, Bruno Law-Ye, and Guillaume Fargeot

Subjects
0301 basic medicine, medicine.medical_specialty, Aura, business.industry, 030105 genetics & heredity, medicine.disease, 03 medical and health sciences, 0302 clinical medicine, Neurology, Cerebral blood flow, Migraine, Internal medicine, Arterial spin labeling, medicine, Cardiology, Neurology (clinical), business, Migraine aura, Perfusion, 030217 neurology & neurosurgery, Diffusion MRI
Published
2017

48. Diffusion Tractography: Methods, Validation and Applications in Patients with Neurosurgical Lesions

Author

Jacques Chiras, Stéphane Lehéricy, Nicolas Menjot de Champfleur, Delphine Leclercq, and Christine Delmaire

Subjects
medicine.medical_specialty, Neuronavigation, Pyramidal Tracts, Brain tumor, behavioral disciplines and activities, Brain mapping, Neurosurgical Procedures, White matter, Nerve Fibers, Image Processing, Computer-Assisted, medicine, Humans, Medical physics, In patient, Diffusion Tractography, Brain Mapping, Brain Neoplasms, business.industry, Reproducibility of Results, General Medicine, medicine.disease, Diffusion Tensor Imaging, medicine.anatomical_structure, nervous system, Surgery, Neurology (clinical), Radiology, Artifacts, business, Diffusion MRI, Tractography
Abstract

Diffusion tensor imaging (DTI) tractography is increasingly used in presurgical mapping in tumors located in eloquent areas since it is the only non invasive technique that permits in vivo dissection of white matter tracts. Concordance between the DTI tracts and subcortical electrical intraoperative mapping is high, and DTI tractography has proven useful to guide surgery. However, it presents limitations due to the technique and the tumor, which must be known before using the images in the operative room. This review focuses on the possibilities and limits of DTI imaging in intraoperative tumoral mapping and presents an overview of current knowledge.

Published
2011

49. Safety and preliminary efficacy data from a phase I study of an implantable low intensity pulsed ultrasound (LIPU) device for disrupting the blood-brain barrier (BBB) in patients treated by chemotherapy for recurrent glioblastoma (GBM)

Author

Alexandre Carpentier, Caroline Dehais, Michael Canney, Yann De Ricke, Lisa Belin, Khê Hoang-Xuan, Alexandre Vignot, Jean-Yves Delattre, Florence Laigle-Donadey, Carole Desseaux, Caroline Houillier, Delphine Leclercq, Bruno Law-Ye, Anne Bissery, Marc Sanson, and Ahmed Idbaih

Subjects
0301 basic medicine, Cancer Research, Chemotherapy, Blocking (radio), business.industry, medicine.medical_treatment, Recurrent glioblastoma, 02 engineering and technology, Low-intensity pulsed ultrasound, 021001 nanoscience & nanotechnology, Blood–brain barrier, Phase i study, 03 medical and health sciences, 030104 developmental biology, medicine.anatomical_structure, Oncology, medicine, Cancer research, In patient, 0210 nano-technology, business
Abstract

2016Background: The BBB limits the efficacy of many chemotherapies in GBM patients by blocking the passage of drugs to the brain. Two to four minutes of LIPU in combination with injection of micron...

Published
2018

50. Phénotypes radiologiques de la leucodystrophie dans la maladie de Krabbe débutant à l’âge adulte : étude d’une cohorte multicentrique internationale de 21 cas

Author

Rabab Debs, Nadya Pyatigorskaya, Louis Cousyn, Bruno Law, Delphine Leclercq, and Yann Nadjar

Subjects
Neurology, Neurology (clinical)
Abstract

Introduction La presentation radiologique de la maladie de Krabbe (MK) debutant a l’âge adulte differe des formes plus precoces. Nous ne disposons que de peu de donnees dans la litterature, principalement a travers des rapports de cas. Objectifs Nous proposons de realiser la premiere analyse systematique des IRM cerebrales a l’aide d’une cohorte multicentrique internationale, afin de decrire les phenotypes radiologiques de la leucodystrophie de la MK debutant a l’âge adulte. Methodes Les auteurs ayant publie des cas ont ete contactes afin de remplir un questionnaire clinique et partager les premieres images IRM. Seuls les patients avec symptomes apparus apres l’âge de 10 ans et une MK confirmee ont ete inclus. Un score radiologique des hypersignaux de la substance blanche (HSB) a ete elabore (BLY, YN), puis les images ont ensuite ete cotees separement par deux neuro-radiologues (DL, NP), le score final etant etabli par consensus. Resultats Au total, 21 patients ont ete inclus. L’atteinte du faisceau corticospinal (FCS) etait constante mais inhomogene predominant en proximal : gyrus precentral medial (100 % des patients, score moyen 2,9/4), lateral (76,2 %, 2,4/4), corona radiata (95,2 %, 1,8/2), bras posterieur de la capsule interne (81 %, 1,8/2) et tronc cerebral ( Discussion 15 patients (71,4 %) avait une profil d’HSB typique, avec atteinte limitee aux regions les plus frequemment touchees. Trois (14,3 %) avaient des HSB plus diffus, 2 (9,5 %) avaient des HSB plus patchy et 1 (4,8 %) un profil atypique avec une atteinte subtile du FCS. Dans chaque profil, l’atteinte du FCS proximal, de la jonction temporo-parietale, des radiations optiques, de l’isthme du corps calleux et du lemnisque median demeure frequente. Conclusion Une leucodystrophie associant une atteinte du FCS proximal, de la jonction temporo-parietale, des radiations optiques, de l’isthme du corps calleux et du lemnisque median est tres evocatrice d’une MK debutant a l’âge adulte, que les HSB soient localises, diffus ou patchy.

Published
2018

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