Smart-EEG: a Tele-medicine System for EEG Exams

National audienceThis paper presents Smart-EEG, a telemedicine project aiming to improve remote diagnosis of brain diseases. Those exams are commonly done by acquiring EEG, ECG, EOG, EMG and a video of the scene. Nowadays, systems uses video acquisition limited to standard frame-rate (30 fps) and unreliable synchronization mechanism. Those current limitations may lead to wrong diagnosis of a patient. To get around those limitation, the system architecture is centered around a hardware acquisition system handling synchronization and compression and a self contained EEG exam file to permit remote diagnosis. This device aims at providing reliable synchronization and high frame-rate video recordin

CDK5RAP2 primary microcephaly is associated with hypothalamic, retinal and cochlear developmental defects

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Non invasive brain stimulation to enhance post-stroke recovery

Brain plasticity after stroke remains poorly understood. Patients may improve spontaneously within the first 3 months and then more slowly in the coming year. The first days, decreased edema and reperfusion of the ischemic penumbra may possibly account for these phenomena, but the improvement during the next weeks suggests plasticity phenomena and cortical reorganization of the brain ischemic areas and of more remote areas. Indeed, the injured ischemic motor cortex has a reduced cortical excitability at the acute phase and a suspension of the topographic representation of affected muscles, whereas the contralateral motor cortex has an increased excitability and an enlarged somatomotor representation; furthermore, contralateral cortex exerts a transcallosal interhemispheric inhibition on the ischemic cortex. This results from the imbalance of the physiological reciprocal interhemispheric inhibition of each hemisphere on the other, contributing to worsening of neurological deficit. Cortical excitability is measurable through transcranial magnetic stimulation (TMS) and prognosis has been established according to the presence of motor evoked potentials (MEP) at the acute phase of stroke, which is predictive of better recovery. Conversely, the lack of response to early stimulation is associated with a poor functional outcome. Non-invasive stimulation techniques such as repetitive TMS (rTMS) or transcranial direct current stimulation (tDCS) have the potential to modulate brain cortical excitability with long lasting effects. In the setting of cerebrovascular disease, around 1000 stroke subjects have been included in placebo-controlled trials so far, most often with an objective of promoting motor recovery of the upper limb. High frequency repetitive stimulation (> 3 Hz) rTMS, aiming to increase excitability of the ischemic cortex, or low frequency repetitive stimulation (≤ 1 Hz), aiming to reduce excitability of the contralateral homonymous cortex, or combined therapies, have shown various effects on the functional disability score and neurological scales of treated patients and on the duration of the treatment. We review here the patients’ characteristics and parameters of stimulation that could predict a good response, as well as safety issues. At last, we review what we have learnt from experimental studies and discuss potential directions to conduct future studies

ETUDE DE L'ADAPTATION DES GROS VAISSEAUX ET DES ARTERES DE RESISTANCE AUX VARIATIONS CHRONIQUES DES CONTRAINTES HEMODYNAMIQUES (ROLE PARTICULIER DU MONOXYDE D'AZOTE)

UNE ARTERE SOUMISE A UNE MODIFICATION CHRONIQUE DES CONTRAINTES HEMODYNAMIQUES S'ADAPTE PAR UN REMODELAGE GEOMETRIQUE ET STRUCTURAL. UNE ADAPTATION PARTICULIERE DES ARTERES DE LA MICROCIRCULATION EST LA RAREFACTION MICROVASCULAIRE, OU LA PROLIFERATION MICROVASCULAIRE OU ANGIOGENESE. NOUS AVONS ETUDIE PAR L'ECHO-DOPPLER CHEZ DES PATIENTS AYANT UNE OCCLUSION CHRONIQUE DE L'ARTERE CAROTIDE INTERNE (ACI), LA CAPACITE DES ARTERES CAROTIDES PRIMITIVES (ACP) HUMAINES PATHOLOGIQUES A SE REMODELER. PUIS, NOUS AVONS ETUDIE LE PHENOTYPE VASCULAIRE DES SOURIS ENOS - / - HYPERTENDUES, EN ESSAYANT D'INDIVIDUALISER LES MECANISMES IMPLIQUES DANS CETTE HYPERTENSION ARTERIELLE ET ENFIN, DETERMINE LE ROLE DU MONOXYDE D'AZOTE DANS L'ANGIOGENESE INDUITE PAR L'AUGMENTATION CHRONIQUE DU DEBIT SANGUIN ARTERIEL. NOUS AVONS MESURE ET CALCULE CHEZ 17 PATIENTS AYANT UNE OCCLUSION UNILATERALE DE L'ACI D'ORIGINE ATHEROMATEUSE POUR MOITIE QUE L'ACP HOMOLATERALE S'ADAPTAIT A LA DIMINUTION CHRONIQUE DU DEBIT SANGUIN ARTERIEL EN DIMINUANT SON DIAMETRE LUMINAL, AFIN DE MAINTENIR CONSTANTES LES CONTRAINTES DE CISAILLEMENT, AINSI QUE SA SURFACE TRANSVERSE DE MEDIA INDIQUANT QUE CETTE DIMINUTION DU DIAMETRE ETAIT PLUS PROBABLEMENT EN RAPPORT AVEC UN REMODELAGE QU'AVEC UNE MODIFICATION DU TONUS VASOMOTEUR. NOUS AVONS DETERMINE QUE L'HYPERTENSION DES SOURIS ENOS - / - APPARAIT ENTRE 8 ET 12 SEMAINES ET S'ACCOMPAGNE D'UNE RAREFACTION ARTERIOLAIRE DE 20% DANS LE CUR ET LE MUSCLE GRACILIS, ALORS QUE LA DENSITE CAPILLAIRE EST INCHANGEE. CETTE RAREFACTION EST PREVENUE EN MEME TEMPS QUE L'HYPERTENSION ARTERIELLE LORS DE L'ADMINISTRATION CHRONIQUE D'UN VASODILATATEUR ANTI-HYPERTENSEUR, L'HYDRALAZINE. EN UTILISANT LA TECHNIQUE DE DIFFUSION DES MICROSPHERES FLUORESCENTES, NOUS AVONS MONTRE QUE CETTE RAREFACTION ARTERIOLAIRE DEMONTREE SUR UN PLAN ANATOMIQUE JOUAIT PROBABLEMENT UN ROLE DANS L'ENTRETIEN DE L'HYPERTENSION ARTERIELLE AVEC LA VASOCONSTRICTION. DANS UN MODELE D'AUGMENTATION CHRONIQUE DU DEBIT SANGUIN, NOUS AVONS MONTRE CHEZ DES RATS COTRAITES PAR LA PRAZOSINE ET UN INHIBITEUR NON SPECIFIQUE DE LA NO-SYNTHESE, ET DES SOURIS ENOS - / - TRAITEES PAR LA PRAZOSINE, QUE L'ANGIOGENESE INDUITE PAR L'ELEVATION DES CONTRAINTES DE CISAILLEMENT VIA L'AUGMENTATION CHRONIQUE DU DEBIT SANGUIN, EST INDEPENDANTE DE LA VOIE DU NO.PARIS7-Bibliothèque centrale (751132105) / SudocSudocFranceF

Gross anatomy and development of the peripheral nervous system

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Gouvernance et développement des réseaux de santé. Le cas de la télétransmission en électroencéphalographie

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Intravenous Administration of Human Adipose Derived-Mesenchymal Stem Cells Is Not Efficient in Diabetic or Hypertensive Mice Subjected to Focal Cerebral Ischemia

Copyright © 2019 Mangin, Cogo, Moisan, Bonnin, Maïer and Kubis.As the second cause of death and cognitive decline in industrialized countries, stroke is a major burden for society. Vascular risks factors such as hypertension and diabetes are involved in most stroke patients, aggravate stroke severity, but are still poorly taken into account in preclinical studies. Microangiopathy and sustained inflammation are exacerbated, likely explaining the severity of stroke in those patients. We sought to demonstrate that intravenous administration of human adipose derived-mesenchymal stem cells (hADMSC) that have immunomodulatory properties, could accelerate sensorimotor recovery, prevent long-term spatial memory impairment and promote neurogenesis, in diabetic or hypertensive mice, subjected to permanent middle cerebral artery occlusion (pMCAo). Diabetic (streptozotocin IP) or hypertensive (L-NAME in drinking water) male C57Bl6 mice subjected to pMCAo, were treated by hADMSC (500,000 cells IV) 2 days after cerebral ischemia induction. Infarct volume, neurogenesis, microglial/macrophage density, T-lymphocytes density, astrocytes density, and vessel density were monitored 7 days after cells injection and at 6 weeks. Neurological sensorimotor deficit and spatial memory were assessed until 6 weeks post-stroke. Whatever the vascular risk factor, hADMSC showed no effect on functional sensorimotor recovery or cognitive decline prevention at short or long-term assessment, nor significantly modified neurogenesis, microglial/macrophage, T-lymphocytes, astrocytes, and vessel density. This work is part of a European program (H2020, RESSTORE). We discuss the discrepancy of our results with those obtained in rats and the optimal cell injection time frame, source and type of cells according to the species stroke model. A comprehensive understanding of the mechanisms preventing recovery should help for successful clinical translation, but first could allow identifying good and bad responders to cell therapy in stroke.The RESSTORE project received funding from the European Union’s Horizon 2020 Research and Innovation Programme under the Grant Agreement No. 681044 RESSTORE project (www.resstore.eu) and GM was directly funded by the RESSTORE project

Gouvernance et développement des réseaux de santé. Le cas de la télétransmission en électroencéphalographie

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Low-pressure sequential compression of lower limbs enhances forearm skin blood flow

Purpose: We investigated whether forearm skin blood flow could be improved when a multilayer pulsatile inflatable suit was applied at a low pressure to the lower limbs and abdomen. We hypothesized that a non-invasive purely mechanical stimulation of the lower limbs could induce remote forearm blood flow modifications. Methods: The pulsatile suit induced a sequential compartmentalized low compression (65 mmHg), which was synchronized with each diastole of the cardiac cycle with each phase evolving centripetally (lower limbs to abdomen). Modifications of the forearm skin blood flow were continuously recorded by laser Doppler flowmetry (LDF) at baseline and during the pulsatile suit application. Endothelium-dependent and endothelium-independent vasodilations of the forearm skin microcirculation were measured by LDF in response to a local transdermal iontophoretic application of acetylcholine (ACh-test) and to hyperthermia (hyperT- test). Results: Twenty-four healthy volunteers, 12 men and 12 women (43±14 years) were included in the study. LDF responses increased 1) under pulsatile suit (97±106%,