Supraorbital transcutaneous neurostimulation has sedative effects in healthy subjects

Transcutaneous neurostimulation (TNS) at extracephalic sites is a well known treatment of pain. Thanks to recent technical progress, the Cefaly® device now also allows supraorbital TNS. During observational clinical studies, several patients reported decreased vigilance or even sleepiness during a session of supraorbital TNS. We decided therefore to explore in more detail the potential sedative effect of supraorbital TNS, using standardized psychophysical tests in healthy volunteers.Clinical TrialJournal Articleinfo:eu-repo/semantics/publishe

Retrospective evaluation of prognostic score performances in cirrhotic patients admitted to an intermediate care unit

International audienc

Aortic Function's Adaptation in Response to Exercise-Induced Stress Assessing by 1.5T MRI : A Pilot Study in Healthy Volunteers

International audienceEvaluation of the aortic "elastic reserve" might be a relevant marker to assess the risk of aortic event. Our aim was to compare regional aortic elasticity at rest and during supine bicycle exercise at 1.5 T MRI in healthy individuals. Fifteen volunteers (8 men), with a mean age of 29 (23-41) years, completed the entire protocol. Images were acquired immediately following maximal exercise. Retrospective cine sequences were acquired to assess compliance, distensibility, maximum rates of systolic distension and diastolic recoil at four different locations: ascending aorta, proximal descending aorta, distal descending aorta and aorta above the coeliac trunk level. Segmental aortic pulse wave velocity (PWV) was assessed by through plane velocity-encoded MRI. Exercise induced a significant decrease of aortic compliance and distensibility, and a significant increase of the absolute values of maximum rates of systolic distension and diastolic recoil at all sites (p<10-3). At rest and during stress, ascending aortic compliance was statistically higher compared to the whole descending aorta (p≤0.0007). We found a strong correlation between the rate pressure product and aortic distensibility at all sites (r = - 0.6 to -0.75 according to the site, p<10-4). PWV measured at the proximal and distal descending aorta increased significantly during stress (p = 0.02 and p = 0.008, respectively). Assessment of regional aortic function during exercise is feasible using MRI. During stress, aortic elasticity decreases significantly in correlation with an increase of the PWV. Further studies are required to create thresholds for ascending aorta dysfunction among patients with aneurysms, and to monitor the impact of medication on aortic remodeling

Regional aortic compliance at rest and under exercise conditions (n = 15; *p≤0.0007).

<p>Regional aortic compliance at rest and under exercise conditions (n = 15; *p≤0.0007).</p

Correlation between regional aortic distensibility and cardiac work.

<p>The regional heterogeneity of aortic distensibility (AD) at rest is still relevant at peak stress (medians at rest and at peak stress in mmHg^-1, ^AAAD = 6 (4.88–7.12) to 4.64 (4.08–5.2), ^PDAAD = 5.83 (4.96–6.7) to 3.23 (2.95–4.24), ^DDAAD = 7.38 (6.6–7.79) to 5.3 (4.13–5.9), ^CAAD = 7.4 (6.72–9.05) to 5.27 (4.2–6.06)).</p

Baseline characteristics of the volunteers.

<p>Baseline characteristics of the volunteers.</p

Functionnal MRI methodology.

<p>SSFP images in oblique sagittal plane (A) to describe aortic segmentation and lengths at three levels (pulmonary arterial trunk, descending aorta 3 cm above the diaphragm, and aorta above the coeliac trunk), and to focus on four locations (AA, ascending aorta, PDA, proximal descending aorta, DDA, distal descending aorta, CA, aorta above the coeliac trunk). Retrospective cine sequence acquired at the AA and DDA (B) to assess compliance (AC) and distensibility (AD), with respective area profiles during a cardiac cycle, at rest ((C), at the AA level, ΔS = 147 mm², AC = 2.62 mm²/mmHg, AD = 6.6.10⁻³ mmHg^-1) and at peak stress ((D), at the AA level, ΔS = 122 mm², AC = 1.76 mm²/mmHg, AD = 4.8.10⁻³ mmHg^-1). Aortic arch PWV assessed by through plane velocity-encoded MRI (E) at rest ((F), Δt = 61 ms, PWV = 3.89 m/s) and at peak stress ((G), Δt = 57ms, PWV = 4.18 m/s).</p

Regional variation in pulse wave velocity at rest and under exercise conditions (mean±SD, m/s).

<p>Comparison between MRI and tonometry (correlation coefficient and Bland Altman test (mean± SD, m/s)).</p

Amagnetic ergometer (LODE, Netherlands) allowing a supine treadmill test during MRI (1.5 T).

<p>Amagnetic ergometer (LODE, Netherlands) allowing a supine treadmill test during MRI (1.5 T).</p