Publications by authors named "Lejeune T"

Background: Intensive rehabilitation through challenging and individualized tasks are recommended to enhance upper limb recovery after stroke. Robot-assisted therapy (RAT) and serious games could be used to enhance functional recovery by providing simultaneous motor and cognitive rehabilitation.

Objective: The aim of this study is to clinically validate the dynamic difficulty adjustment (DDA) mechanism of ROBiGAME, a robot serious game designed for simultaneous rehabilitation of motor impairments and hemispatial neglect.

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Adeno-associated virus (AAV)-based vectors are the most frequently used platform for retinal gene therapy. Initially explored for the treatment of loss-of-function mutations underpinning many inherited retinal diseases, AAV-based ocular gene therapies are increasingly used to transduce endogenous cells to produce therapeutic proteins, thus producing site-specific biofactories. Relatively invasive ocular routes of administration (ROA) mean prominent procedure-related in-life, and histopathological findings may be observed with some regularity.

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Background: Following upper motor neuron syndromes (UMNS), intrinsic viscoelastic muscle properties such as elastic stiffness may be altered, which leads to muscle hyper-resistance to passive mobilization. So far, no gold standard assessment of hyper-resistance, whether clinical or instrumental, is available. Shear wave elastography (SWE) has been increasingly used for non-invasive evaluation of elastic stiffness of skeletal muscles in people with hyper-resistance.

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The 2024 annual Division of Translational Toxicology (DTT) Satellite Symposium, entitled "Pathology Potpourri," was held in Baltimore, Maryland, at the Society of Toxicologic Pathology's 42nd annual meeting. The goal of this symposium was to present and discuss challenging diagnostic pathology and/or nomenclature issues. This article presents summaries of the speakers' talks along with select images that were used by the audience for voting and discussion.

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The INHAND (International Harmonization of Nomenclature and Diagnostic Criteria for Lesions) Project (www.toxpath.org/ inhand.

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Article Synopsis
  • * The speed at which potassium levels increase is crucial because quicker changes can lead to severe and potentially life-threatening symptoms; thus, acute hyperkalemia requires immediate treatment.
  • * Although there's no universal standard for measuring the severity of hyperkalemia, electrocardiogram (ECG) changes are important indicators; this article discusses current knowledge and suggests a management approach for acute cases.
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Introduction: Injections of botulinum toxin type A (BoNT-A) are the first-line treatment for spastic muscle overactivity (MO). Some authors observed that BoNT-A injections lead to changes in muscle structure and muscle elasticity that are probably not completely reversible. This possible effect is critical, as it could lead to negative impacts on the effectiveness of BoNT-A interventions.

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Background: Recent technological advancements present promising opportunities to enhance the frequency and objectivity of functional assessments, aligning with recent stroke rehabilitation guidelines. Within this framework, we designed and adapted different manual dexterity tests in extended reality (XR), using immersive virtual reality (VR) with controllers (BBT-VR-C), immersive VR with hand-tracking (BBT-VR-HT), and mixed-reality (MD-MR).

Objective: This study primarily aimed to assess and compare the validity of the BBT-VR-C, BBT-VR-HT and MD-MR to assess post-stroke manual dexterity.

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Cardiovascular diseases represent the first cause of mortality in the world. Various exploration methods exist to prevent and diagnose them. Among them, cardiac scintigraphy holds a predominant place.

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Introduction: Parkinson's disease patients' gait is characterized by shorter step length, reduced gait velocity and deterioration of temporal organization of stride duration variability (modified Long Range Autocorrelations). The objective of this study was to compare effects of rhythmic auditory stimulations (RAS) and Rhythmic Vibrotactile Stimulations (RVS) on Parkinson's disease patients' gait.

Methods: Ten Parkinson's disease patients performed three walking conditions lasting 5-7 min each: control condition (CC), RAS condition and RVS condition.

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This cross-sectional study aimed to evaluate the effect of visual feedback, age and movement repetition on the upper limb (UL) accuracy and kinematics during a reaching task in immersive virtual reality (VR). Fifty-one healthy participants were asked to perform 25 trials of a reaching task in immersive VR with and without visual feedback of their hand. They were instructed to place, as accurately and as fast as possible, a controller held in their non-dominant hand in the centre of a virtual red cube of 3 cm side length.

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Background: Treisman (1980) proposed that visual-spatial attention to targets presented with distractors involves parallel and serial cognition. When the target is different from distractors by a single feature, the number of distractors does not influence search speed (parallel). However, when the target is different from the distractor by a conjunction of features, increased numbers of distractors increase task difficulty (serial).

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Hyper-resistance after a central nervous system injury has been largely referred to as spasticity, which is but one of its neural components. Assessment largely relies on clinical scales (Modified Ashworth scale - MAS and Modified Tardieu scale, MTS) which are unable to distinguish between the non-neural (tissue-related) and the neural (central nervous system-related) components. This study assessed criterion validity and reliability (reproducibility) of muscle stiffness measures, namely, maximum elastic stiffness (ELmax), viscous stiffness (VI), and path length (L-path) in the hand flexor muscles among people with stroke.

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Background: To plan treatment and measure post-stroke recovery, frequent and time-bounded functional assessments are recommended. With increasing needs for neurorehabilitation advances, new technology based methods, such as virtual reality (VR) have emerged. Here, we developed an immersive VR version of the Action Research Arm Test (ARAT-VR) to complement neurorehabilitation.

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The 6-minute walk test (6MWT) is widely used to assess walking capacity among persons with stroke. Whether a shorter and more convenient test, the 2-minute walk test (2MWT) could replace it, was tested. Two retrospective analyses were conducted.

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Article Synopsis
  • Recent advancements in wearable powered exoskeletons (WPE) have enabled gait training (GT) for patients with spinal cord injury, but there's a lack of focus on tetraplegic patients.
  • The review aimed to evaluate the feasibility and safety of GT using WPE for tetraplegic patients and identified 41 studies, showing that while minor adverse events occurred in some cases, major events were rare and less frequent in tetraplegic patients compared to paraplegics.
  • The findings suggest that GT using WPE is a safe and effective treatment for tetraplegia, highlighting the need for careful patient selection and further research to confirm potential benefits.
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Introduction: The primary aim of this work was to summarize and compare the effects of active rehabilitation assisted by new technologies (virtual reality [VR], robot-assisted therapy [RAT] and telerehabilitation [TR)) on upper limb motor function and everyday living activity during the subacute and chronic phases of stroke. The secondary aims were to compare the effects of these technologies according to the intervention design (in addition to or in substitution of conventional therapy), the duration of active rehabilitation and the severity of patients' motor impairments.

Evidence Acquisition: Several databases, namely PubMed, Scopus, Embase and Cochrane Library, were searched.

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Background: After a stroke, experts recommend regular monitoring and kinematic assessments of patients to objectively measure motor recovery. With the rise of new technologies and increasing needs for neurorehabilitation, an interest in virtual reality has emerged. In this context, we have developed an immersive virtual reality version of the Box and Block Test (BBT-VR).

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Article Synopsis
  • Increasing stroke incidence and limited rehabilitation resources have created a higher demand for effective self-rehabilitation programs for stroke patients.
  • This meta-analysis aimed to compare self-rehabilitation's impact on motor outcomes against conventional rehabilitation and examined various factors like location and technology use.
  • Findings revealed that self-rehabilitation is as effective as conventional therapy in improving motor function, regardless of trial location or other assessed factors.
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A Working Group of the Society of Toxicologic Pathology's Scientific and Regulatory Policy Committee conducted a technical and scientific review of current practices relating to the fixation, trimming, and sectioning of the nonrodent eye to identify key points and species-specific anatomical landmarks to consider when preparing and evaluating eyes of rabbits, dogs, minipigs, and nonhuman primates from ocular and general toxicity studies. The topics addressed in this article include determination of situations when more comprehensive evaluation of the globe and/or associated extraocular tissues should be implemented (expanded ocular sampling), and what constitutes expanded ocular sampling. In addition, this manuscript highlights the practical aspects of fixing, trimming, and sectioning the eye to ensure adequate histopathological evaluation of all major ocular structures, including the cone-dense areas (visual streak/macula/fovea) of the retina for rabbits, dogs, minipigs, and nonhuman primates, which is a current regulatory expectation for ocular toxicity studies.

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The Society of Toxicologic Pathology (STP, https://www.toxpath.org/) was founded in North America in 1971 as a nonprofit scientific and educational association to promote the professional practice of pathology as applied to pharmaceutical and environmental safety assessment.

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Background: Approximately two thirds of stroke survivors maintain upper limb (UL) impairments and few among them attain complete UL recovery 6 months after stroke. Technological progress and gamification of interventions aim for better outcomes and constitute opportunities in self- and tele-rehabilitation.

Objectives: Our objective was to assess the efficacy of serious games, implemented on diverse technological systems, targeting UL recovery after stroke.

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Background: People with multiple sclerosis have reduced walking speed and impaired gait pattern. Prolonged release-fampridine is a potassium channel blocker that improves nerve conduction in patients with multiple sclerosis, leading to walking benefits. Whether fampridine alters gait pattern is unknown.

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