Response: A. Peskine, A. Cariou, D. Hajage, et al.Long-term disabilities of survivors of out-of-hospital cardiac arrest: the Hanox studyChest, 159 (2) (2021), pp. 699-711

International audienceNo abstract availabl

Evaluation par une batterie écologique du maniement des données chiffrées chez les patients aphasiques vasculaires

Les patients aphasiques après lésion vasculaire cérébrale présentent souvent des troubles de la manipulation des chiffres. Néanmoins, leur dépistage est mal validé et leur retentissement au quotidien rarement recherché. Nous avons évalué les capacités numériques chez des patients aphasiques post-AVC hémisphérique gauche, par une échelle écologique, la BENQ (Batterie d Evaluation des Nombres au Quotidien), comparativement à une batterie analytique du calcul, le TLC2 (Test Lillois du Calcul). Douze patients droitiers bénéficièrent d une évaluation neurologique, orthophonique (batterie de Ducarne) et d une imagerie cérébrale. Après être rentrés au domicile, ils passèrent le TLC2 puis la BENQ : ce test écologique récemment normalisé en population témoin comportait 11 épreuves manipulant des données chiffrées en situation de vie quotidienne (prise de RDV, paiement avec billets ou pièces de monnaie...). L âge moyen des patients était de 44 ans. Neuf avaient un score de Barthel supérieur à 95. 75% se plaignaient d une gêne importante dans la manipulation des données chiffrées au quotidien. La passation de la BENQ durait en moyenne 55 minutes. Neuf eurent des résultats pathologiques à la BENQ. La BENQ dépiste de façon rapide les troubles de manipulation des données chiffrées chez des patients aphasiques de sévérité variable. La corrélation entre certains scores du TLC2 et de la BENQ (transcodage des chiffres et remplissage d'un chèque, lecture de nombres et lecture de l heure...), révèle à la fois une déficience et une incapacité. Le dépistage de ce handicap par cette batterie écologique permet une prise en charge spécifique en rééducation.PARIS6-Bibl.Pitié-Salpêtrie (751132101) / SudocSudocFranceF

Neurological sequelae after cerebral anoxia.

International audiencePRIMARY OBJECTIVE: Cardiac arrest can cause neurological impairment. The aim of this study is to confirm the disability and the predominant part of executive and behavioural impairments after cardiac arrest. RESEARCH DESIGN: A retrospective study is proposed. METHODS AND PROCEDURES: All consecutive patients admitted to the Department of Rehabilitation for Neurological Impairments following cerebral anoxia after cardiac arrest between 1995-2007 were included. Clinical and neuropsychological assessment was proposed. MAIN OUTCOMES AND RESULTS: Thirty patients, 19 men, were examined. Ages ranged from 16-58 (mean = 39.5). Fourteen patients presented with severe disability and 16 patients presented with moderate disability. In the first group (severe disability) no patients were autonomous for daily life activities. They presented with dysexecutive syndrome and behavioural disorders associated with amnesia syndrome; 64% of them presented with motor disorders. In the second group, patients with moderate disability were autonomous in daily life but not for the complex activities or functioning. They had no motor impairment but suffered from executive and memory impairments. Behavioural changes were noted. Medical history or demographic data did not differ between the two groups. CONCLUSION: The study confirms the predominant part of executive, memory and behavioural impairments after cardiac arrest. This retrospective study cannot provide prognosis factors and further prognosis studies are needed

Long-term functional outcome of cardiac arrest survivors.

epub ahead of printInternational audienceAbstract no availabl

Contribution of Corticospinal Tract and Functional Connectivity in Hand Motor Impairment after Stroke

<div><p>Background</p><p>Motor outcome after stroke is associated with reorganisation of cortical networks and corticospinal tract (CST) integrity. However, the relationships between motor severity, CST damage, and functional brain connectivity are not well understood. Here, the main objective was to study the effect of CST damage on the relationship between functional motor network connectivity and hand motor function in two groups of stroke patients: the severely (n=8) and the mildly impaired (n=14).</p> <p>Methods</p><p>Twenty-two carotid stroke patients with motor deficits were studied with magnetic resonance imaging (MRI) at 3 weeks, at 3 and 6 months. Healthy subjects (n=28) were scanned once. The CST injury was assessed by fractional anisotropy values. Functional connectivity was studied from a whole-hand grip task fMRI in a cortical and cerebellar motor network. Functional connectivity indexes were computed between these regions at each time point. The relationship between hand motor strength, ipsilesional CST damage and functional connectivity from the primary motor cortex (M1) was investigated using global and partial correlations.</p> <p>Findings</p><p>In mildly impaired patients, cortico-cortical connectivity was disturbed at three weeks but returned to a normal pattern after 3 months. Cortico-cerebellar connectivity was still decreased at 6 months. In severely impaired patients, the cortico-cortical connectivity tended to return to a normal pattern, but the cortico-cerebellar connectivity was totally abolished during the follow-up. In the entire group of patients, the hand motor strength was correlated to the ipsilesional functional connectivity from M1. Partial correlations revealed that these associations were not anymore significant when the impact of CST damage was removed, except for the ipsilesional M1-contralateral cerebellum connectivity.</p> <p>Conclusion</p><p>Functional brain connectivity changes can be observed, even in severely impaired patients with no recovery. Upper limb function is mainly explained by the CST damage and by the ipsilesional cortico-cerebellar connectivity.</p> </div

Localisation of infarction.

<p>Overlap of infarct lesions on a T1 anatomical template in (A) mildly impaired patients (n=14) and (B) severely impaired patients (n=8). Colour bar indicates the proportion of patients with infarction for each voxel.</p