Publications by authors named "Lilamand M"
Background: Increasing evidence supports the use of plasma biomarkers of amyloid, tau, neurodegeneration and neuroinflammation for diagnosis of dementia. However, their performance for positive and differential diagnosis of dementia with Lewy bodies (DLB) in clinical settings is still uncertain.
Method: We conducted a retrospective biomarker study in two tertiary memory centers, Paris Lariboisière and CM2RR Strasbourg, France, enrolling patients with DLB (n=104), Alzheimer's disease (AD, n=76) and neurological controls (NC, n=27).
Article Synopsis
- The study investigates the relationship between plasma neurofilament light (NfL) protein levels and cognitive impairment across various patient groups, including Alzheimer’s disease and other dementias.
- The research was conducted on 320 patients, measuring NfL levels and assessing cognitive performance, with significant associations found between higher NfL levels and lower cognition, particularly in memory and executive functions.
- Despite noteworthy findings, the clinical application of plasma NfL in daily practice for unselected cognitive impairment patients remains largely unaddressed.
Article Synopsis
- P-glycoprotein (P-gp) is a transporter that controls the movement of various substances across the blood-brain barrier, limiting harmful compounds from entering the brain.
- It can interact with other drugs, making it important to consider its function, especially in older individuals or those with neurodegenerative diseases.
- Recent improvements in neuroimaging techniques are enhancing our ability to study P-gp in humans, offering new insights into its role in brain health and disease.
Article Synopsis
- Research indicates that plasma biomarkers related to amyloid, tau, neurodegeneration, and neuroinflammation could be useful in diagnosing dementia, but their effectiveness for diagnosing dementia with Lewy bodies (DLB) specifically remains unclear.
- A study involving patients with DLB, Alzheimer's disease (AD), and neurological controls measured various plasma biomarkers and found that DLB patients had altered biomarker levels compared to controls and AD patients.
- Plasma p-tau181 was the most effective biomarker for distinguishing DLB from AD and controls, suggesting it plays a key role in identifying amyloid-related issues in DLB, although the overall diagnostic performance of these biomarkers was moderate.
Article Synopsis
- P-glycoprotein (P-gp) is a crucial transporter that controls the entry of drugs and other substances into the brain by limiting their passage across the blood-brain barrier (BBB).
- This protein can be influenced by drug interactions, aging, and neurodegenerative diseases, making its study particularly important for older adults.
- Recent advancements in neuroimaging techniques are enhancing our ability to study P-gp activity in real-time, providing new insights into its role in health and disease.
Article Synopsis
- - Psychosis, marked by delusions and hallucinations, is common in Alzheimer's and other neurodegenerative dementias, leading to challenges in diagnosis and treatment.
- - A systematic review of 98 studies reveals high prevalence rates of psychotic symptoms across different dementias, with notable patterns such as misidentification delusions in dementia with Lewy bodies and paranoid ideas in Alzheimer's.
- - The findings highlight significant variations in psychotic symptoms among different neurodegenerative diseases, emphasizing the need for more research on early-stage psychosis to improve diagnosis and management.
Article Synopsis
- Adiponectin is a special protein related to how our body uses energy and deals with fats and sugars.
- Researchers looked at how this protein might be connected to Alzheimer's disease (AD) by reviewing many studies from the past ten years.
- While lab studies showed that adiponectin could help protect against AD, studies on people didn't find clear results, meaning more research is needed to understand its true effects.
Plasma neurofilament light chain (NfL) is a promising biomarker of axonal damage for the diagnosis of neurodegenerative diseases. Phosphorylated neurofilament heavy chain (pNfH) has demonstrated its value in motor neuron diseases diagnosis, but has less been explored for dementia diagnosis. In a cross-sectional study, we compared cerebrospinal fluid (CSF) and plasma NfL and pNfH levels in n = 188 patients from Lariboisière Hospital, Paris, France, including AD patients at mild cognitive impairment stage (AD-MCI, n = 36) and dementia stage (n = 64), non-AD MCI (n = 38), non-AD dementia (n = 28) patients and control subjects (n = 22).
View Article and Find Full Text PDFCognitive functions enable us to receive, select, store, transform, process and retrieve the information we receive from the outside world. These functions are controlled by different brain structures that interact with each other, enabling us to interact with and understand the world around us. In the course of aging or the onset of neurocognitive diseases, these functions may be impaired to a greater or lesser extent, giving rise to a considerable variety of neurocognitive impairment profiles.
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- The study aimed to investigate if the profiles of behavioral and psychological symptoms of dementia (BPSD) vary according to the type of dementia in patients with severe BPSD.
- Researchers analyzed data from 398 patients diagnosed with different types of dementia, including Alzheimer's, frontotemporal, Lewy body/Parkinsonian, and vascular dementia.
- Results showed distinct neuropsychiatric symptom profiles based on the dementia type, with Lewy body/PD patients exhibiting more hallucinations and anxiety, while frontotemporal dementia patients showed less delusions but more disinhibition.
[Evaluation of the perspectives and experiences regarding lumbar puncture in cognitively impaired older adults over 70, their relatives and the care teams].
Geriatr Psychol Neuropsychiatr Vieil
March 2023
Article Synopsis
- Lumbar puncture (LP) is a key diagnostic tool often avoided in older adults due to fears of complications, particularly among healthcare teams unfamiliar with the procedure.
- A qualitative study involving interviews with cognitively impaired patients over 70, their relatives, and healthcare teams aimed to gather perspectives on scheduled LP experiences.
- Findings revealed a poor understanding of LP among patients, who had exaggerated fears about risks and pain, while both relatives and healthcare teams expressed a desire for accurate diagnoses, indicating a gap in knowledge and communication surrounding the procedure.
Article Synopsis
- Objective structured clinical examinations (OSCE) help assess medical students' skills, and this study evaluated third-year students' roles as standardized patients in these exams.
- In a pilot session, their OSCE scores were compared with third-year students who did not participate, revealing that those involved had significantly better scores (17 vs. 14.5 out of 20).
- Most participating students felt that being standardized patients reduced their stress, enhanced their preparedness, and improved their communication skills, indicating the potential for broader implementation of this approach in medical education.
Article Synopsis
- The study aimed to evaluate geriatrics residents' self-confidence and skills in performing lumbar punctures (LP) and explored the benefits of using simulation and virtual reality for training.
- A survey found that an overwhelming majority of residents recognized the need for LP competency and supported additional practical training, while participants in simulated training praised its effectiveness.
- Results showed a significant improvement in residents' self-assessed skills after training, leading to an 85.8% success rate in actual clinical practice, highlighting the potential of simulation-based training for enhancing confidence and performance.
Background: Parkinson's disease (PD) is associated with a 3-fold mortality risk, which is closely related to advancing age. Evidence is lacking regarding the factors associated with the risks of mortality or nursing-home (NH) admission, in elderly patients with PD. We aimed at identifying the clinical characteristics associated with these outcomes, in older community-dwelling patients with late-onset PD.
View Article and Find Full Text PDFObjective: To explore the accuracy of plasma neurofilament light chain (NfL) as a biomarker for diagnosis and staging of cognitive impairment, in a large cohort with of previously diagnosed patients in clinical practice.
Methods: Retrospective, cross-sectional, monocentric study, from a tertiary memory clinic. Patients underwent cerebrospinal fluid core Alzheimer's disease (AD) biomarker evaluation using ELISA or Elecsys methods, and plasma NfL analysis using the single molecule array technology.
Article Synopsis
- Metabolic dysfunction and leptin signaling have been linked to Alzheimer's disease (AD), leading researchers to investigate the connections between plasma leptin levels and various biomarkers related to cognitive impairment.
- The study analyzed data from over 1,000 cognitively impaired patients and found that those diagnosed with AD had significantly lower plasma leptin levels compared to those without amyloid-related issues.
- The results suggest a potential link between leptin metabolism and brain amyloid deposition, indicating that plasma leptin levels might play a role in diagnosing and understanding AD pathophysiology.
Article Synopsis
- The study investigated cerebrospinal fluid (CSF) alpha-synuclein levels to distinguish between Dementia with Lewy Bodies (DLB) and Alzheimer’s disease (AD), as abnormal aggregation of this protein is linked to DLB.
- The results showed significantly lower CSF alpha-synuclein levels in DLB patients compared to those with AD and established a potential diagnostic threshold with high sensitivity and specificity.
- The findings suggest that measuring CSF alpha-synuclein could aid in the early diagnosis of DLB in conjunction with other biomarkers, although it was not associated with specific brain atrophy patterns.
Background: Core cerebrospinal fluid (CSF) amyloid and tau biomarker assessment has been recommended to refine the diagnostic accuracy of Alzheimer's disease. Lumbar punctures (LP) are invasive procedures that might induce anxiety and pain. The use of non-pharmacological techniques must be considered to reduce the patient's discomfort, in this setting.
View Article and Find Full Text PDFBackground And Objectives: To elaborate a new algorithm to establish a standardized method to define cutoffs for CSF biomarkers of Alzheimer disease (AD) by validating the algorithm against CSF classification derived from PET imaging.
Methods: Low and high levels of CSF phosphorylated tau were first identified to establish optimal cutoffs for CSF β-amyloid (Aβ) peptide biomarkers. These Aβ cutoffs were then used to determine cutoffs for CSF tau and phosphorylated tau markers.
Alzheimer's disease (AD) is the most frequent age-related neurodegenerative disorder, with no curative treatment available so far. Alongside the brain deposition of β-amyloid peptide and hyperphosphorylated tau, neuroinflammation triggered by the innate immune response in the central nervous system, plays a central role in the pathogenesis of AD. Glucose usually represents the main fuel for the brain.
View Article and Find Full Text PDFPurpose: Major neurocognitive disorders (MND) have multiple negative consequences on patients' lives and on their caregivers' health. Occupational therapy and cognitive stimulation have failed to show any significant efficacy on quality of life (QoL), cognitive functioning and behavioural symptoms. Bretonneau Hospital's Day Care Unit offers personalized and structured multi-domain interventions to cognitively impaired older patients on a weekly basis, for a 3-month period.
View Article and Find Full Text PDFPost-lumbar puncture headache is the main adverse event from lumbar puncture and occurs in 3.5% to 33% of patients, causing functional and socio-professional disability. We searched the post-lumbar puncture headache literature and, based on this review and personal expertise, identified and addressed 19 frequently asked questions regarding post-lumbar puncture headache risk factors and prevention.
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