How to Capitalize on the Retest Effect in Future Trials on Huntington's Disease.

The retest effect-improvement of performance on second exposure to a task-may impede the detection of cognitive decline in clinical trials for neurodegenerative diseases. We assessed the impact of the retest effect in Huntington's disease trials, and investigated its possible neutralization. We enrolled 54 patients in the Multicentric Intracerebral Grafting in Huntington's Disease (MIG-HD) trial and 39 in the placebo arm of the Riluzole trial in Huntington's Disease (RIL-HD). All were assessed with the Unified Huntington's Disease Rating Scale (UHDRS) plus additional cognitive tasks at baseline (A1), shortly after baseline (A2) and one year later (A3). We used paired t-tests to analyze the retest effect between A1 and A2. For each task of the MIG-HD study, we used a stepwise algorithm to design models predictive of patient performance at A3, which we applied to the RIL-HD trial for external validation. We observed a retest effect in most cognitive tasks. A decline in performance at one year was detected in 3 of the 15 cognitive tasks with A1 as the baseline, and 9 of the 15 cognitive tasks with A2 as the baseline. We also included the retest effect in performance modeling and showed that it facilitated performance prediction one year later for 14 of the 15 cognitive tasks. The retest effect may mask cognitive decline in patients with neurodegenerative diseases. The dual baseline can improve clinical trial design, and better prediction should homogenize patient groups, resulting in smaller numbers of participants being required

La migraine en 2009: De la crise au traitement

Migraine is Europe and North America's most frequent neurological illness. Its prevalence is about 12 %, affecting women twice more than men. Migraine illness is defined by the occurrence of several episodes of pulsatile headaches, uni- or bilateral, accompanied or preceded by signs of central and autonomic nervous system dysfunction. Considered benign, it can lead to non negligible social and professional handicap. Its social and economic repercussions are serious, due to consequences in terms of work incapacity. Essentially relying on drugs, therapeutic divides itself into migraine attack treatment and migraine prophylaxis. Migraine attack treatment relies essentially on acetaminophen and non-steroidal anti-inflammatory agents, associated or not with antiemetics like domperidone and metoclopramide, accessorily on ergot derivatives and triptans. Migraine prophylaxis is best provided by propranolol, valproic acid and amitryptiline, anti-serotoninergic agents, topiramate, flunarizine and other agents should be reserved to particular cases. In some cases, children in particular, non-drug approaches such as relaxation, biofeedback or behavioral therapy can be privileged although relying on weak scientific evidences.SCOPUS: no.jinfo:eu-repo/semantics/publishe

Identification and measurement of dystonia in cerebral palsy

SCOPUS: no.jinfo:eu-repo/semantics/publishe

How to capitalize on the retest effect in future trials on Huntington's disease

The retest effect - improvement of performance on second exposure to a task - may impede the detection of cognitive decline in clinical trials for neurodegenerative diseases. We assessed the impact of the retest effect in Huntington's disease trials, and investigated its possible neutralization.We enrolled 54 patients in the Multicentric Intracerebral Grafting in Huntington's Disease (MIG-HD) trial and 39 in the placebo arm of the Riluzole trial in Huntington's Disease (RIL-HD). All were assessed with the Unified Huntington's Disease Rating Scale (UHDRS) plus additional cognitive tasks at baseline (A1), shortly after baseline (A2) and one year later (A3). We used paired t-tests to analyze the retest effect between A1 and A2. For each task of the MIG-HD study, we used a stepwise algorithm to design models predictive of patient performance at A3, which we applied to the RIL-HD trial for external validation. We observed a retest effect in most cognitive tasks. A decline in performance at one year was detected in 3 of the 15 cognitive tasks with A1 as the baseline, and 9 of the 15 cognitive tasks with A2 as the baseline.We also included the retest effect in performance modeling and showed that it facilitated performance prediction one year later for 14 of the 15 cognitive tasks. The retest effect may mask cognitive decline in patients with neurodegenerative diseases. The dual baseline can improve clinical trial design, and better prediction should homogenize patient groups, resulting in smaller numbers of participants being required.0SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Bilateral vocal fold palsy caused by chronic motor axonal neuropathy

SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Devic’s disease associated with anti-Ro/SSA antibodies

info:eu-repo/semantics/publishe

Tacrolimus neurotoxicity heralded by myoclonus

info:eu-repo/semantics/publishe

Painful arm and moving fingers: Clinical features of four new cases

The syndrome of painful arm and moving fingers associates pain in one arm or hand with involuntary movement of one or several fingers. In the 4 cases described, an association between a central and a peripheral nervous system lesion is demonstrated or suspected. Treatment of the condition is disappointing. © 2002 Movement Disorder Society.SCOPUS: ar.jFLWINinfo:eu-repo/semantics/publishe

Pas de larme pour la neuromyélite optique, une maladie de Devic associée à des anti-Ssa

info:eu-repo/semantics/publishedJournées de neurologie de langue française, Lyon Avril 201