Repetitive transcranial magnetic stimulation and transcranial direct current stimulation in motor rehabilitation after stroke: An update

AbstractStroke is a leading cause of adult motor disability. The number of stroke survivors is increasing in industrialized countries, and despite available treatments used in rehabilitation, the recovery of motor functions after stroke is often incomplete. Studies in the 1980s showed that non-invasive brain stimulation (mainly repetitive transcranial magnetic stimulation [rTMS] and transcranial direct current stimulation [tDCS]) could modulate cortical excitability and induce plasticity in healthy humans. These findings have opened the way to the therapeutic use of the 2 techniques for stroke. The mechanisms underlying the cortical effect of rTMS and tDCS differ. This paper summarizes data obtained in healthy subjects and gives a general review of the use of rTMS and tDCS in stroke patients with altered motor functions. From 1988 to 2012, approximately 1400 publications were devoted to the study of non-invasive brain stimulation in humans. However, for stroke patients with limb motor deficit, only 141 publications have been devoted to the effects of rTMS and 132 to those of tDCS. The Cochrane review devoted to the effects of rTMS found 19 randomized controlled trials involving 588 patients, and that devoted to tDCS found 18 randomized controlled trials involving 450 patients. Without doubt, rTMS and tDCS contribute to physiological and pathophysiological studies in motor control. However, despite the increasing number of studies devoted to the possible therapeutic use of non-invasive brain stimulation to improve motor recovery after stroke, further studies will be necessary to specify their use in rehabilitation

Opsoclonus in a child with neuroborreliosis: Case report and review of the literature

Opsoclonus consists of massive erratic rapid eye jerks. They may occur in isolation or in association with myoclonus and ataxia, i.e., opsoclonus-myoclonus syndrome (OMS). We report the case of a 9-year-old girl who suffered from headaches for several days and was shown to have opsoclonus and left peripheral facial palsy. Work-up excluded the diagnosis of neuroblastoma, but CSF analysis showed aseptic meningitis, and serology for Borrelia burgdorferi (Lyme) was positive. The outcome was favorable with complete regression of symptoms after treatment with ceftriaxone 2g/day for 3 weeks. Although rare, the diagnosis of Lyme neuroborreliosis must be raised in the presence of isolated opsoclonus, particularly if the clinical picture is incomplete and if other features, such as peripheral facial palsy and pleocytosis in the CSF, are present

Phosphodiesterase type 4 expression and anti-proliferative effects in human pulmonary artery smooth muscle cells

BACKGROUND: Pulmonary arterial hypertension is a proliferative vascular disease, characterized by aberrant regulation of smooth muscle cell proliferation and apoptosis in distal pulmonary arteries. Prostacyclin (PGI(2)) analogues have anti-proliferative effects on distal human pulmonary artery smooth muscle cells (PASMCs), which are dependent on intracellular cAMP stimulation. We therefore sought to investigate the involvement of the main cAMP-specific enzymes, phosphodiesterase type 4 (PDE4), responsible for cAMP hydrolysis. METHODS: Distal human PASMCs were derived from pulmonary arteries by explant culture (n = 14, passage 3–12). Responses to platelet-derived growth factor-BB (5–10 ng/ml), serum, PGI(2 )analogues (cicaprost, iloprost) and PDE4 inhibitors (roflumilast, rolipram, cilomilast) were determined by measuring cAMP phosphodiesterase activity, intracellular cAMP levels, DNA synthesis, apoptosis (as measured by DNA fragmentation and nuclear condensation) and matrix metalloproteinase-2 and -9 (MMP-2, MMP-9) production. RESULTS: Expression of all four PDE4A-D genes was detected in PASMC isolates. PDE4 contributed to the main proportion (35.9 ± 2.3%, n = 5) of cAMP-specific hydrolytic activity demonstrated in PASMCs, compared to PDE3 (21.5 ± 2.5%), PDE2 (15.8 ± 3.4%) or PDE1 activity (14.5 ± 4.2%). Intracellular cAMP levels were increased by PGI(2 )analogues and further elevated in cells co-treated with roflumilast, rolipram and cilomilast. DNA synthesis was attenuated by 1 μM roflumilast (49 ± 6% inhibition), rolipram (37 ± 6%) and cilomilast (30 ± 4%) and, in the presence of 5 nM cicaprost, these compounds exhibited EC(50 )values of 4.4 (2.6–6.1) nM (Mean and 95% confidence interval), 59 (36–83) nM and 97 (66–130) nM respectively. Roflumilast attenuated cell proliferation and gelatinase (MMP-2 and MMP-9) production and promoted the anti-proliferative effects of PGI(2 )analogues. The cAMP activators iloprost and forskolin also induced apoptosis, whereas roflumilast had no significant effect. CONCLUSION: PDE4 enzymes are expressed in distal human PASMCs and the effects of cAMP-stimulating agents on DNA synthesis, proliferation and MMP production is dependent, at least in part, on PDE4 activity. PDE4 inhibition may provide greater control of cAMP-mediated anti-proliferative effects in human PASMCs and therefore could prove useful as an additional therapy for pulmonary arterial hypertension

Contribution à l'étude des races d'oïdium du haricot (Erysiphe polygoni D.C.) en Guadeloupe

L’hypothèse d’une hétérogénéité de la population d’oïdium (Erysiphe polygoni D.C.) en Guadeloupe, suggérée par l’observation de la maladie en serre et au champ sur diverses variétés de haricot, a été vérifiée par inoculation en pièces climatiques de variétés différentielles. Deux races physiologiques d’oïdium ont pu être mises en évidence. En culture, la race 1 apparaît au début de la saison la plus favorable à la maladie (décembre-mai), son développement est rapide tant que les températures maximales ne dépassent pas 30°C. La race 2 apparaît plus tardivement, affecte avec une plus ou moins grande aggressivité un plus grand nombre de variétés et supporte mieux les températures élevées. L’incidence de l’existence de ces deux races sur les programmes de sélection pour la résistance est discutée.Greenhouse and field reactions of different varieties, naturally or artificially mildewed, suggested an heterogeneity of the pathogen population ( Erysiphe polygoni D.C). Two races differing in virulence and agressiveness prevail during the cultural season (December to June on 1987-1988.). Both survive on wild legumes. Race 1 appears first on bean and requires cooler temperatures than race 2 for development. Race 2 comes later and has a wider spectrum. Expected consequences on breeding for resistance are discussed

Les septorioses [Septoria nodorum, Septoria tritici

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Les fusarioses des cereales [Fusarium nivale, Fusarium roseum

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Etudes de gradients de dissémination dans le cas de l’oïdium du haricot en Guadeloupe

En Guadeloupe, la régularité des alizés (secteur est) permet d’étudier des gradients de dispersion de maladies disséminées par le vent. La progression de l’oïdium (Erysiphe polygoni DC) a été notée dans 6 variétés de haricot (Phaseolus vulgaris L) placées à des distances variables d’une source d’inoculum constituée par une parcelle infectée de la variété sensible Borlotto nano vigevano située dans la partie est de l’essai. La transformation de Gregory (1968) traduit correctement la progression moyenne de l’oïdium. La progression dans chaque variété est influencée par la résistance à la maladie, celle-ci s’exprimant parfois à l’état adulte. Il apparaît que quelles que soient les variétés, le rendement est diminué au voisinage de la source d’inoculum, les mécanismes de résistance consommant de l’énergie. En pratique, des variétés résistantes placées près de parcelles infectées peuvent subir des pertes de rendement non décelées.In Guadeloupe trade winds of regular direction provide good conditions for epidemiological studies on wind-borne disease gradients. Six varieties of bean (Phaseolus vulgaris L) were studied for powdery mildew progression (Erysiphe polygoni DC). The source of inoculum came from a plot of the susceptible variety Borlotto nano vigevano in the eastern part of the field (fig 1). The resulting powdery mildew gradient was measured on 4 different dates (fig 2). Regression analysis of mean disease severity with distance indicated that the log-log disease spread model fitted the data (table I). The apparent variety susceptibility estimated by the area under the severity curve (table II) affected the powdery mildew spread. However, resistance mechanisms resulted in an energy expenditure, and all the varieties showed a yield decrease near the source of inoculum (figs 3, 4). So in practice, the vicinity of infected crops may reduce the performance of bean resistant varieties which are apparently symptom-free