Evidence for the Re-Enactment of a Recently Learned Behavior during Sleepwalking

Animal studies have shown that sequenced patterns of neuronal activity may be replayed during sleep. However, the existence of such replay in humans has not yet been directly demonstrated. Here we studied patients who exhibit overt behaviors during sleep to test whether sequences of movements trained during the day may be spontaneously reenacted by the patients during sleep

Le valproate de sodium pourrait-il avoir un effet neuroprotecteur dans la paralysie supranucléaire progressive ? (étude multicentrique contre placebo)

Objectifs. La paralysie supranucléaire progressive (PSP) est une tauopathie rare pour laquelle aucun traitement n'est validé, elle évolue inéluctablement vers un décès après 6 ans d'évolution en moyenne. Le valproate de sodium a montré in vitro et in vivo des effets inhibiteurs sur la GSK3b une kinase majeure dans la phosphorylation et donc la régulation de la protéine tau. Nous avons testé les éventuelles propriétés neuroprotectrices du valproate de sodium dans la PSP. Méthodes. Vingt-sept patients atteints de PSP ont participé à cette étude randomisée et en double aveugle, 13 étaient sous valproate de sodium et 14 sous placebo. A 12 et 24 mois, la PSP rating scale (PSPRS), une évaluation cognitive et comportementale ainsi qu'une étude de tolérance et d'observance étaient réalisées. Résultats. A 12 mois, la PSPRS s'aggravait plus rapidement chez les patients sous valproate de sodium (60,8 +- 20) que sous placebo (46,9 +- 18,6, p=0,01), les scores PSPRS ne différaient pas à 24 mois. Les évaluations cognitives et comportementales étaient identiques entre les 2 groupes. La tolérance était similaire en nombre d'effets indésirables mais la durée moyenne de traitement était plus courte chez les patients sous valproate de sodium. L'observance était égale chez les patients des 2 groupes encore sous traitement. Conclusion. Le valproate de sodium n'a pas montré d'effet neuroprotecteur dans la PSP dans notre étude. L'aggravation de la PSPRS sous valproate de sodium semble être liée à une mauvaise tolérance plus qu'à un effet neurotoxique. Le développement d'un diagnostic précoce voire présymptomatique pourrait permettre l'instauration d'un traitement neuroprotecteur avant l'apparition de lésions irréversibles chez des patients ayant un état général encore conservé.NANTES-BU Médecine pharmacie (441092101) / SudocSudocFranceF

Is Parkinson’s disease a chronic low-grade inflammatory bowel disease?

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Cyclooxygenase 2 is upregulated in the gastrointestinal tract in Parkinson's disease

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Non-lesional status epilepticus in a patient with coronavirus disease 2019

International audienceA 59-year-old man with a history of atrial fibrillation and treated obstructive sleep apnea presented to the emergency department on March 26, 2020 with fever, dry cough, dyspnea and headache. He had no history of personal or familial seizures. A first reverse-transcriptase–polymerase-chain-reaction (RT-PCR) of nasopharyngeal swab test for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) was negative but SARS-CoV-2 infection was subsequently confirmed by RT-PCR assay performed on tracheal secretions and by computed tomography scan of the chest. The illness rapidly progressed to hypoxemic respiratory failure warranting the initiation of invasive mechanical ventilation on March 28. Lung bacterial overinfection by Hafnia alveii and Proteus vulgaris was diagnosed and sequentially treated with amoxicillin-clavulanic acid/rovamycine (7 days), tazobactam-piperacillin (5 days) and finally with cefepime (7 days). Deep sedation with midazolam was stopped on April 8 and the patient was extubated the following day.From April 10, the patient started to exhibit short episodes of impaired consciousness together with confusion and behavioral disturbances. Forty-nine minute electroencephalogram (EEG), performed when the patient was awake but confused, showed background fluctuating alertness with preserved responses to simple orders (Fig. 1b) and two widespread long rhythmic delta discharges with superimposed spikes in predominantly frontal localization simultaneous with impaired awareness (Fig. 1c), highly suggestive of epileptic seizures. The first seizure lasted 6 minutes (Fig. 1c), followed by a moderate interictal frontal activity (Fig. 1d) and the second seizure lasted at least 5 minutes (Fig. 1e), leading to the diagnosis of non-convulsive status epilepticus. Laboratory blood tests and brain MRI were normal; plasma cefepime concentrations were within the normal range. Routine cerebrospinal fluid (CSF) analysis was unremarkable and CSF SARS-CoV2 RT-PCR was negative. Clobazam (30 mg/day) and levetiracetam (1.5 g/day) were introduced. On April 14, the patient had only one brief episode of impaired consciousness and his long-term EEG monitoring was normal. He is now clinically stable and discharged from ICU

Electrochemical skin conductance for quantitative assessment of sweat function: Normative values in children

Objectives: The Sudoscan™ system (Impeto Medical, Paris, France) has been recently proposed as a standardized, easy, painless tool for sudomotor function assessment. It is now used as an additional diagnostic tool in small fibre neuropathy. So far, no work has been published in children. The aim of this study was to measure electrochemical skin conductance (ESC) using the Sudoscan™ system in children in order to assess its feasibility and to provide normative values. Methods: 100 children were included in the study: 55 girls and 45 boys, age rank 2–17, mean 10.5 y. They were accompanying their brother or sister who came as outclinic patients in the Department of Paediatrics or the Department of Paediatric surgery of the University Hospital. Results: All subjects underwent the test. It was performed without any difficulty, except for some of the youngest who sometimes had some trouble in keeping calm for 3 min over the plates. 4 subjects who took the test were excluded from the analysis (2 diabetic patients and 2 having had previous chemotherapy). ESC was quite stable along childhood with an overall 80.1 μS value for hands and 81.9 μS for feet, very similar to what is observed in adults. Conclusion: Maturation process seems to occur early in life, in accordance to sudomotor control when assessed by sympathetic skin response, which is also recorded early in infancy. Significance: ESC measurement is a simple and easy-to-perform test that can be performed in the clinical setting in children in 5 min. Keywords: Autonomic nerve system, Sudation assessment, Childre

Detection of alpha-synuclein aggregates in gastrointestinal biopsies by protein misfolding cyclic amplification

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