Search

Fanny Levy,1 Pierre Leboucher,2 Gilles Rautureau,2 Odile Komano,2 Bruno Millet,1 Roland Jouvent1 1Department of Adults Psychiatry, 2PRISME-Virtual Reality, ICM-A- IHU, UPMC UMR_S 975, Inserm U 1127, CNRS UMR 7225, GH Pitié-Salpêtrière, Paris, France Objective: Fear of falling is defined as an ongoing concern about falling that is not explained by physical examination. Focusing on the psychological dimension of this pathology (phobic reaction to walking), we looked at how virtual reality associated with serious games can be used to treat this pathology.Methods: Participants with fear of falling were randomly assigned to either a treatment group or a waiting list. The therapy consisted of 12 weekly sessions of virtual reality exposure therapy associated with serious games.Results: Sixteen participants were included. The mean age of the treatment group was 72 years and that of the control group was 69 years. Participants’ scores on the fear of falling measure improved after treatment with virtual reality associated with serious games, leading to a significant difference between the two groups.Conclusion: Virtual reality exposure therapy associated with serious games can be used in the treatment of fear of falling. The two techniques are complementary (top-down and bottom-up processes). To our knowledge, this is the first time that a combination of the two has been assessed. There was a specific effect of this therapy on the phobic reaction. Further studies are needed to confirm its efficacy and identify its underlying mechanism. Keywords: fear of falling, virtual reality exposure therapy, serious games, phobia, anxiety disorders

Alain Gérard,1 François Liard,2 Anne Crochard,3 Sylvia Goni,3 Bruno Millet41Rue des Marronniers’ Psychiatry Clinic, Paris; 2General Practice, Saint Epain, 3Medical Affairs Department, Laboratoire Lundbeck SAS, Issy-Les-Moulineaux, 4Psychiatry Department, Guillaume Regner University Hospital, University of Rennes 1, Rennes, FranceBackground: The primary objective of this prospective observational study was to evaluate changes in self-reported disability in patients with anxiety or mood disorders 3 months after initiating antidepressant treatment.Methods: This study included 8396 patients consulting 2433 general practitioners in France for a major mood episode, generalized anxiety disorder, social anxiety disorder, panic disorder, or obsessive-compulsive disorder. Treatment was initiated with the antidepressant that the physician considered appropriate. Patients were evaluated with the Sheehan Disability Scale (SDS), Hospital Anxiety and Depression Scale, and Clinical Global Impression-Severity (CGI-S) at baseline and after 6 and 12 weeks.Results: At 12 weeks, 6617 patients (78.8%) were evaluable. At inclusion, the mean SDS subscores were 6.5 ± 2.2 on the work/school activities dimension, 6.8 ± 1.9 on the social activities dimension, and 6.5 ± 2.0 on the family life dimension. At the 12-week follow-up visit, the mean change in score on these three dimensions was -3.9 ± 2.6, -4.2 ± 2.5, and -4.0 ± 2.5, respectively. At the 12-week follow-up visit, 90.0% of patients were responders (defined as patients whose SDS dimension scores decreased by at least one point) on the work/school SDS subscores; 92.8% were responders on the social life SDS subscores, and 91.1% were responders on family life/home responsibilities SDS subscores. Functional remission (defined as an SDS subscore of 0 at study end) rates were 18.0% for the work/school dimension, 16.8% for the social activities dimension, and 19.5% for the family life dimension. Using a cutoff of ≤2, remission rates were 56.8%, 55.0%, and 58.0%, respectively. Improvements in self-rated disability were correlated with improvements in symptoms measured with clinician-rated CGI-S.Conclusion: Patients consulting for anxiety or mood disorders report significant disability, which can be effectively reduced by antidepressant treatment.Keywords: depression, anxiety disorder, antidepressant, disability

The Methane Remote Sensing Lidar Mission (MERLIN), currently in phase B, is a joint cooperation between France and Germany on the development, launch and operation of a methane (CH4) monitoring satellite. MERLIN is focused on global measurements of the spatial and temporal gradients of atmospheric CH4, the second most anthropogenic gas, with a precision and accuracy sufficient to constrain Methane fluxes significantly better than with the current observation network. For the first time, measurements of atmospheric composition will be performed from space thanks to an IPDA (Integrated Path Differential Absorption) LIDAR (Light Detecting And Ranging). This payload is under the responsibility of the German space agency (DLR), while the platform (MYRIADE Evolutions product line) is developed by the French space agency (CNES). The IPDA technique relies on DIAL (Differential Absorption LIDAR) measurements using a pulsed laser emitting at two wavelengths, one wavelength accurately locked on a spectral feature of the methane absorption line, and the other wavelength free from absorption to be used as reference. This technique enables measurements in all seasons, at all latitudes. It also guarantees almost no contamination by aerosols or water vapour cross-sensitivity, and thus has the advantage of an extremely low level of systematic error on the dry-air column mixing ratio of CH4.

Aim: The aim of this paper is to describe the clinical features of COVID‐19‐related encephalopathy and their metabolic correlates using brain 2‐desoxy‐2‐fluoro‐D‐glucose (FDG)‐positron‐emission tomography (PET)/computed tomography (CT) imaging. Background and purpose: A variety of neurological manifestations have been reported in association with COVID‐19. COVID‐19‐related encephalopathy has seldom been reported and studied. Methods: We report four cases of COVID‐19‐related encephalopathy. The diagnosis was made in patients with confirmed COVID‐19 who presented with new‐onset cognitive disturbances, central focal neurological signs, or seizures. All patients underwent cognitive screening, brain magnetic resonance imaging (MRI), lumbar puncture, and brain 2‐desoxy‐2‐fluoro‐D‐glucose (FDG)‐positron‐emission tomography (PET)/computed tomography (CT) (FDG‐PET/CT). Results: The four patients were aged 60 years or older, and presented with various degrees of cognitive impairment, with predominant frontal lobe impairment. Two patients presented with cerebellar syndrome, one patient had myoclonus, one had psychiatric manifestations, and one had status epilepticus. The delay between first COVID‐19 symptoms and onset of neurological symptoms was between 0 and 12 days. None of the patients had MRI features of encephalitis nor significant cerebrospinal fluid (CSF) abnormalities. SARS‐CoV‐2 RT‐PCR in the CSF was negative for all patients. All patients presented with a consistent brain FDG‐PET/CT pattern of abnormalities, namely frontal hypometabolism and cerebellar hypermetabolism. All patients improved after immunotherapy. Conclusions: Despite varied clinical presentations, all patients presented with a consistent FDG‐PET pattern, which may reflect an immune mechanism. [ABSTRACT FROM AUTHOR]