Publications by authors named "Olivier Detante"

Article Synopsis
  • The study investigates the differences between cerebral amyloid angiopathy-related inflammation (CAA-RI) and biopsy-positive primary angiitis of the CNS (BP-PACNS), focusing on their clinical and radiologic presentations as well as relapse rates.
  • It included 104 patients with CAA-RI and 52 with BP-PACNS, revealing that CAA-RI tends to show more white matter lesions and hemorrhagic features, while BP-PACNS is associated more with headaches and motor deficits.
  • The results indicate significant differences in features between the two conditions, suggesting that they may require different diagnostic approaches and could have varying outcomes in terms of recurrence.
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  • Severe sleep apnea affects about one-third of stroke patients and contributes to increased sleepiness, which worsens recovery outcomes after a stroke.
  • In a study of 81 stroke patients, researchers found that while both groups reported similar levels of sleepiness at the start, stroke patients experienced a greater improvement in their sleepiness over time compared to matched individuals without stroke.
  • Interestingly, the study concluded that having sleep apnea and using CPAP didn't significantly impact how sleepiness changed post-stroke, suggesting that sleepiness may not be a key indicator of sleep apnea in these patients.
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Background: Lateropulsion is a deficit in body orientation with respect to gravity, frequent after stroke. Although it is a primary factor affecting mobility, the impact of its attenuation on balance and gait recovery has never been investigated. Moreover, most studies on the lateropulsion time-course focus on severe forms suspected to have a poor recovery, which is not proven.

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  • Stroke is the leading cause of disability, with brain repair mechanisms often failing to ensure complete recovery, affecting various brain cell types and the extracellular matrix crucial for brain plasticity.
  • Regenerative medicine, particularly cell therapies, shows promise in reducing post-stroke disability by enhancing neuroprotection and neural repair, though optimal methods and timing for treatment remain topics of debate.
  • Current research focuses on different cell types, such as mesenchymal stem cells and neural stem cells, as well as innovative strategies involving growth factors and biomaterials to improve the efficacy of therapies in post-stroke recovery.
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  • The study aimed to determine which clinical and radiological features are linked to positive CNS biopsies in patients suspected of having primary angiitis of the central nervous system (PACNS).
  • Out of 200 patients with PACNS, 100 underwent biopsies, with 61% returning positive; factors like being female, having seizures or cognitive impairment, and specific imaging findings were associated with positive results.
  • The findings suggest that certain characteristics can aid doctors in deciding whether or not to perform a CNS biopsy for suspected PACNS cases.
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  • The study investigates the effectiveness of endovascular therapy (EVT) compared to intravenous thrombolysis (IVT) in patients with a minor acute ischemic stroke and large vessel occlusion, specifically focusing on the National Institutes of Health Stroke Scale (NIHSS) scores.
  • Data was collected from 533 patients treated between 2005 and 2021, showing that while 25.5% received bridging therapy, only facial palsy on admission associated more with excellent outcomes in those receiving IVT alone.
  • The analysis concluded that NIHSS subitems were not significant predictors of patients who would benefit from EVT over IVT alone, indicating a need for further research in this area.
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Rationale: Oxygen is essential for cellular energy metabolism. Neurons are particularly vulnerable to hypoxia. Increasing oxygen supply shortly after stroke onset could preserve the ischemic penumbra until revascularization occurs.

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Cell therapy is promising to treat many conditions, including neurological and osteoarticular diseases. Encapsulation of cells within hydrogels facilitates cell delivery and can improve therapeutic effects. However, much work remains to be done to align treatment strategies with specific diseases.

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Blood phenotypes are defined by the presence or absence of specific blood group antigens at the red blood cell (RBC) surface, due to genetic polymorphisms among individuals. The recent development of genomic and proteomic approaches enabled the characterization of several enigmatic antigens. The choline transporter-like protein CTL2 encoded by the SLC44A2 gene plays an important role in platelet aggregation and neutrophil activation.

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Background: Whether bridging therapy (intravenous thrombolysis [IVT] followed by mechanical thrombectomy) is superior to IVT alone in minor stroke with large vessel occlusion is unknown. Perfusion imaging may identify subsets of large vessel occlusion-related minor stroke patients with distinct response to bridging therapy.

Methods: We conducted a multicenter international observational study of consecutive IVT-treated patients with minor stroke (National Institutes of Health Stroke Scale score ≤5) who had an anterior circulation large vessel occlusion and perfusion imaging performed before IVT, with a subset undergoing immediate thrombectomy.

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Purpose: The ipsilateral hand (ILH) is impaired after unilateral stroke, but the underlying mechanisms remain unresolved. Based on the degeneracy theory of network connectivity that many connectivity patterns are functionally equivalent, we hypothesized that ILH impairment would result from the summation of microstructural white matter (WM) disruption in the motor network, with a task-related profile. We aimed to determine the WM disruption patterns associated with ILH impairment.

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Background: Ipsilateral hand (ILH) impairment is documented following motor stroke, but its impact on long-term outcome remains unknown. We assessed ILH impairment in subacute stroke and tested whether ILH impairment predicted long-term outcome.

Methods: We performed a longitudinal study in 209 consecutive patients with unilateral stroke and sensorimotor deficit at admission.

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Sleep apnoea, one of the most common chronic diseases, is a risk factor for ischaemic stroke, stroke recurrence, and poor functional recovery after stroke. More than half of stroke survivors present with sleep apnoea during the acute phase after stroke, with obstructive sleep apnoea being the most common subtype. Following a stroke, sleep apnoea frequency and severity might decrease over time, but moderate to severe sleep apnoea is nevertheless present in up to a third of patients in the chronic phase after an ischaemic stroke.

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Rationale: Sleep-disordered breathing (SDB) is highly prevalent after stroke. The clinical and ventilatory chemosensitivity characteristics of SDB, namely obstructive, central and coexisting obstructive and central sleep apnoea (coexisting sleep apnoea) following stroke are poorly described.

Objective: To determine the respective clinical and ventilatory chemosensitivity characteristics of SDB at least 3 months after a first ischaemic stroke.

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Background And Purpose: The efficacy of patent foramen ovale (PFO) closure to reduce the frequency of migraine attacks remains controversial.

Methods: This was a planned sub-study in migraine patients enrolled in a randomized, clinical trial designed to assess the superiority of PFO closure plus antiplatelet therapy over antiplatelet therapy alone to prevent stroke recurrence in patients younger than 60 years with a PFO-associated cryptogenic ischaemic stroke. The main outcome was the mean annual number of migraine attacks in migraine patients with aura and in those without aura, as recorded at each follow-up visit by study neurologists.

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Background: White matter hyperintensities (WMHs) are well known to affect post-stroke disability, mainly by cognitive impairment. Their impact on post-stroke balance and gait disorders is unclear.

Objectives: We aimed to test the hypothesis that WMHs would independently deteriorate post-stroke balance and gait recovery.

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Article Synopsis
  • - Apraxia is a cognitive disorder affecting motor control, causing issues with object-related actions and resulting in incorrect movements, such as using a hammer improperly or holding tools incorrectly.
  • - The case of a left-handed patient with severe apraxia after a right brain lesion showed that while she made many hand posture errors, she used tools correctly, challenging existing theories about tool use and knowledge impairment.
  • - The study concluded that the patient's high rate of hand posture errors could not be explained by damaged manipulation knowledge, while her ability to avoid action errors suggested preserved mechanical knowledge; this indicates the need for new explanations beyond traditional manipulation-based theories.
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Background And Purpose: Severe intracranial atherosclerotic stenosis (SIAS) remains at risk of recurrent ischemic events despite intensive medical management. Exhausted cerebrovascular reserve seems to be associated with higher risk of recurrent stroke.

Materials And Methods: We used whole brain MRI to estimate basal perfusion using dynamic susceptibility contrast and cerebrovascular reactivity (CVR) to hypercapnic challenge (CO2 inhalation) using BOLD contrast, in 20 patients with symptomatic SIAS (>70%) of the middle cerebral artery (MCA) or the distal internal carotid artery.

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While preclinical stroke studies have shown that mesenchymal stem cells (MSCs) promote recovery, few randomized controlled trials (RCT) have assessed cell therapy in humans. In this RCT, we assessed the safety, feasibility, and efficacy of intravenous autologous bone marrow-derived MSCs in subacute stroke. ISIS-HERMES was a single-center, open-label RCT, with a 2-year follow-up.

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Motor hand deficits impact autonomy in everyday life, and neuroplasticity processes of motor recovery can be explored using functional MRI (fMRI). However, few studies have used fMRI to explore the mechanisms underlying hand recovery following stroke. Based on the dual visuomotor model positing that two segregated dorsomedial and dorsolateral cerebral networks control reach and grasp movements, we explored the relationship between motor task-related activity in the sensorimotor network and hand recovery following stroke.

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Background and Purpose- Hypertension is the most frequent comorbidity in stroke.The purpose of this study was to evaluate whether hypertension alters the response to treatment with adipose tissue-derived mesenchymal stem cells (ADMSCs) after an ischemic stroke in rats. Methods- Ischemic stroke was induced in male normotensive or hypertensive rats.

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Background: Over 50% of acute stroke patients have hyperglycemia, which is associated with a poorer prognosis and outcome. Our aim was to investigate the impact of hyperglycemia on behavioral recovery and brain repair of delivered human adipose tissue-derived mesenchymal stem cells (hAD-MSCs) in a rat model of permanent middle cerebral artery occlusion (pMCAO).

Methods: Hyperglycemia was induced in rats by the administration of nicotinamide and streptozotocin.

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Background: Setting up a follow-up secondary prevention program after stroke is difficult due to motor and cognitive impairment, but necessary to prevent recurrence and improve patients' quality of life. To involve a referent nurse and a caregiver from the patient's social circle in nurse-led multimodal and long-term management of risk factors after stroke could be an advantage due to their easier access to the patient and family. The aim of this study is to compare the benefit of optimized follow up by nursing personnel from the vascular neurology department including therapeutic follow up, and an interventional program directed to the patient and a caregiving member of their social circle, as compared with typical follow up in order to develop a specific follow-up program of secondary prevention of stroke.

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In the future, stroke patients may receive stem cell therapy as this has the potential to restore lost functions. However, the development of clinically deliverable therapy has been slower and more challenging than expected. Despite recommendations by STAIR and STEPS consortiums, there remain flaws in experimental studies such as lack of animals with comorbidities, inconsistent approaches to experimental design, and concurrent rehabilitation that might lead to a bias towards positive results.

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