54 research outputs found
Impact of the Thrombectomy Trials on the Management and Outcome of Large Vessel Stroke: Data From the Lyon Stroke Center
Introduction: Randomized trials (RT) have recently validated the superiority of thrombectomy over standard medical care, including intravenous thrombolysis (IVT). However, data on their impact on routine clinical care remains scarce.Methods: Using a prospective observational registry, we assessed: (1) the clinical and radiological characteristics of all consecutive patients treated with thrombectomy; (2) the outcome of all patients with M1 occlusion (treated with thrombectomy or IVT alone). Two periods were compared: before (2013â2014) and after (2015â2016) the publication of RT.Results: Endovascular procedures significantly increased between the two periods (N = 82 vs. 314, p < 0.0001). In 2015â2016, patients were older (median [IQR]: 69 [57-80]; vs. 66 [53-74]; p = 0.008), had shorter door-to-clot times (69 [47-95]; vs. 110 [83-155]; p < 0.0001) resulting in a trend toward shorter delay from symptom onset to reperfusion (232 [185-300]; vs. 250 [200-339]; p = 0.1), with higher rates of reperfusion (71 vs. 48%; p = 0.0001). Conversely, no significant differences in baseline NIHSS scores, ASPECTS, delay to IVT or intracranial hemorrhage were found. In 2015â2016, patients with M1 occlusion were treated with thrombectomy more often than in 2013â2014 (87 vs. 32%, respectively; p < 0.0001), with a significant improvement in clinical outcome (shift analysis, lower modified Rankin scale scores: OR = 1.68; 95% CI: 1.10â2.57; p = 0.017).Conclusion: Following the publication of RT, thrombectomy was rapidly implemented with significant improvements in intrahospital delay and reperfusion rates. Treatment with thrombectomy increased with better clinical outcomes in patients with M1 occlusion
Time to treatment with bridging intravenous alteplase before endovascular treatment:subanalysis of the randomized controlled SWIFT-DIRECT trial.
BACKGROUND
We hypothesized that treatment delays might be an effect modifier regarding risks and benefits of intravenous thrombolysis (IVT) before mechanical thrombectomy (MT).
METHODS
We used the dataset of the SWIFT-DIRECT trial, which randomized 408 patients to IVT+MTâor MT alone. Potential interactions between assignment to IVT+MTâand expected time from onset-to-needle (OTN) as well as expected time from door-to-needle (DTN) were included in regression models. The primary outcome was functional independence (modified Rankin Scale (mRS) 0-2) at 3 months. Secondary outcomes included mRS shift, mortality, recanalization rates, and (symptomatic) intracranial hemorrhage at 24 hours.
RESULTS
We included 408 patients (IVT+MT 207, MT 201, median age 72 years (IQR 64-81), 209 (51.2%) female). The expected median OTN and DTN were 142âmin and 54âmin in the IVT+MT group and 129âmin and 51âmin in the MT alone group. Overall, there was no significant interaction between OTN and bridging IVT assignment regarding either the functional (adjusted OR (aOR) 0.76, 95% CI 0.45 to 1.30) and safety outcomes or the recanalization rates. Analysis of in-hospital delays showed no significant interaction between DTN and bridging IVT assignment regarding the dichotomized functional outcome (aOR 0.48, 95% CI 0.14 to 1.62), but the shift and mortality analyses suggested a greater benefit of IVT when in-hospital delays were short.
CONCLUSIONS
We found no evidence that the effect of bridging IVT on functional independence is modified by overall or in-hospital treatment delays. Considering its low power, this subgroup analysis could have missed a clinically important effect, and exploratory analysis of secondary clinical outcomes indicated a potentially favorable effect of IVT with shorter in-hospital delays. Heterogeneity of the IVT effect size before MT should be further analyzed in individual patient meta-analysis of comparable trials.
TRIAL REGISTRATION NUMBER
URL: https://www.
CLINICALTRIALS
gov ; Unique identifier: NCT03192332
Decline in subarachnoid haemorrhage volumes associated with the first wave of the COVID-19 pandemic
BACKGROUND: During the COVID-19 pandemic, decreased volumes of stroke admissions and mechanical thrombectomy were reported. The study\u27s objective was to examine whether subarachnoid haemorrhage (SAH) hospitalisations and ruptured aneurysm coiling interventions demonstrated similar declines.
METHODS: We conducted a cross-sectional, retrospective, observational study across 6 continents, 37 countries and 140 comprehensive stroke centres. Patients with the diagnosis of SAH, aneurysmal SAH, ruptured aneurysm coiling interventions and COVID-19 were identified by prospective aneurysm databases or by International Classification of Diseases, 10th Revision, codes. The 3-month cumulative volume, monthly volumes for SAH hospitalisations and ruptured aneurysm coiling procedures were compared for the period before (1âyear and immediately before) and during the pandemic, defined as 1 March-31 May 2020. The prior 1-year control period (1 March-31 May 2019) was obtained to account for seasonal variation.
FINDINGS: There was a significant decline in SAH hospitalisations, with 2044 admissions in the 3âmonths immediately before and 1585 admissions during the pandemic, representing a relative decline of 22.5% (95% CI -24.3% to -20.7%, p\u3c0.0001). Embolisation of ruptured aneurysms declined with 1170-1035 procedures, respectively, representing an 11.5% (95%CI -13.5% to -9.8%, p=0.002) relative drop. Subgroup analysis was noted for aneurysmal SAH hospitalisation decline from 834 to 626 hospitalisations, a 24.9% relative decline (95%âCI -28.0% to -22.1%, p\u3c0.0001). A relative increase in ruptured aneurysm coiling was noted in low coiling volume hospitals of 41.1% (95% CI 32.3% to 50.6%, p=0.008) despite a decrease in SAH admissions in this tertile.
INTERPRETATION: There was a relative decrease in the volume of SAH hospitalisations, aneurysmal SAH hospitalisations and ruptured aneurysm embolisations during the COVID-19 pandemic. These findings in SAH are consistent with a decrease in other emergencies, such as stroke and myocardial infarction
IschĂ©mie-reperfusion cĂ©rĂ©brale : rĂŽle de lâinflammation
Ntravenous thrombolysis and, more recently, mechanical thrombectomy have improved acute ischemic stroke management in improving restoration of brain perfusion and the preservation of the penumbra and thus functional outcome. Despite early recanalisation, a poor clinical outcome likely related to ischemia-reperfusion damages is frequently observed. Post-ischemic inflammatory response may contribute to these damages. To date, little is known about the kinetics of this process, especially in the setting of mechanical thrombectomy, whereas a better understanding of that phenomenom would allow a more targeted neuroprotective approach. Here, we proposed to assess the relationship between serum markers of inflammation and key prognostic factors, through an original approach focused on patients treated with mechanical thrombectomy. For this, we did a sequential assessement of both serum markers of inflammation and ischemic damages on magnetic resonance imaging within the HIBISCUS-STROKE cohort (CoHort of Patients to Identify Biological and Imaging markerS of CardiovascUlar Outcomes in Stroke). In the first part of our work, we aimed to clarify the relationship between post-ischemic inflammation and collateral circulation status, as the latter impacts the timing of tissue loss and response to reperfusion therapies in acute ischemic stroke. We have etablished that low Matrix Metalloproteinase-9 (MMP-9) and high Monocyte Chemoattractant Protein-1 levels were associated with good pretreatment collateral status. In the second part of our work, we assessed the relationship between MMP-9, a proteolytic enzyme involved in the breakdown of the blood-brain barrier, and the risk of hemorrhagic transformation and infarct growth. We have identified that MMP-9 peaked at 6 hours and that its level predicted hemorrhagic transformation, mainly minor, and infarct growth. In the third part, we aimed to investigate the relationship between post-ischemic inflammation and futile recanalization, defined as poor functional outcome despite successful recanalization and occurring in half of the patients. We observed that interleukin 6 peaked at 24 hours and was a marker of futile recanalization. HIBISCUS-STROKE cohort gave us the opportunity to assess the relationship between serum markers of inflammation and key prognostic factors in the setting of mechanical thrombectomy. This original approach pave the way for new perspectives in terms of neuroprotectionLa thrombolyse intraveineuse et, plus rĂ©cemment la thrombectomie mĂ©canique, ont bouleversĂ© la prise en charge de lâinfarctus cĂ©rĂ©bral. Le principal objectif de ces thĂ©rapeutiques est de restaurer la perfusion cĂ©rĂ©brale et de prĂ©server la pĂ©nombre et ainsi de rĂ©duire le handicap neurologique. Cependant en dĂ©pit dâune recanalisation artĂ©rielle prĂ©coce, lâĂ©volution clinique demeure pĂ©jorative chez certains patients probablement du fait des lĂ©sions dâischĂ©mie/reperfusion auxquelles contribue lâinflammation. A ce jour la dynamique de la rĂ©ponse inflammatoire reste peu documentĂ©e, en particulier dans le cadre de la thrombectomie mĂ©canique. Une meilleure connaissance de ce phĂ©nomĂšne autoriserait une approche plus ciblĂ©e de la neuroprotection dans lâischĂ©mie cĂ©rĂ©brale. Notre travail de thĂšse se propose dâĂ©tudier la relation entre les marqueurs sĂ©riques de lâinflammation et les facteurs clefs du pronostic clinique, ce qui est une approche inĂ©dite dans le contexte de la thrombectomie. Dans cette perspective, nous avons couplĂ© au sein de la cohorte HIBISCUS-STROKE (CoHort of Patients to Identify Biological and Imaging markerS of CardiovascUlar Outcomes in Stroke) lâanalyse dynamique des marqueurs sĂ©riques de lâinflammation Ă lâĂ©valuation sĂ©quentielle des lĂ©sions ischĂ©miques en imagerie par rĂ©sonance magnĂ©tique. Dans la premiĂšre partie de ce travail nous nous sommes interrogĂ©s sur la relation entre la rĂ©ponse inflammatoire et la qualitĂ© de la circulation collatĂ©rale, cette derniĂšre Ă©tant impliquĂ©e dans la rapiditĂ© de progression de lâinfarctus et la rĂ©ponse Ă la thrombectomie. Nous avons mis en Ă©vidence quâune collatĂ©ralitĂ© leptomĂ©ningĂ©e de bonne qualitĂ© Ă lâadmission Ă©tait associĂ©e Ă des taux faibles de mĂ©talloprotĂ©ase matricielle 9 (MMP-9 : Matrix Metalloproteinase-9) et Ă des taux Ă©levĂ©s de Monocyte Chemoattractant Protein-1. Dans la deuxiĂšme partie de notre travail, nous avons Ă©valuĂ© la relation entre la MMP-9, une enzyme protĂ©olytique impliquĂ©e dans la dĂ©gradation de la barriĂšre hĂ©mato-encĂ©phalique, et le risque de transformation hĂ©morragique et la croissance de lâinfarctus. Nous avons observĂ© que le taux de MMP-9 Ă©tait maximal Ă 6 heures et que ce taux Ă©tait associĂ© Ă un risque accru de transformation hĂ©morragique mais le plus souvent mineure, et Ă la croissance de lâinfarctus cĂ©rĂ©bral. Dans la troisiĂšme partie de notre travail, nous avons souhaitĂ© prĂ©cisĂ© la relation entre lâinflammation et la recanalisation dite « futile », câest-Ă -dire sans bĂ©nĂ©fice clinique, constatĂ©e chez la moitiĂ© des patients. Nous avons rĂ©vĂ©lĂ© que le taux dâinterleukine 6, maximal 24 heures aprĂšs lâadmission, Ă©tait un facteur prĂ©dictif de recanalisation dite «futile». La cohorte HIBISCUS-STROKE nous a donc permis dâidentifier les marqueurs sĂ©riques de lâinflammation associĂ©s aux facteurs clefs du pronostic clinique dans le cadre de la thrombectomie. Cette approche est susceptible de gĂ©nĂ©rer de nouvelles perspectives thĂ©rapeutique
IschĂ©mie-reperfusion cĂ©rĂ©brale : rĂŽle de lâinflammation
Ntravenous thrombolysis and, more recently, mechanical thrombectomy have improved acute ischemic stroke management in improving restoration of brain perfusion and the preservation of the penumbra and thus functional outcome. Despite early recanalisation, a poor clinical outcome likely related to ischemia-reperfusion damages is frequently observed. Post-ischemic inflammatory response may contribute to these damages. To date, little is known about the kinetics of this process, especially in the setting of mechanical thrombectomy, whereas a better understanding of that phenomenom would allow a more targeted neuroprotective approach. Here, we proposed to assess the relationship between serum markers of inflammation and key prognostic factors, through an original approach focused on patients treated with mechanical thrombectomy. For this, we did a sequential assessement of both serum markers of inflammation and ischemic damages on magnetic resonance imaging within the HIBISCUS-STROKE cohort (CoHort of Patients to Identify Biological and Imaging markerS of CardiovascUlar Outcomes in Stroke). In the first part of our work, we aimed to clarify the relationship between post-ischemic inflammation and collateral circulation status, as the latter impacts the timing of tissue loss and response to reperfusion therapies in acute ischemic stroke. We have etablished that low Matrix Metalloproteinase-9 (MMP-9) and high Monocyte Chemoattractant Protein-1 levels were associated with good pretreatment collateral status. In the second part of our work, we assessed the relationship between MMP-9, a proteolytic enzyme involved in the breakdown of the blood-brain barrier, and the risk of hemorrhagic transformation and infarct growth. We have identified that MMP-9 peaked at 6 hours and that its level predicted hemorrhagic transformation, mainly minor, and infarct growth. In the third part, we aimed to investigate the relationship between post-ischemic inflammation and futile recanalization, defined as poor functional outcome despite successful recanalization and occurring in half of the patients. We observed that interleukin 6 peaked at 24 hours and was a marker of futile recanalization. HIBISCUS-STROKE cohort gave us the opportunity to assess the relationship between serum markers of inflammation and key prognostic factors in the setting of mechanical thrombectomy. This original approach pave the way for new perspectives in terms of neuroprotectionLa thrombolyse intraveineuse et, plus rĂ©cemment la thrombectomie mĂ©canique, ont bouleversĂ© la prise en charge de lâinfarctus cĂ©rĂ©bral. Le principal objectif de ces thĂ©rapeutiques est de restaurer la perfusion cĂ©rĂ©brale et de prĂ©server la pĂ©nombre et ainsi de rĂ©duire le handicap neurologique. Cependant en dĂ©pit dâune recanalisation artĂ©rielle prĂ©coce, lâĂ©volution clinique demeure pĂ©jorative chez certains patients probablement du fait des lĂ©sions dâischĂ©mie/reperfusion auxquelles contribue lâinflammation. A ce jour la dynamique de la rĂ©ponse inflammatoire reste peu documentĂ©e, en particulier dans le cadre de la thrombectomie mĂ©canique. Une meilleure connaissance de ce phĂ©nomĂšne autoriserait une approche plus ciblĂ©e de la neuroprotection dans lâischĂ©mie cĂ©rĂ©brale. Notre travail de thĂšse se propose dâĂ©tudier la relation entre les marqueurs sĂ©riques de lâinflammation et les facteurs clefs du pronostic clinique, ce qui est une approche inĂ©dite dans le contexte de la thrombectomie. Dans cette perspective, nous avons couplĂ© au sein de la cohorte HIBISCUS-STROKE (CoHort of Patients to Identify Biological and Imaging markerS of CardiovascUlar Outcomes in Stroke) lâanalyse dynamique des marqueurs sĂ©riques de lâinflammation Ă lâĂ©valuation sĂ©quentielle des lĂ©sions ischĂ©miques en imagerie par rĂ©sonance magnĂ©tique. Dans la premiĂšre partie de ce travail nous nous sommes interrogĂ©s sur la relation entre la rĂ©ponse inflammatoire et la qualitĂ© de la circulation collatĂ©rale, cette derniĂšre Ă©tant impliquĂ©e dans la rapiditĂ© de progression de lâinfarctus et la rĂ©ponse Ă la thrombectomie. Nous avons mis en Ă©vidence quâune collatĂ©ralitĂ© leptomĂ©ningĂ©e de bonne qualitĂ© Ă lâadmission Ă©tait associĂ©e Ă des taux faibles de mĂ©talloprotĂ©ase matricielle 9 (MMP-9 : Matrix Metalloproteinase-9) et Ă des taux Ă©levĂ©s de Monocyte Chemoattractant Protein-1. Dans la deuxiĂšme partie de notre travail, nous avons Ă©valuĂ© la relation entre la MMP-9, une enzyme protĂ©olytique impliquĂ©e dans la dĂ©gradation de la barriĂšre hĂ©mato-encĂ©phalique, et le risque de transformation hĂ©morragique et la croissance de lâinfarctus. Nous avons observĂ© que le taux de MMP-9 Ă©tait maximal Ă 6 heures et que ce taux Ă©tait associĂ© Ă un risque accru de transformation hĂ©morragique mais le plus souvent mineure, et Ă la croissance de lâinfarctus cĂ©rĂ©bral. Dans la troisiĂšme partie de notre travail, nous avons souhaitĂ© prĂ©cisĂ© la relation entre lâinflammation et la recanalisation dite « futile », câest-Ă -dire sans bĂ©nĂ©fice clinique, constatĂ©e chez la moitiĂ© des patients. Nous avons rĂ©vĂ©lĂ© que le taux dâinterleukine 6, maximal 24 heures aprĂšs lâadmission, Ă©tait un facteur prĂ©dictif de recanalisation dite «futile». La cohorte HIBISCUS-STROKE nous a donc permis dâidentifier les marqueurs sĂ©riques de lâinflammation associĂ©s aux facteurs clefs du pronostic clinique dans le cadre de la thrombectomie. Cette approche est susceptible de gĂ©nĂ©rer de nouvelles perspectives thĂ©rapeutique
IschĂ©mie-reperfusion cĂ©rĂ©brale : rĂŽle de lâinflammation
Ntravenous thrombolysis and, more recently, mechanical thrombectomy have improved acute ischemic stroke management in improving restoration of brain perfusion and the preservation of the penumbra and thus functional outcome. Despite early recanalisation, a poor clinical outcome likely related to ischemia-reperfusion damages is frequently observed. Post-ischemic inflammatory response may contribute to these damages. To date, little is known about the kinetics of this process, especially in the setting of mechanical thrombectomy, whereas a better understanding of that phenomenom would allow a more targeted neuroprotective approach. Here, we proposed to assess the relationship between serum markers of inflammation and key prognostic factors, through an original approach focused on patients treated with mechanical thrombectomy. For this, we did a sequential assessement of both serum markers of inflammation and ischemic damages on magnetic resonance imaging within the HIBISCUS-STROKE cohort (CoHort of Patients to Identify Biological and Imaging markerS of CardiovascUlar Outcomes in Stroke). In the first part of our work, we aimed to clarify the relationship between post-ischemic inflammation and collateral circulation status, as the latter impacts the timing of tissue loss and response to reperfusion therapies in acute ischemic stroke. We have etablished that low Matrix Metalloproteinase-9 (MMP-9) and high Monocyte Chemoattractant Protein-1 levels were associated with good pretreatment collateral status. In the second part of our work, we assessed the relationship between MMP-9, a proteolytic enzyme involved in the breakdown of the blood-brain barrier, and the risk of hemorrhagic transformation and infarct growth. We have identified that MMP-9 peaked at 6 hours and that its level predicted hemorrhagic transformation, mainly minor, and infarct growth. In the third part, we aimed to investigate the relationship between post-ischemic inflammation and futile recanalization, defined as poor functional outcome despite successful recanalization and occurring in half of the patients. We observed that interleukin 6 peaked at 24 hours and was a marker of futile recanalization. HIBISCUS-STROKE cohort gave us the opportunity to assess the relationship between serum markers of inflammation and key prognostic factors in the setting of mechanical thrombectomy. This original approach pave the way for new perspectives in terms of neuroprotectionLa thrombolyse intraveineuse et, plus rĂ©cemment la thrombectomie mĂ©canique, ont bouleversĂ© la prise en charge de lâinfarctus cĂ©rĂ©bral. Le principal objectif de ces thĂ©rapeutiques est de restaurer la perfusion cĂ©rĂ©brale et de prĂ©server la pĂ©nombre et ainsi de rĂ©duire le handicap neurologique. Cependant en dĂ©pit dâune recanalisation artĂ©rielle prĂ©coce, lâĂ©volution clinique demeure pĂ©jorative chez certains patients probablement du fait des lĂ©sions dâischĂ©mie/reperfusion auxquelles contribue lâinflammation. A ce jour la dynamique de la rĂ©ponse inflammatoire reste peu documentĂ©e, en particulier dans le cadre de la thrombectomie mĂ©canique. Une meilleure connaissance de ce phĂ©nomĂšne autoriserait une approche plus ciblĂ©e de la neuroprotection dans lâischĂ©mie cĂ©rĂ©brale. Notre travail de thĂšse se propose dâĂ©tudier la relation entre les marqueurs sĂ©riques de lâinflammation et les facteurs clefs du pronostic clinique, ce qui est une approche inĂ©dite dans le contexte de la thrombectomie. Dans cette perspective, nous avons couplĂ© au sein de la cohorte HIBISCUS-STROKE (CoHort of Patients to Identify Biological and Imaging markerS of CardiovascUlar Outcomes in Stroke) lâanalyse dynamique des marqueurs sĂ©riques de lâinflammation Ă lâĂ©valuation sĂ©quentielle des lĂ©sions ischĂ©miques en imagerie par rĂ©sonance magnĂ©tique. Dans la premiĂšre partie de ce travail nous nous sommes interrogĂ©s sur la relation entre la rĂ©ponse inflammatoire et la qualitĂ© de la circulation collatĂ©rale, cette derniĂšre Ă©tant impliquĂ©e dans la rapiditĂ© de progression de lâinfarctus et la rĂ©ponse Ă la thrombectomie. Nous avons mis en Ă©vidence quâune collatĂ©ralitĂ© leptomĂ©ningĂ©e de bonne qualitĂ© Ă lâadmission Ă©tait associĂ©e Ă des taux faibles de mĂ©talloprotĂ©ase matricielle 9 (MMP-9 : Matrix Metalloproteinase-9) et Ă des taux Ă©levĂ©s de Monocyte Chemoattractant Protein-1. Dans la deuxiĂšme partie de notre travail, nous avons Ă©valuĂ© la relation entre la MMP-9, une enzyme protĂ©olytique impliquĂ©e dans la dĂ©gradation de la barriĂšre hĂ©mato-encĂ©phalique, et le risque de transformation hĂ©morragique et la croissance de lâinfarctus. Nous avons observĂ© que le taux de MMP-9 Ă©tait maximal Ă 6 heures et que ce taux Ă©tait associĂ© Ă un risque accru de transformation hĂ©morragique mais le plus souvent mineure, et Ă la croissance de lâinfarctus cĂ©rĂ©bral. Dans la troisiĂšme partie de notre travail, nous avons souhaitĂ© prĂ©cisĂ© la relation entre lâinflammation et la recanalisation dite « futile », câest-Ă -dire sans bĂ©nĂ©fice clinique, constatĂ©e chez la moitiĂ© des patients. Nous avons rĂ©vĂ©lĂ© que le taux dâinterleukine 6, maximal 24 heures aprĂšs lâadmission, Ă©tait un facteur prĂ©dictif de recanalisation dite «futile». La cohorte HIBISCUS-STROKE nous a donc permis dâidentifier les marqueurs sĂ©riques de lâinflammation associĂ©s aux facteurs clefs du pronostic clinique dans le cadre de la thrombectomie. Cette approche est susceptible de gĂ©nĂ©rer de nouvelles perspectives thĂ©rapeutique
Pollution atmosphérique et infarctus cérébraux (l'étude AVC69)
LYON1-BU Santé (693882101) / SudocSudocFranceF
The Elusive Origin of Atherosclerotic Plaque Calcification
International audienceIt has been known for decades or even centuries that arteries calcify as they age. Vascular calcification probably affects all adults, since virtually all have atherosclerotic plaques: an accumulation of lipids, inflammatory cells, necrotic debris, and calcium phosphate crystals. A high vascular calcium score is associated with a high cardiovascular mortality risk, and relatively recent data suggest that even microcalcifications that form in early plaques may destabilize plaques and trigger a cardiovascular event. If the cellular and molecular mechanisms of plaque calcification have been relatively well characterized in mice, human plaques appear to calcify through different mechanisms that remain obscure. In this context, we will first review articles reporting the location and features of early calcifications in human plaques and then review the articles that explored the mechanisms though which human and mouse plaques calcify
Word processing in Parkinson's disease is impaired for action verbs but not for concrete nouns.: Action word processing in Parkinson's Disease
International audienceRecent studies have demonstrated that processing of action words recruits cortical motor regions that are also involved in the planning and execution of the actions words refer to. The functional role of these regions in word understanding remains, however, to be clarified. The present study investigates this issue by examining the impact of Parkinson's disease (PD) on lexical decision performance for action words, relative to concrete nouns, in a masked priming paradigm. Priming effects for the two word categories were measured in non-demented PD patients off and on dopaminergic treatment, and in healthy participants. Our results revealed that although overall performances did not differ between verbs and nouns, priming effects showed a clear dissociation between word categories. While priming for concrete nouns was not affected by Levodopa intake, it dissociated as a function of treatment for action verbs. No priming was actually obtained for action verbs in PD patients off dopaminergic treatment. Following Levodopa intake, this deficit recovered, however, because priming effects for verbs became comparable to those for concrete nouns and similar to performance of healthy participants. Overall, this study thus brings compelling evidence that processing lexico-semantic information about action words depends on the integrity of the motor system
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