Place de la parathormone dans le traitement de l'ostéoporose post-ménopausique

LYON1-BU Santé (693882101) / SudocRENNES1-BU Santé (352382103) / SudocSudocFranceF

Comparaison de la qualité de vie de patients atteints d’atrophie multisystématisée et de maladie de Parkinson

International audiencePURPOSE: Quality of life (QoL) in multiple system atrophy (MSA) is thought to be poorer than in Parkinson's disease (PD), primarily because of motor impairment, autonomic dysfunction and depression. The aim of the study was to investigate QoL in 10 patients with probable MSA (parkinsonian subtype) compared with 10 PD patients matched for motor disability on UPDRS III motor score. METHODS: All patients were ambulatory and non-demented. Mean durations of disease in MSA and PD patients were respectively 3.6 and 9.0 years. QoL was assessed using the SF-36 health-related questionnaire and a life satisfaction visual analogue scale. Patients were also evaluated for cognitive function (Mattis Dementia Rating Scale [Mattis DRS], Wisconsin Card Sorting Test [WCST], Stroop, Fluencies), depression (Beck Depression Inventory-II [BDI-II]), apathy (Modified Apathy Evaluation Scale) and were screened for non-motor symptoms (NMS Quest). RESULTS: The only difference in QoL between MSA and PD patients matched for motor disability was that the SF-36 vitality subscore was more impaired in MSA and negatively correlated with interference index on Stroop word colour testing. Depression and non-motor symptoms were associated with poorer QoL in both groups. Among MSA patients, cognitive impairment (Stroop interference index) and apathy also had a negative impact. CONCLUSION: There was no major difference in QoL between MSA and PD patients matched for motor disability with a disease duration about 5 years longer. The SF-36 vitality subscore was more impaired in MSA and associated with interference sensitivity.INTRODUCTION: La qualité de vie (QDV) dans l’atrophie multisystématisée (AMS) est considérée plus altérée que celle de la maladie de Parkinson (MP). Le but de cette étude était de comparer la QDV chez dix patients atteints d’AMS probable (sous-type parkinsonien) et dix patients atteints de MP, appariés sur le handicap moteur. METHODE: Les patients inclus étaient ambulatoires et non déments. Les durées d’évolution dans le groupe AMS et MP étaient respectivement de 3,6 et 9,0 ans. Les patients étaient évalués sur la QDV, mesurée par le questionnaire SF-36 et une échelle visuelle analogique, l’état cognitif, l’apathie, la dépression, et les signes non moteurs. RESULTATS: La seule différence observée sur la QDV entre les deux groupes concernait la dimension vitalité de la SF-36, plus altérée chez les patients AMS et corrélée au score d’interférence du Stroop. La dépression et les signes non moteurs avaient un rôle délétère sur la QDV dans les deux groupes mais l’apathie et les difficultés au Stroop retentissaient uniquement sur la QDV des patients AMS. CONCLUSION: La QDV des patients AMS est comparable à celle des patients MP, appariés sur le handicap moteur, excepté sur la dimension vitalité plus altérée dans l’AMS et liée à la sensibilité à l’interférence

Cognitive inhibition impairments in presymptomatic C9orf72 carriers

International audiencebjective To investigate cognitive inhibition in presymptomatic C9orf72 mutation carriers (C9+) and its associated neuroanatomical correlates.Methods Thirty-eight presymptomatic C9orf72 mutation carriers (C9+, mean age 38.2±8.0 years) and 22 C9− controls from the PREV-DEMALS cohort were included in this study. They underwent a cognitive inhibition assessment with the Hayling Sentence Completion Test (HSCT; time to completion (part B−part A); error score in part B) as well as a 3D MRI.Results C9+ individuals younger than 40 years had higher error scores (part B) but equivalent HSCT time to completion (part B−part A) compared to C9− individuals. C9+ individuals older than 40 years had both higher error scores and longer time to completion. HSCT time to completion significantly predicted the proximity to estimated clinical conversion from presymptomatic to symptomatic phase in C9+ individuals (based on the average age at onset of affected relatives in the family). Anatomically, we found that HSCT time to completion was associated with the integrity of the cerebellum.Conclusion The HSCT represents a good marker of cognitive inhibition impairments in C9+ and of proximity to clinical conversion. This study also highlights the key role of the cerebellum in cognitive inhibition