Multimodal Imaging in Parkinson's Disease

Présentation des résultats de travaux de recherche portant sur l'imagerie multimodale en Maladie de Parkinson, et plus particulièrement sur l'étude des relations entre l'IRM sensible au Fer, à la Neuromélanine et le PETscan cérébral à la FDOPA.New MRI biomarkers in Parkinson's Diseas

Sporadic Creutzfeldt-Jakob disease: a case study.

Description d'un cas clinique de maladie de Creutzfeldt-Jakob sporadique et discussion de son diagnostic différentiel (dont les encéphalites limbiques)

Functional neurological disorders: gait and movement disorders

editorial reviewedLes troubles neurologiques fonctionnels constituent un ensemble de symptômes et syndromes neurologiques dont une cause «organique» ne peut être démontrée. Ils représentent toujours actuellement un des défis diagnostiques le plus difficile pour le neurologue dès lors qu’il ne peut s’appuyer que sur des critères cliniques. Les troubles de la marche et les mouvements anormaux fonctionnels constituent un sous-groupe significatif de ces affections et un motif fréquent de consultation. Les bases neurobiologiques de ces manifestations demeurent largement incomprises en dépit des progrès de la neuro-imagerie fonctionnelle. Au-delà du processus diagnostique, l’annonce au patient du diagnostic et de sa signification impose une expertise et un soin particulier parce que participant à la démarche thérapeutique

Narcolepsy-Cataplexy Today

peer reviewedDiagnostic criteria and pathophysiology of narcolepsy- cataplexy have evolved considerably over the last 10 years. The main cause, already mentioned in a previous paper, in the Revue Médicale de Liège, in 2002, is based, in human beings, on a destruction of specific cells located in the lateral and posterior part of the hypothalamus (the perifornical nuclei, containing some 70,000 neurons), producing peptides which stimulate the central nervous system; they are called hypocretins or orexins. The role of autoimmunity in their disappearance becomes more evident. The treatment is simplified but remains symptomatic. It is mainly based on Sodium Oxybate or Gamma-Hydroxybutyrate, syrup, prescribed for the night. The authors report on their own experience in this regard and on future therapeutics more targeted towards the cause of the disease

Imagerie multimodale dans la maladie de Parkinson: PET FDOPA, IRM quantitative sensible au fer et à la neuromélanine

peer reviewedParkinson’s disease is a neurodegenerative synucleinopathy characterized by the degeneration of neuromelanin-containing dopaminergic neurons and deposition of iron in the substantia nigra (SN). How regional neuromelanin (NM) loss and iron accumulation within specific areas of SN relates to nigro-striatal dysfunction needs to be clarified. We measured dopaminergic function in pre- and post-commissural putamen by [18F]DOPA PET in twenty-three Parkinson’s disease (PD) patients and 23 healthy control (HC) participants in whom NM content and iron load was assessed in medial and lateral SN, respectively by neuromelanin-sensitive and quantitative R2* MRI. Data analysis consisted of voxelwise regressions testing the group effect and its interaction with NM or iron signals. In PD patients, R2* was selectively increased in left lateral SN as compared to healthy participants, suggesting a local accumulation of iron in Parkinson’s disease. By contrast, NM signal differed between PD and HC, without specific regional specificity within SN. Dopaminergic function in posterior putamen decreased as R2* increased in lateral SN, indicating that dopaminergic function impairment progresses with iron accumulation in the SN. Dopaminergic function was also positively correlated with NM signal in lateral SN, indicating that dopaminergic function impairment progresses with depigmentation in the SN. A complex relationship was detected between R2* in the lateral SN and NM signal in the medial substantia nigra. In conclusion, multimodal imaging reveals regionally-specific relationships between iron accumulation and depigmentation within the SN of Parkinson’s disease and provides in vivo insights in its neuropathology.Parkinson's disease multimodal imagin