Stimulation magnétique transcrânienne répétée : efficacité et tolérance dans le traitement des dépressions chez le sujet âgé

International audienceAu fur et à mesure des études, les données suggérant l'efficacité de la Stimulation Magnétique Transcranienne répétée dans le traitement des dépressions chez les patients âgés se complètent, en dépit de quelques résultats contradictoires. Plusieurs paramètres pourraient être associés avec une efficacité antidépressive de la stimulation haute fréquence du cortex préfrontal dorso-latéral gauche : intensité de la stimulation supérieure à 90 %, voire 110 % du seuil moteur, nombre de stimulations par session supérieur à 1 000, nombre total de jours de traitement supérieur à dix. En revanche, un âge plus élevé où l'existence de certaines lésions cérébrales semblent liées à une moindre réponse. Enfin, la tolérance de la SMTr, notamment au niveau des fonctions cognitives, paraît excellente, y compris chez des patients fragiles, notamment du fait d'une maladie cérébro-vasculaire

The effects of Gilles de la Tourette syndrome and other chronic tic disorders on quality of life across the lifespan:a systematic review

Gilles de la Tourette syndrome (GTS) and other chronic tic disorders are neurodevelopmental conditions characterized by the presence of tics and associated behavioral problems. Whilst converging evidence indicates that these conditions can affect patients' quality of life (QoL), the extent of this impairment across the lifespan is not well understood. We conducted a systematic literature review of published QoL studies in GTS and other chronic tic disorders to comprehensively assess the effects of these conditions on QoL in different age groups. We found that QoL can be perceived differently by child and adult patients, especially with regard to the reciprocal contributions of tics and behavioral problems to the different domains of QoL. Specifically, QoL profiles in children often reflect the impact of co-morbid attention-deficit and hyperactivity symptoms, which tend to improve with age, whereas adults' perception of QoL seems to be more strongly affected by the presence of depression and anxiety. Management strategies should take into account differences in age-related QoL needs between children and adults with GTS or other chronic tic disorders

Alzheimers Dement

INTRODUCTION: The clinical relevance of brain atrophy subtypes categorization in non-demented persons without a priori knowledge regarding their amyloid status or clinical presentation is unknown. METHODS: A total of 2083 outpatients with either subjective cognitive complaint or mild cognitive impairment at study entry were followed during 4 years (MEMENTO cohort). Atrophy subtypes were defined using baseline magnetic resonance imaging (MRI) and previously described algorithms. RESULTS: Typical/diffuse atrophy was associated with faster cognitive decline and the highest risk of developing dementia and Alzheimer's disease (AD) over time, both in the whole analytic sample and in amyloid-positive participants. Hippocampal-sparing and limbic-predominant atrophy were also associated with incident dementia, with faster cognitive decline in the limbic predominant atrophy group. Lewy body dementia was more frequent in the hippocampal-sparing and minimal/no atrophy groups. DISCUSSION: Atrophy subtypes categorization predicted different subsequent patterns of cognitive decline and rates of conversion to distinct etiologies of dementia in persons attending memory clinics

Quality of life in adults with Gilles de la Tourette Syndrome

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