Petit guide de l'accompagnement à la conception collective d'une transition agroécologique à l'échelle du territoire

Le guide méthodologique, à destination des animateurs de terrain est divisé en trois parties. La première est un dictionnaire imagé des concepts clefs des démarches participatives pour la transition agroécologique . La deuxième partie est une narration de l’expérience TATA-BOX, présentée « comme une recette de cuisine », avec son mode d’emploi étape par étape et un retour d’expérience des scientifiques et des participants des ateliers. Une démarche participative nécessite une construction pas à pas afin de s’adapter au contexte dans lequel elle s'inscrit, au jeu d'acteurs considéré, à la question posée. Aussi la troisième section du guide est composée de d’un ensemble de 23 fiches techniques permettant aux animateurs de terrain de : - suivre le cheminement logique pour la conception de leur propre dispositif - d’opter pour les méthodes et outils participatifs les plus adaptés en ayant un aperçu de leur conditions d’application, leur mode d’emploi, de leurs avantages et inconvénient

Impact of Macrophagic Activity on Tissue Structure in Patients Suffering from Clinically Isolated Syndrome Suggestive of Multiple Sclerosis: A Multicentric USPIO Enhancement Study at 3T

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Impact of Macrophagic Activity on Tissue Structure in Patients Suffering from Clinically Isolated Syndrome Suggestive of Multiple Sclerosis: A Multicentric USPIO Enhancement Study at 3T

International audienc

Ultra-small Super Paramagnetic Iron Oxide predicts higher disease activity in clinically isolated syndrome

Background: Macrophages are important components of inflammatory processes inmultiple sclerosis, closely linked to axonal loss, and can now be observed in-vivo usingUltra-Small super-Paramagnetic Iron Oxide (USPIO). We aimed to determine theprevalence of macrophage infiltration and to assess the predictive value on diseaseactivity and tissue injury after one year in clinical isolated syndrome patients.Methods: Thirty-five patients were imaged using conventional-MRI, magnetizationtransfer ratio (MTR) to assess tissue destructuration, gadolinium (Gd) to probe bloodbrain barrier integrity, and USPIO to study macrophage infiltration.Results: At baseline, patients showed 17 USPIO-positive lesions reflecting infiltrationof macrophages present from the onset. This infiltration was associated with higherlocal tissue destructuration as emphasized by lower MTR values of USPIO-positive/Gdpositivelesions compared to USPIO-negative/Gd-positive and to non-enhanced lesions,at baseline and Month-12, and no difference between USPIO-negative/Gd-positive andnon-enhanced lesions. While at baseline T2-lesion load of patients with USPIOenhancementcompared to patients with Gd-enhancement was not different, it washigher at Month-12. T1-lesion load was also higher at Month-12 in patients withUSPIO-enhancement.Conclusion: Infiltration of activated macrophages evidenced by USPIO enhancement,is present at the onset of MS and is associated with higher local and global progressionof tissue destructuration

Ultra-small Super Paramagnetic Iron Oxide predicts higher disease activity in clinically isolated syndrome

Background: Macrophages are important components of inflammatory processes inmultiple sclerosis, closely linked to axonal loss, and can now be observed in-vivo usingUltra-Small super-Paramagnetic Iron Oxide (USPIO). We aimed to determine theprevalence of macrophage infiltration and to assess the predictive value on diseaseactivity and tissue injury after one year in clinical isolated syndrome patients.Methods: Thirty-five patients were imaged using conventional-MRI, magnetizationtransfer ratio (MTR) to assess tissue destructuration, gadolinium (Gd) to probe bloodbrain barrier integrity, and USPIO to study macrophage infiltration.Results: At baseline, patients showed 17 USPIO-positive lesions reflecting infiltrationof macrophages present from the onset. This infiltration was associated with higherlocal tissue destructuration as emphasized by lower MTR values of USPIO-positive/Gdpositivelesions compared to USPIO-negative/Gd-positive and to non-enhanced lesions,at baseline and Month-12, and no difference between USPIO-negative/Gd-positive andnon-enhanced lesions. While at baseline T2-lesion load of patients with USPIOenhancementcompared to patients with Gd-enhancement was not different, it washigher at Month-12. T1-lesion load was also higher at Month-12 in patients withUSPIO-enhancement.Conclusion: Infiltration of activated macrophages evidenced by USPIO enhancement,is present at the onset of MS and is associated with higher local and global progressionof tissue destructuration

Ultra-small superparamagnetic iron oxide enhancement is associated with higher loss of brain tissue structure in clinically isolated syndrome

International audienceMacrophages are important components of inflammatory processes in multiple sclerosis, closely linked to axonal loss, and can now be observed in vivo using ultra-small superparamagnetic iron oxide (USPIO). In the present 1-year longitudinal study, we aimed to determine the prevalence and the impact on tissue injury of macrophage infiltration in patients after the first clinical event of multiple sclerosis

Spinal cord microstructural damage measured in recently diagnosed Relapsing Remitting MS patients: prognostic value at 5-year

International audienceIntroductionEarly spinal cord (SC) lesions in patients with relapsing-remitting MS (RRMS) are associated with an increased risk of disability in the medium term. However, accurate quantification of these lesions on conventional MRI is difficult and imperfectly reflects the severity of SC damage. In this study, we assessed the added value of different metrics extracted from quantitative spinal cord MRI and reflecting microstructure to predict patient disability at 5 years.ObjectivesTo assess the relationship between baseline SC fractional anisotropy (FA) and magnetization transfer ratio (MTR), the occurrence of atrophy and disability at 5-year in early RRMS patients and their added value compared to initial brain and SC lesion load.MethodsAfter IRB approval (NCT02117375), 76 RRMS patients (disease duration <1 year; mean EDSS=0.78) were included in a multicenter study and scanned at baseline and 5 years. For each subject, we measured 1) SC microstructural damage using magnetization transfer ratio (MTR) and DTI fractional anisotropy (FA) averaged over C4C6; 2) SC atrophy using cross sectional area (CSA) averaged over C2C3; 3) SC lesion load manually segmented on axial cervical T2*w; 4) brain lesion load automatically segmented on 3D FLAIR. Partial correlations between each quantitative metric and disability score or atrophy measurement at 5-year were calculated, with age and gender, and in a second model with SC lesion load as additional covariates.ResultsThe 5-year EDSS was associated with the baseline SC lesion load (r=.29, p=.049), but not with the brain lesion load. The 5-year pyramidal sub-score was not associated with either cervical or brain lesion load. Concerning the microstructural components, both the baseline SC FA and MTR values were associated with the EDSS (r=-.32, p=.02; r=-.31, p=.04, resp.) and the pyramidal sub-score at 5-year (r=-.38, p=.01; r=-.42, p=.005, resp.). These associations were confirmed independently of cervical lesion load for cervical FA value and 5-year EDSS and for FA and MTR values and 5-year pyramidal sub-score. By contrast, we found no significant association between initial brain or SC lesion load or initial microstructural damage and evolution of CSA at 5-year.ConclusionWe highlighted the dominant role of initial SC involvement in the subsequent development of disability in early RRMS patients. In particular, initial spinal cord MTR and FA values may offer a reliable complement to lesion volume, able to capture lesion severity and non focal structural changes in this key structure

Spinal cord microstructural damage measured in recently diagnosed Relapsing Remitting MS patients: prognostic value at 5-year

International audienceIntroductionEarly spinal cord (SC) lesions in patients with relapsing-remitting MS (RRMS) are associated with an increased risk of disability in the medium term. However, accurate quantification of these lesions on conventional MRI is difficult and imperfectly reflects the severity of SC damage. In this study, we assessed the added value of different metrics extracted from quantitative spinal cord MRI and reflecting microstructure to predict patient disability at 5 years.ObjectivesTo assess the relationship between baseline SC fractional anisotropy (FA) and magnetization transfer ratio (MTR), the occurrence of atrophy and disability at 5-year in early RRMS patients and their added value compared to initial brain and SC lesion load.MethodsAfter IRB approval (NCT02117375), 76 RRMS patients (disease duration <1 year; mean EDSS=0.78) were included in a multicenter study and scanned at baseline and 5 years. For each subject, we measured 1) SC microstructural damage using magnetization transfer ratio (MTR) and DTI fractional anisotropy (FA) averaged over C4C6; 2) SC atrophy using cross sectional area (CSA) averaged over C2C3; 3) SC lesion load manually segmented on axial cervical T2*w; 4) brain lesion load automatically segmented on 3D FLAIR. Partial correlations between each quantitative metric and disability score or atrophy measurement at 5-year were calculated, with age and gender, and in a second model with SC lesion load as additional covariates.ResultsThe 5-year EDSS was associated with the baseline SC lesion load (r=.29, p=.049), but not with the brain lesion load. The 5-year pyramidal sub-score was not associated with either cervical or brain lesion load. Concerning the microstructural components, both the baseline SC FA and MTR values were associated with the EDSS (r=-.32, p=.02; r=-.31, p=.04, resp.) and the pyramidal sub-score at 5-year (r=-.38, p=.01; r=-.42, p=.005, resp.). These associations were confirmed independently of cervical lesion load for cervical FA value and 5-year EDSS and for FA and MTR values and 5-year pyramidal sub-score. By contrast, we found no significant association between initial brain or SC lesion load or initial microstructural damage and evolution of CSA at 5-year.ConclusionWe highlighted the dominant role of initial SC involvement in the subsequent development of disability in early RRMS patients. In particular, initial spinal cord MTR and FA values may offer a reliable complement to lesion volume, able to capture lesion severity and non focal structural changes in this key structure

Spinal cord microstructural damage measured in recently diagnosed Relapsing Remitting MS patients: prognostic value at 5-year

International audienceIntroductionEarly spinal cord (SC) lesions in patients with relapsing-remitting MS (RRMS) are associated with an increased risk of disability in the medium term. However, accurate quantification of these lesions on conventional MRI is difficult and imperfectly reflects the severity of SC damage. In this study, we assessed the added value of different metrics extracted from quantitative spinal cord MRI and reflecting microstructure to predict patient disability at 5 years.ObjectivesTo assess the relationship between baseline SC fractional anisotropy (FA) and magnetization transfer ratio (MTR), the occurrence of atrophy and disability at 5-year in early RRMS patients and their added value compared to initial brain and SC lesion load.MethodsAfter IRB approval (NCT02117375), 76 RRMS patients (disease duration <1 year; mean EDSS=0.78) were included in a multicenter study and scanned at baseline and 5 years. For each subject, we measured 1) SC microstructural damage using magnetization transfer ratio (MTR) and DTI fractional anisotropy (FA) averaged over C4C6; 2) SC atrophy using cross sectional area (CSA) averaged over C2C3; 3) SC lesion load manually segmented on axial cervical T2*w; 4) brain lesion load automatically segmented on 3D FLAIR. Partial correlations between each quantitative metric and disability score or atrophy measurement at 5-year were calculated, with age and gender, and in a second model with SC lesion load as additional covariates.ResultsThe 5-year EDSS was associated with the baseline SC lesion load (r=.29, p=.049), but not with the brain lesion load. The 5-year pyramidal sub-score was not associated with either cervical or brain lesion load. Concerning the microstructural components, both the baseline SC FA and MTR values were associated with the EDSS (r=-.32, p=.02; r=-.31, p=.04, resp.) and the pyramidal sub-score at 5-year (r=-.38, p=.01; r=-.42, p=.005, resp.). These associations were confirmed independently of cervical lesion load for cervical FA value and 5-year EDSS and for FA and MTR values and 5-year pyramidal sub-score. By contrast, we found no significant association between initial brain or SC lesion load or initial microstructural damage and evolution of CSA at 5-year.ConclusionWe highlighted the dominant role of initial SC involvement in the subsequent development of disability in early RRMS patients. In particular, initial spinal cord MTR and FA values may offer a reliable complement to lesion volume, able to capture lesion severity and non focal structural changes in this key structure