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Batzianouli ET, Caranzano L, Nguepnjo Nguissi NA, Miaz B, Herrmann FR, Benninger DH. The paired-pulse TMS paradigm of short intracortical inhibition is mediated by a reduction of repetitive motor neuron discharges. J Neurophysiol 2024; 131:541-547. [PMID: 38264793 DOI: 10.1152/jn.00346.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 01/19/2024] [Accepted: 01/21/2024] [Indexed: 01/25/2024] Open
Abstract
Transcranial magnetic stimulation (TMS) causes repetitive spinal motoneuron discharges (repMNDs), but the effects of short-interval intracortical inhibition (SICI) and intracortical facilitation (ICF) on repMNDs remain unknown. Triple stimulation technique (TST) and the extended TST-protocols that include a fourth and fifth stimulation, the Quadruple (QuadS) and Quintuple (QuintS) stimulation, respectively, offer a precise estimate of cortical and spinal motor neuron discharges, including repMNDs. The objective of our study was to explore the effects of SICI and ICF on repMNDs. We explored conventional paired-pulse TMS protocols of SICI and ICF with the TMS, TST, the QuadS, and the QuintS protocols, in a randomized study design in 20 healthy volunteers. We found significantly less repMNDs in the SICI paradigm compared with a single-pulse TMS (SP-TMS). No significant difference was observed in the ICF paradigm. There was a significant inter- and intrasubject variability in both SICI and ICF. We demonstrate a significant reduction of repMNDs in SICI, which may result from the suppression of later I-waves and mediate the inhibition of motor-evoked potential (MEP). There is no increase in repMNDs in ICF suggesting another mechanism underlying facilitation. This study provides the proof that a reduction of repMNDs mediates the inhibition seen in SICI.NEW & NOTEWORTHY Significant reduction of repetitive motor neuron discharges (repMNDs) in short-interval intracortical inhibition (SICI) may result from the suppression of later I-waves and mediate the inhibition of motor-evoked potential (MEP). There is no change in the number of repMNDs in intracortical facilitation (ICF). There was a significant variability in SICI and ICF in healthy subjects.
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Affiliation(s)
- Eleni T Batzianouli
- Neurology Service, Department of Clinical Neurosciences, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
- Lemanic Neuroscience Doctoral School, Faculté de Biologie et de Médecine, Université de Lausanne, Lausanne, Switzerland
| | - Leonardo Caranzano
- Neurology Service, Department of Clinical Neurosciences, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Nathalie A Nguepnjo Nguissi
- Neurology Service, Department of Clinical Neurosciences, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Baptiste Miaz
- Neurology Service, Department of Clinical Neurosciences, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - François R Herrmann
- Division of Geriatrics and rehabilitation, Department of Rehabilitation and Geriatrics, University Hospitals and University of Geneva, Geneva, Switzerland
| | - David H Benninger
- Neurology Service, Department of Clinical Neurosciences, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
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Weber K, Herrmann FR, Menu C, Giannakopoulos P. [Court-ordered inpatient psychiatric care in Switzerland. Length of stay and treatment outcome]. Rev Med Suisse 2024; 20:410-413. [PMID: 38380664 DOI: 10.53738/revmed.2024.20.862.410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/22/2024]
Abstract
Mentally disordered offenders may be convicted to court-ordered psychiatric-psychotherapeutic inpatient care. Based on the concept of a forensic therapeutic community, the treatments of 204 inmates of a medium-security hospital, who presented with psychosis, personality disorders or substance-use disorders, have been assessed. After a median stay of 2.5 years, 56% of the offenders had been transferred to a sheltered educational housing or to an open low-security psychiatric ward. Length of stay was independent of psychiatric diagnosis, yet dependent on the nature of the offense. Having a cluster B personality disorder or a conviction for a sexual offense increased the risk of return to prison. Younger age and offenses without interpersonal violence increased the chances to enter sheltered educational housing.
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Affiliation(s)
- Kerstin Weber
- Psychologue, PhD, Service des mesures institutionnelles, Direction médicale et qualité, Hôpitaux universitaires de Genève, 1211 Genève 14
- PD, Département de psychiatrie, Université de Genève, 1211 Genève 4
| | - François R Herrmann
- Département de réadaptation et gériatrie, Hôpitaux universitaires de Genève et Université de Genève, 1226 Thônex
| | - Christophe Menu
- Établissement fermé Curabilis, Office cantonal de la détention, 1241 Puplinge
| | - Panteleimon Giannakopoulos
- Service des mesures institutionnelles, Direction médicale et qualité, Hôpitaux universitaires de Genève, 1208 Genève
- Département de psychiatrie, Université de Genève, 1211 Genève 4
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D'Orta I, Weber K, Herrmann FR, Giannakopoulos P. Women in acute forensic psychiatric care: comparison of clinical, sociodemographic, and detention-related characteristics in pretrial detention, sentence execution, and court-ordered treatment. BMC Psychiatry 2024; 24:94. [PMID: 38308259 PMCID: PMC10835924 DOI: 10.1186/s12888-024-05546-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 01/21/2024] [Indexed: 02/04/2024] Open
Abstract
Compared to men inmates, women display decreased prevalence of severe mental disorder but increased occurrence of substance use disorders (SUD) and higher rates of previous contacts with mental health services. The group of women in detention is highly heterogeneous according to the status of incarceration (pre-trial detention (PTD), sentence execution (SE) and court ordered treatments (COT)). Studies focusing on the comparison of sociodemographic patterns, detention-related and clinical variables between these groups are still lacking. We explored these parameters in 136 women admitted for acute psychiatric care in the sole Geneva forensic unit during a nine year period (2014-2023). Sociodemographic and detention-related data included age, nationality, marital status, presence of children, education attainment, most frequently speaking language, social support, employment before conviction and type of offenses. Clinical variables included the main ICD-10 diagnosis, presence of concomitant SUD, type of personality disorders, presence of suicidal thoughts and attempts at admission, as well as number and mean duration of stays. PTD and SE women had at least 9 years of formal education in 38.9% and 30.3% of cases. Most women in PTD (77.7%), SE (56.6%) and COT (56.2%) groups were Swiss or European citizens. The level of French knowledge was excellent in most of the cases. 43.8% of COT women had at least one child and this percentage is even higher for PTD and SE cases. The employment rate before conviction was also quite high, mainly for PTD and SE (61.1% and 60.6%) and, in a lesser degree, for COT (43.8%) women. Significant social support was present in the vast majority of women without any significant group difference. The distribution of type of offenses did not differ between the three types of detention with a predominance of physical violence, and drug trafficking. The number of stays during the period of reference was significantly higher in COT compared to both SE and PTD women. History of previous inpatient care was also significantly more frequent in COT that SE and PTD women. Adjustment and affective disorders were more often found in SE and PTD cases, these diagnoses were absent in the COT group. In contrast, a main diagnosis of psychotic disorders was found in 62.5% of COT cases compared to only 21.2% in SE and 24.1% in PTD cases. The number of stays, history of inpatient care and diagnosis of psychosis were independent predictors of COT status. In conclusion, the present data reveal the good social integration and emotional support of women needing acute psychiatric care in prison independently of the type of detention. Clinically, women in PTD and SE display more often emotional distress whereas those in COT suffer from acute psychotic symptoms with previous history of psychiatric care and multiple inpatient stays.
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Affiliation(s)
- Isabella D'Orta
- Division of Institutional Measures, Medical Direction, Geneva University Hospitals, Geneva, Switzerland.
- Institute of Global Health, University of Geneva, Geneva, Switzerland.
| | - Kerstin Weber
- Division of Institutional Measures, Medical Direction, Geneva University Hospitals, Geneva, Switzerland
- Department of Psychiatry, University of Geneva, Geneva, Switzerland
| | - François R Herrmann
- Department of Rehabilitation and Geriatrics, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Panteleimon Giannakopoulos
- Division of Institutional Measures, Medical Direction, Geneva University Hospitals, Geneva, Switzerland
- Department of Psychiatry, University of Geneva, Geneva, Switzerland
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Ballester J, Quijal-Zamorano M, Méndez Turrubiates RF, Pegenaute F, Herrmann FR, Robine JM, Basagaña X, Tonne C, Antó JM, Achebak H. Author Correction: Heat-related mortality in Europe during the summer of 2022. Nat Med 2024; 30:603. [PMID: 37875570 PMCID: PMC10878972 DOI: 10.1038/s41591-023-02649-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2023]
Affiliation(s)
| | | | | | | | - François R Herrmann
- Medical School of the University of Geneva, Geneva, Switzerland
- Division of Geriatrics, Department of Rehabilitation and Geriatrics, Geneva University Hospitals, Thônex, Switzerland
| | - Jean Marie Robine
- Molecular Mechanisms in Neurodegenerative Dementia, University of Montpellier, Montpellier, France
- École Pratique des Hautes Études, Institut National de la Santé et de la Recherche Médicale, Montpellier, France
- PSL Research University, Paris, France
| | - Xavier Basagaña
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
- CIBER Epidemiología y Salud Pública, Barcelona, Spain
| | - Cathryn Tonne
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
- CIBER Epidemiología y Salud Pública, Barcelona, Spain
| | - Josep M Antó
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
- CIBER Epidemiología y Salud Pública, Barcelona, Spain
| | - Hicham Achebak
- ISGlobal, Barcelona, Spain
- Institut National de la Santé et de la Recherche Médicale, France Cohortes, Paris, France
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D’Orta I, Herrmann FR, Giannakopoulos P. Patterns of admission in forensic units during the COVID-19 pandemic: a process analysis. Front Psychiatry 2024; 14:1339545. [PMID: 38274430 PMCID: PMC10808362 DOI: 10.3389/fpsyt.2023.1339545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 12/26/2023] [Indexed: 01/27/2024] Open
Abstract
Introduction The impact of COVID-19 pandemic on forensic service practice remains matter of debate. Increased rates of anxiety, depression, and exacerbation of psychotic symptoms were reported in the early phases of the pandemic among detained persons. However, longitudinal analyses in medium-security hospitals taking into account the whole pandemic period led to mitigated results. Methods This report examines the evolution of the type (voluntary versus involuntary) and reason of admissions, length of stay, history of outpatient care, short-term seclusion hours for aggressive behaviors, and clinical diagnoses for detainees needing acute psychiatric care during the COVID-19 pandemic in the sole secure ward located in the central prison of Geneva, Switzerland. To determine the general trend of the processes over time we applied a combination of process analysis with run chart plotting, and fractional polynomial regression. Results Run tests showed that the proportion of cases with personality disorders, substance use disorders (SUD), and previous outpatient care tended to increase during the COVID pandemic with subsequent decrease to reach the pre-COVID values. This was also the case for depressive symptoms as reason for admission. The proportion of involuntary admission showed a steady increase both during the COVID and post-COVID time periods. In contrast, short-term seclusion hours decreased during the COVID pandemic followed by a return to their pre-COVID values. Regression models revealed that the COVID pandemic was associated with a significant increase in the rates of inmates with personality disorders and SUD admitted for forensic care explaining 36 and 41% of their variance. Discussion These data support the idea that, in terms of acute care needs, the COVID-19 pandemic was associated with increased needs for acute forensic care that concerned detainees with personality disorders characterized by increased levels of impulsiveness, decreased tolerance to frustrations, loss of control, increased extraversion and frequent SUD comorbidity.
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Affiliation(s)
- Isabella D’Orta
- Division of Institutional Measures, Medical Direction, Geneva University Hospitals, Geneva, Switzerland
- Institute of Global Health, University of Geneva, Geneva, Switzerland
| | - François R. Herrmann
- Department of Rehabilitation and Geriatrics, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Panteleimon Giannakopoulos
- Division of Institutional Measures, Medical Direction, Geneva University Hospitals, Geneva, Switzerland
- Department of Psychiatry, University of Geneva, Geneva, Switzerland
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Ballester J, van Daalen KR, Chen ZY, Achebak H, Antó JM, Basagaña X, Robine JM, Herrmann FR, Tonne C, Semenza JC, Lowe R. The effect of temporal data aggregation to assess the impact of changing temperatures in Europe: an epidemiological modelling study. Lancet Reg Health Eur 2024; 36:100779. [PMID: 38188278 PMCID: PMC10769891 DOI: 10.1016/j.lanepe.2023.100779] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 10/20/2023] [Accepted: 10/25/2023] [Indexed: 01/09/2024]
Abstract
Background Daily time-series regression models are commonly used to estimate the lagged nonlinear relation between temperature and mortality. A major impediment to this type of analysis is the restricted access to daily health records. The use of weekly and monthly data represents a possible solution unexplored to date. Methods We temporally aggregated daily temperatures and mortality records from 147 contiguous regions in 16 European countries, representing their entire population of over 400 million people. We estimated temperature-lag-mortality relationships by using standard time-series quasi-Poisson regression models applied to daily data, and compared the results with those obtained with different degrees of temporal aggregation. Findings We observed progressively larger differences in the epidemiological estimates with the degree of temporal data aggregation. The daily data model estimated an annual cold and heat-related mortality of 290,104 (213,745-359,636) and 39,434 (30,782-47,084) deaths, respectively, and the weekly model underestimated these numbers by 8.56% and 21.56%. Importantly, differences were systematically smaller during extreme cold and heat periods, such as the summer of 2003, with an underestimation of only 4.62% in the weekly data model. We applied this framework to infer that the heat-related mortality burden during the year 2022 in Europe may have exceeded the 70,000 deaths. Interpretation The present work represents a first reference study validating the use of weekly time series as an approximation to the short-term effects of cold and heat on human mortality. This approach can be adopted to complement access-restricted data networks, and facilitate data access for research, translation and policy-making. Funding The study was supported by the ERC Consolidator Grant EARLY-ADAPT (https://www.early-adapt.eu/), and the ERC Proof-of-Concept Grants HHS-EWS and FORECAST-AIR.
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Affiliation(s)
| | | | - Zhao-Yue Chen
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Hicham Achebak
- ISGlobal, Barcelona, Spain
- Inserm, France Cohortes, Paris, France
| | - Josep M. Antó
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Xavier Basagaña
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Jean-Marie Robine
- MMDN, University of Montpellier, Montpellier, France
- EPHE, Inserm, Montpellier, France
- PSL Research University, Paris, France
| | - François R. Herrmann
- Medical School of the University of Geneva, Geneva, Switzerland
- Division of Geriatrics, Department of Rehabilitation and Geriatrics, Geneva University Hospitals, Thônex, Switzerland
| | - Cathryn Tonne
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Jan C. Semenza
- Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany
| | - Rachel Lowe
- Barcelona Supercomputing Center, Barcelona, Spain
- Catalan Institution for Research and Advanced Studies (ICREA), Barcelona, Spain
- Centre on Climate Change & Planetary Health and Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, UK
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Tournier BB, Sorce S, Marteyn A, Ghidoni R, Benussi L, Binetti G, Herrmann FR, Krause K, Zekry D. CCR5 deficiency: Decreased neuronal resilience to oxidative stress and increased risk of vascular dementia. Alzheimers Dement 2024; 20:124-135. [PMID: 37489764 PMCID: PMC10917026 DOI: 10.1002/alz.13392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 05/09/2023] [Accepted: 06/19/2023] [Indexed: 07/26/2023]
Abstract
INTRODUCTION As the chemokine receptor5 (CCR5) may play a role in ischemia, we studied the links between CCR5 deficiency, the sensitivity of neurons to oxidative stress, and the development of dementia. METHODS Logistic regression models with CCR5/apolipoprotein E (ApoE) polymorphisms were applied on a sample of 205 cognitively normal individuals and 189 dementia patients from Geneva. The impact of oxidative stress on Ccr5 expression and cell death was assessed in mice neurons. RESULTS CCR5-Δ32 allele synergized with ApoEε4 as risk factor for dementia and specifically for dementia with a vascular component. We confirmed these results in an independent cohort from Italy (157 cognitively normal and 620 dementia). Carriers of the ApoEε4/CCR5-Δ32 genotype aged ≥80 years have an 11-fold greater risk of vascular-and-mixed dementia. Oxidative stress-induced cell death in Ccr5-/- mice neurons. DISCUSSION We propose the vulnerability of CCR5-deficient neurons in response to oxidative stress as possible mechanisms contributing to dementia.
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Affiliation(s)
- Benjamin B. Tournier
- Department of PsychiatryGeneva University Hospitals and University of GenevaGenevaSwitzerland
| | - Silvia Sorce
- Department of Pathology and ImmunologyFaculty of MedicineUniversity of GenevaGenevaSwitzerland
| | - Antoine Marteyn
- Department of Pathology and ImmunologyFaculty of MedicineUniversity of GenevaGenevaSwitzerland
- Division of GeriatricsDepartment of Rehabilitation and GeriatricsGeneva University HospitalsThônexSwitzerland
- Division of Internal Medicine for the AgedDepartment of Rehabilitation and GeriatricsGeneva University HospitalsThônexSwitzerland
| | - Roberta Ghidoni
- Molecular Markers LaboratoryIRCCS Istituto Centro San Giovanni di Dio FatebenefratelliBresciaItaly
| | - Luisa Benussi
- Molecular Markers LaboratoryIRCCS Istituto Centro San Giovanni di Dio FatebenefratelliBresciaItaly
| | - Giuliano Binetti
- MAC Memory Clinic and Molecular Markers LaboratoryIRCCS Istituto Centro San Giovanni di Dio FatebenefratelliBresciaItaly
| | - François R Herrmann
- Division of GeriatricsDepartment of Rehabilitation and GeriatricsGeneva University HospitalsThônexSwitzerland
| | - Karl‐Heinz Krause
- Department of Pathology and ImmunologyFaculty of MedicineUniversity of GenevaGenevaSwitzerland
| | - Dina Zekry
- Division of Internal Medicine for the AgedDepartment of Rehabilitation and GeriatricsGeneva University HospitalsThônexSwitzerland
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Haller S, Montandon ML, Rodriguez C, Herrmann FR, Giannakopoulos P. Automatic MRI volumetry in asymptomatic cases at risk for normal pressure hydrocephalus. Front Aging Neurosci 2023; 15:1242158. [PMID: 38020768 PMCID: PMC10655029 DOI: 10.3389/fnagi.2023.1242158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Accepted: 10/05/2023] [Indexed: 12/01/2023] Open
Abstract
The occurrence of significant Alzheimer's disease (AD) pathology was described in approximately 30% of normal pressure hydrocephalus (NPH) cases, leading to the distinction between neurodegenerative and idiopathic forms of this disorder. Whether or not there is a specific MRI signature of NPH remains a matter of debate. The present study focuses on asymptomatic cases at risk for NPH as defined with automatic machine learning tools and combines automatic MRI assessment of cortical and white matter volumetry, risk of AD (AD-RAI), and brain age gap estimation (BrainAge). Our hypothesis was that brain aging and AD process-independent volumetric changes occur in asymptomatic NPH-positive cases. We explored the volumetric changes in normal aging-sensitive (entorhinal cortex and parahippocampal gyrus/PHG) and AD-signature areas (hippocampus), four control cortical areas (frontal, parietal, occipital, and temporal), and cerebral and cerebellar white matter in 30 asymptomatic cases at risk for NPH (NPH probability >30) compared to 30 NPH-negative cases (NPH probability <5) with preserved cognition. In univariate regression models, NPH positivity was associated with decreased volumes in the hippocampus, parahippocampal gyrus (PHG), and entorhinal cortex bilaterally. The strongest negative association was found in the left hippocampus that persisted when adjusting for AD-RAI and Brain Age values. A combined model including the three parameters explained 36.5% of the variance, left hippocampal volumes, and BrainAge values, which remained independent predictors of the NPH status. Bilateral PHG and entorhinal cortex volumes were negatively associated with NPH-positive status in univariate models but this relationship did not persist when adjusting for BrainAge, the latter remaining the only predictor of the NPH status. We also found a negative association between bilateral cerebral and cerebellar white matter volumes and NPH status that persisted after controlling for AD-RAI or Brain Age values, explaining between 50 and 65% of its variance. These observations support the idea that in cases at risk for NPH, as defined by support vector machine assessment of NPH-related MRI markers, brain aging-related and brain aging and AD-independent volumetric changes coexist. The latter concerns volume loss in restricted hippocampal and white matter areas that could be considered as the MRI signature of idiopathic forms of NPH.
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Affiliation(s)
- Sven Haller
- CIMC - Centre d’Imagerie Médicale de Cornavin, Geneva, Switzerland
- Department of Surgical Sciences, Radiology, Uppsala University, Uppsala, Sweden
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Marie-Louise Montandon
- Department of Rehabilitation and Geriatrics, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Cristelle Rodriguez
- Division of Institutional Measures, Medical Direction, Geneva University Hospitals, Geneva, Switzerland
| | - François R. Herrmann
- Department of Rehabilitation and Geriatrics, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Panteleimon Giannakopoulos
- Division of Institutional Measures, Medical Direction, Geneva University Hospitals, Geneva, Switzerland
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland
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Weber K, Morier S, Lesaffre L, Menu C, Bertschy P, Herrmann FR, Giannakopoulos P. Court-ordered inpatient psychiatric care in Switzerland: determinants of length of stay and treatment outcome. Front Psychiatry 2023; 14:1222337. [PMID: 37854441 PMCID: PMC10579584 DOI: 10.3389/fpsyt.2023.1222337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Accepted: 09/18/2023] [Indexed: 10/20/2023] Open
Abstract
IntroductionIn several European countries, offenders with decreased or abolished responsibility and high risk of recidivism due to long-lasting mental disorders are compulsory admitted for court-ordered treatments (COT) that take place in high and medium-security hospitals. As a rule, length of stay in these structures is very long implying major restrictions for the inmate and high societal cost. Despite intensive research, the predictors of length of stay and treatment outcome in long stay forensic services is still matter of debate.MethodsWe report here a detailed analysis of the demographic, psychiatric and offense predictors of length of stay and discharge locations of 204 mentally disordered offenders convicted to COT in a new medium-security forensic psychiatry clinic in Geneva, Switzerland. Kaplan-Meier survival estimates were performed to determine time to release. Length of stay was predicted by Cox regressions, and discharge locations were predicted by multinomial logistic regressions.ResultsThe typical inpatient was a 35-age single male re-offender, submitted to COT after a conviction for physical violence (78.9%) or property violation (64.2%), with drug trafficking (52.9%), in relation to psychotic (67.2%), antisocial or borderline personality disorder (35.8%) with comorbid substance use disorders (60.3%). Sex offenses were found in 24.5% of cases and were associated with Cluster B personality disorders. The median length of stay was of 2.5 years and was independent of demographic variables, severity of crime recidivism and psychiatric diagnosis. Longer COT at admission, and type of offense (in particular drug traffic and sexual violence) predicted longer stays. At discharge, 32.8% of cases were transferred to sheltered educational housing, 23.1% to open low-security wards, while 30.6% returned to regular prisons and 9.7% to their country of origin.DiscussionYounger age and conviction for property violation rather than physical violence increased the chances to be discharged to sheltered educational housing. Longer COT at admission, personality disorders, and conviction for sexual offense increased the risk to return to prison. These data suggest that sex offenses determine not only longer stays under COT but also drastically decreases the chance of freedom for inmates with Cluster B personality disorders.
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Affiliation(s)
- Kerstin Weber
- Division of Institutional Measures, Medical Direction, Geneva University Hospitals, Geneva, Switzerland
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Sandrine Morier
- Division of Institutional Measures, Medical Direction, Geneva University Hospitals, Geneva, Switzerland
| | - Lise Lesaffre
- Division of Institutional Measures, Medical Direction, Geneva University Hospitals, Geneva, Switzerland
| | - Christophe Menu
- Department of Institutions and Information Technology, Republic and State of Geneva, Geneva, Switzerland
| | - Philippe Bertschy
- Department of Institutions and Information Technology, Republic and State of Geneva, Geneva, Switzerland
| | - François R. Herrmann
- Department of Rehabilitation and Geriatrics, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Panteleimon Giannakopoulos
- Division of Institutional Measures, Medical Direction, Geneva University Hospitals, Geneva, Switzerland
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland
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10
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Srinivasan M, Duong S, Trombert V, Kalberer N, Zekry D, Herrmann FR, Delavy J, Gold G, Müller F. A novel prosthesis presentation test to screen for cognitive and functional decline. Gerodontology 2023. [PMID: 37584635 DOI: 10.1111/ger.12708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/16/2023] [Indexed: 08/17/2023]
Abstract
OBJECTIVES AND BACKGROUND To validate a novel screening test for cognitive and functional decline in older patients rehabilitated with complete removable dental prostheses (CRDPs). MATERIALS AND METHODS Edentate old in-patients rehabilitated with CRDPs were included in this study. Participants were requested to remove their prostheses before their intraoral examinations. The prostheses were then presented in an inverted orientation. Participants had to correct the orientation of the prostheses and insert them in the appropriate jaws. The test was repeated after the intraoral exam. Appropriate statistical models were used (⍺ = .05) to associate the test results with the participants' mini-mental state examination (MMSE) score, functional independence measure (FIM), age and sex. RESULTS Among the 86 participants (mean-age: 85.4 ± 6.4 years; mean MMSE: 19.8 ± 5.5; mean FIM: 77.9 ± 20.8), 21 (24.4%) failed to correctly insert the prosthesis. The prosthesis presentation test (PPT) was associated with the FIM but not the MMSE. Regression models further confirmed an association with age (P = .043), but not sex. Additional analyses revealed the PPT test is associated with the FIM's cognitive sub-sets of memory, problem solving and social interaction. CONCLUSION The PPT is a novel, simple and quick screening tool that can help detect functional difficulties in older people. It can easily be performed during an oral examination. Future studies are needed to determine whether the PPT can be used to detect deficits in executive function, as a complement to the MMSE and also as a first assessment of a patient's ability to manage dentures independently.
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Affiliation(s)
- Murali Srinivasan
- Clinic of General, Special Care and Geriatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Stephan Duong
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Veronique Trombert
- Division of Internal Medicine for the aged, Department of Rehabilitation and Geriatrics, Geneva University Hospitals, Thônex, Switzerland
| | - Nicole Kalberer
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Dina Zekry
- Division of Internal Medicine for the aged, Department of Rehabilitation and Geriatrics, Geneva University Hospitals, Thônex, Switzerland
| | - François R Herrmann
- Division of Geriatrics and Rehabilitation, Department of Rehabilitation and Geriatrics, Geneva University Hospitals, Thônex, Switzerland
| | - Joris Delavy
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Gabriel Gold
- Department of Rehabilitation and Geriatrics, University of Geneva, Geneva, Switzerland
| | - Frauke Müller
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
- Division of Geriatrics and Rehabilitation, Department of Rehabilitation and Geriatrics, Geneva University Hospitals, Thônex, Switzerland
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11
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Cuvelier C, Hars M, Zamorani-Bianchi MP, Herrmann FR, Wieczorkiewicz CD, Zekry D, Gold G, Trombetti A. Hypnosis to reduce fear of falling in hospitalized older adults: a feasibility randomized controlled trial. Pilot Feasibility Stud 2023; 9:139. [PMID: 37559112 PMCID: PMC10410891 DOI: 10.1186/s40814-023-01366-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 07/18/2023] [Indexed: 08/11/2023] Open
Abstract
BACKGROUND Fear of falling is associated with numerous negative health outcomes in older adults and can limit the rehabilitation process. Hypnosis is now recognized as an effective treatment for a variety of conditions, especially anxiety and pain, which can be integrated safely with conventional medicine. The objective of this study was to assess the feasibility and acceptability of a hypnosis intervention in hospitalized older adults to reduce fear of falling. METHODS In this feasibility randomized controlled trial, 32 older patients, hospitalized in geriatric rehabilitation wards, were randomly allocated (1:1 ratio) to either an intervention group (hypnosis, 2 sessions, one per week, plus usual rehabilitation program) or a control group (usual rehabilitation program only). Clinical assessors and statistician were blinded to group allocation. Primary outcomes were recruitment rate, retention rate, and adherence to the intervention. Exploratory outcomes, analyzed according to the intention-to-treat principle, included impact of hypnosis on fear of falling (assessed by a new scale perform-FES), functional status, in-hospital falls, and length of hospital stay. RESULTS Recruitment rate was 1.3 patients per week. The recruitment of the population sample was achieved in 5.5 months. The retention rate did not differ significantly between groups and a good adherence to the hypnosis intervention was achieved (77% of patients received the full intervention). No adverse event related to the hypnosis intervention was observed. Regarding exploratory clinical outcomes, no differences were found between groups on any outcome. CONCLUSION Hypnosis is feasible and well accepted in a geriatric hospitalized population undergoing rehabilitation. Further pilot work should be conducted, with an increased number of hypnosis sessions, before conducting a full-scale trial to conclude whether, or not, hypnosis is effective to reduce fear of falling. TRIAL REGISTRATION NCT04726774.
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Affiliation(s)
- Clémence Cuvelier
- Division of Geriatrics, Department of Rehabilitation and Geriatrics, Geneva University Hospitals and Faculty of Medicine, Thônex, Switzerland
| | - Mélany Hars
- Division of Geriatrics, Department of Rehabilitation and Geriatrics, Geneva University Hospitals and Faculty of Medicine, Thônex, Switzerland
- Division of Bone Diseases, Department of Medicine, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Maria Pia Zamorani-Bianchi
- Division of Geriatrics, Department of Rehabilitation and Geriatrics, Geneva University Hospitals and Faculty of Medicine, Thônex, Switzerland
| | - François R Herrmann
- Division of Geriatrics, Department of Rehabilitation and Geriatrics, Geneva University Hospitals and Faculty of Medicine, Thônex, Switzerland
- Division of Internal Medicine for the Aged, Department of Rehabilitation and Geriatrics, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Catherine Ducharne Wieczorkiewicz
- Division of Geriatrics, Department of Rehabilitation and Geriatrics, Geneva University Hospitals and Faculty of Medicine, Thônex, Switzerland
- Division of Internal Medicine for the Aged, Department of Rehabilitation and Geriatrics, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Dina Zekry
- Division of Internal Medicine for the Aged, Department of Rehabilitation and Geriatrics, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Gabriel Gold
- Division of Geriatrics, Department of Rehabilitation and Geriatrics, Geneva University Hospitals and Faculty of Medicine, Thônex, Switzerland
| | - Andrea Trombetti
- Division of Geriatrics, Department of Rehabilitation and Geriatrics, Geneva University Hospitals and Faculty of Medicine, Thônex, Switzerland.
- Division of Bone Diseases, Department of Medicine, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland.
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12
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Rochas V, Montandon ML, Rodriguez C, Herrmann FR, Eytan A, Pegna AJ, Michel CM, Giannakopoulos P. Mentalizing and self-other distinction in visual perspective taking: the analysis of temporal neural processing using high-density EEG. Front Behav Neurosci 2023; 17:1206011. [PMID: 37465000 PMCID: PMC10351605 DOI: 10.3389/fnbeh.2023.1206011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 06/16/2023] [Indexed: 07/20/2023] Open
Abstract
This high density EEG report dissects the neural processing in the visual perspective taking using four experimental comparisons (Arrow, Avatar and Self, Other). Early activation differences occurred between the Avatar and the Arrow condition in primary visual pathways concomitantly with alpha and beta phase locked responses predominant in the Avatar condition. In later time points, brain activation was stronger for the Avatar condition in paracentral lobule of frontal lobe. When taking the other's perspective, there was an increased recruitment of generators in the occipital and temporal lobes and later on in mentalizing and salience networks bilaterally before spreading to right frontal lobe subdivisions. Microstate analysis further supported late recruitment of the medial frontal gyrus and precentral lobule in this condition. Other perspective for the Avatar only showed a strong beta response located first in left occipito-temporal and right parietal areas, and later on in frontal lobes. Our EEG data support distinct brain processes for the Avatar condition with an increased recruitment of brain generators that progresses from primary visual areas to the anterior brain. Taking the other's perspective needs an early recruitment of neural processors in posterior areas involved in theory of mind with later involvement of additional frontal generators.
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Affiliation(s)
- Vincent Rochas
- Functional Brain Mapping Laboratory, Department of Basic Neurosciences, University of Geneva, Geneva, Switzerland
- Human Neuroscience Platform, Fondation Campus Biotech Geneva, Geneva, Switzerland
| | - Marie-Louise Montandon
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Department of Rehabilitation and Geriatrics, Geneva University Hospitals, University of Geneva, Geneva, Switzerland
| | - Cristelle Rodriguez
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Division of Institutional Measures, Medical Direction, Geneva University Hospitals, Geneva, Switzerland
| | - François R. Herrmann
- Department of Rehabilitation and Geriatrics, Geneva University Hospitals, University of Geneva, Geneva, Switzerland
| | - Ariel Eytan
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Division of Institutional Measures, Medical Direction, Geneva University Hospitals, Geneva, Switzerland
| | - Alan J. Pegna
- School of Psychology, The University of Queensland, Brisbane, QLD, Australia
| | - Christoph M. Michel
- Functional Brain Mapping Laboratory, Department of Basic Neurosciences, University of Geneva, Geneva, Switzerland
| | - Panteleimon Giannakopoulos
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Division of Institutional Measures, Medical Direction, Geneva University Hospitals, Geneva, Switzerland
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13
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Ballester J, Quijal-Zamorano M, Méndez Turrubiates RF, Pegenaute F, Herrmann FR, Robine JM, Basagaña X, Tonne C, Antó JM, Achebak H. Heat-related mortality in Europe during the summer of 2022. Nat Med 2023; 29:1857-1866. [PMID: 37429922 PMCID: PMC10353926 DOI: 10.1038/s41591-023-02419-z] [Citation(s) in RCA: 34] [Impact Index Per Article: 34.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 05/24/2023] [Indexed: 07/12/2023]
Abstract
Over 70,000 excess deaths occurred in Europe during the summer of 2003. The resulting societal awareness led to the design and implementation of adaptation strategies to protect at-risk populations. We aimed to quantify heat-related mortality burden during the summer of 2022, the hottest season on record in Europe. We analyzed the Eurostat mortality database, which includes 45,184,044 counts of death from 823 contiguous regions in 35 European countries, representing the whole population of over 543 million people. We estimated 61,672 (95% confidence interval (CI) = 37,643-86,807) heat-related deaths in Europe between 30 May and 4 September 2022. Italy (18,010 deaths; 95% CI = 13,793-22,225), Spain (11,324; 95% CI = 7,908-14,880) and Germany (8,173; 95% CI = 5,374-11,018) had the highest summer heat-related mortality numbers, while Italy (295 deaths per million, 95% CI = 226-364), Greece (280, 95% CI = 201-355), Spain (237, 95% CI = 166-312) and Portugal (211, 95% CI = 162-255) had the highest heat-related mortality rates. Relative to population, we estimated 56% more heat-related deaths in women than men, with higher rates in men aged 0-64 (+41%) and 65-79 (+14%) years, and in women aged 80+ years (+27%). Our results call for a reevaluation and strengthening of existing heat surveillance platforms, prevention plans and long-term adaptation strategies.
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Affiliation(s)
| | | | | | | | - François R Herrmann
- Medical School of the University of Geneva, Geneva, Switzerland
- Division of Geriatrics, Department of Rehabilitation and Geriatrics, Geneva University Hospitals, Thônex, Switzerland
| | - Jean Marie Robine
- Molecular Mechanisms in Neurodegenerative Dementia, University of Montpellier, Montpellier, France
- École Pratique des Hautes Études, Institut National de la Santé et de la Recherche Médicale, Montpellier, France
- PSL Research University, Paris, France
| | - Xavier Basagaña
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
- CIBER Epidemiología y Salud Pública, Barcelona, Spain
| | - Cathryn Tonne
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
- CIBER Epidemiología y Salud Pública, Barcelona, Spain
| | - Josep M Antó
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
- CIBER Epidemiología y Salud Pública, Barcelona, Spain
| | - Hicham Achebak
- ISGlobal, Barcelona, Spain
- Institut National de la Santé et de la Recherche Médicale, France Cohortes, Paris, France
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14
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Montandon ML, Rodriguez C, Herrmann FR, Eytan A, Pegna AJ, Haller S, Giannakopoulos P. Seeing in my way or your way: impact of intelligence, attention, and empathy on brain reactivity. Front Hum Neurosci 2023; 17:1071676. [PMID: 37234603 PMCID: PMC10206026 DOI: 10.3389/fnhum.2023.1071676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 04/17/2023] [Indexed: 05/28/2023] Open
Abstract
Previous studies showed that neurotypical adults are able to engage in unconscious analyses of others' mental states in the context of automatic perspective taking and experience systematic difficulties when judging the conflicts between their own (Self) and another's (Other) perspective. Several functional MRI (fMRI) studies reported widespread activation of mentalizing, salience, and executive networks when adopting the Other compared to Self perspective. This study aims to explore whether cognitive and emotional parameters impact on brain reactivity in dot perspective task (dPT). We provide here an fMRI analysis based on individual z-scores in eighty-two healthy adults who underwent the Samson's dPT after detailed assessment of fluid intelligence, attention, levels of alexithymia and social cognition abilities. Univariate regression models were used to explore the association between brain activation patterns and psychological variables. There was a strong positive association between Wechsler Adult Intelligence Scale (WAIS) and fMRI z-scores in Self perspective. When the Other perspective is taken, Continuous Performance Test (CPT)-II parameters were negatively associated with fMRI z-scores. Individuals with higher Toronto Alexithymia scale (TAS) score and lower scores in mini-Social cognition and Emotional Assessment (SEA) displayed significantly higher egocentric interference-related fMRI z-scores. Our data demonstrate that brain activation when focusing on our own perspective depends on the levels of fluid intelligence. Decreased attentional recruitment and decreased inhibitory control affects the brain efforts to adopt the Other perspective. Egocentric interference-associated brain fMRI activation was less marked in cases with better empathy abilities but the opposite was true for persons who experience increased difficulties in the recognition of emotions.
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Affiliation(s)
- Marie-Louise Montandon
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Department of Rehabilitation and Geriatrics, Geneva University Hospitals, University of Geneva, Geneva, Switzerland
| | - Cristelle Rodriguez
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Division of Institutional Measures, Medical Direction, Geneva University Hospitals, Geneva, Switzerland
| | - François R. Herrmann
- Department of Rehabilitation and Geriatrics, Geneva University Hospitals, University of Geneva, Geneva, Switzerland
| | - Ariel Eytan
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Division of Institutional Measures, Medical Direction, Geneva University Hospitals, Geneva, Switzerland
| | - Alan J. Pegna
- School of Psychology, University of Queensland, Brisbane, QLD, Australia
| | - Sven Haller
- CIMC—Centre d’Imagerie Médicale de Cornavin, Geneva, Switzerland
- Department of Surgical Sciences, Radiology, Uppsala University, Uppsala, Sweden
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Panteleimon Giannakopoulos
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Division of Institutional Measures, Medical Direction, Geneva University Hospitals, Geneva, Switzerland
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15
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Montandon ML, Rodriguez C, Herrmann FR, Eytan A, Pegna AJ, Haller S, Giannakopoulos P. Patterns of multiple brain network activation in dot perspective task. Sci Rep 2023; 13:6793. [PMID: 37100844 PMCID: PMC10133244 DOI: 10.1038/s41598-023-33427-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Accepted: 04/12/2023] [Indexed: 04/28/2023] Open
Abstract
In this functional MRI (fMRI) study on 82 healthy adults using the dot perspective task, inconsistency of perspectives was associated with a significant increase of the mean reaction time and number of errors both in Self and Other conditions. Unlike the Arrow (non-mentalizing), the Avatar (mentalizing) paradigm was characterized by the recruitment of parts of the mentalizing and salience networks. These data provide experimental evidence supporting the fMRI distinction between mentalizing and non-mentalizing stimuli. A widespread activation of classical theory of mind (ToM) areas but also of salience network and decision making areas was observed in the Other compared to Self-conditions. Compared to Self-Consistent, Self-Inconsistent trials were related to increased activation in the lateral occipital cortex, right supramarginal and angular gyrus as well as inferior, superior and middle frontal gyri. Compared to the Other-Consistent, Other-Inconsistent trials yielded strong activation in the lateral occipital cortex, precuneus and superior parietal lobule, middle and superior precentral gyri and left frontal pole. These findings reveal that altercentric interference relies on areas involved in self-other distinction, self-updating and central executive functions. In contrast, egocentric interference needs the activation of the mirror neuron system and deductive reasoning, much less related to pure ToM abilities.
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Affiliation(s)
- Marie-Louise Montandon
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland.
- Department of Rehabilitation and Geriatrics, Geneva University Hospitals and University of Geneva, Geneva, Switzerland.
| | - Cristelle Rodriguez
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Division of Institutional Measures, Medical Direction, Geneva University Hospitals, Geneva, Switzerland
| | - François R Herrmann
- Department of Rehabilitation and Geriatrics, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Ariel Eytan
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Division of Institutional Measures, Medical Direction, Geneva University Hospitals, Geneva, Switzerland
| | - Alan J Pegna
- School of Psychology, University of Queensland, Brisbane, Australia
| | - Sven Haller
- CIMC - Centre d'Imagerie Médicale de Cornavin, Geneva, Switzerland
- Department of Surgical Sciences, Radiology, Uppsala University, Uppsala, Sweden
- Faculty of Medicine of the University of Geneva, Geneva, Switzerland
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Panteleimon Giannakopoulos
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Division of Institutional Measures, Medical Direction, Geneva University Hospitals, Geneva, Switzerland
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16
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D'Orta I, Weber K, Herrmann FR, Giannakopoulos P. Determinants of clinical outcome and length of stay in acute care forensic psychiatry units. BMC Psychiatry 2023; 23:264. [PMID: 37072743 PMCID: PMC10111658 DOI: 10.1186/s12888-023-04748-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 04/04/2023] [Indexed: 04/20/2023] Open
Abstract
Criminological and sociodemographic variables, such as previous criminal convictions, increased risk of violence, early onset of mental disorder, antisocial personality, psychosis and low social support, have all been related to longer length of stay (LoS) and poorer outcome in long stay forensic services. The factors impacting on LoS and clinical response in acute care specialized units are poorly documented. To address this issue, we examined the psychiatric records of all cases admitted between January 1st and December 31th 2020 in the sole acute ward for detained persons located in the central prison of the Geneva County, Switzerland. Information on judicial status included pre-trial versus sentence execution, previous incarcerations, and age of the first incarceration. Sociodemographic data included age, gender, marital status, and education attainment. Previous inpatient stays prior to incarceration were recorded. All of the ICD-10 clinical diagnoses were made by two independent, board-certified psychiatrists blind to the scope of the study. The standardized assessment was based on the HoNOS (Health of Nation Outcome Scales) at admission and discharge, HONOS-secure at admission, HCR-20 (Historical Clinical Risk 20) version 2, PCL-R (Psychopathy Checklist Revised), and SAPROF (Structured Assessment of Protective Factors). Stepwise forward multiple linear regression models predicting the LoS and delta HONOS respectively were built with the above mentioned parameters. The selected variables were then used in univariate and multivariable regression models. Higher HCR-scores (mainly on clinical items), and longer LoS were related to higher delta HONOS scores. In contrast, cases in pre-trial detention showed a worst clinical outcome. In multivariable models, all three variables remained independent predictors of the clinical outcome and explained 30.7% of its variance. Only education and diagnosis of borderline personality were related to the LoS and explained 12.6% of its variance in multivariable models. Our results suggest that the use of acute wards specialized in forensic psychiatry are mainly useful for patients with prior inpatient care experience, and higher violence risk during sentence execution. In contrast, they seem to be less performant for persons in pre-trial detention that could benefit from less restrictive clinical settings.
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Affiliation(s)
- Isabella D'Orta
- Division of Institutional Measures, Medical Direction, Geneva University Hospitals, Geneva, Switzerland.
- Institute of Global Health, University of Geneva, Geneva, Switzerland.
| | - Kerstin Weber
- Division of Institutional Measures, Medical Direction, Geneva University Hospitals, Geneva, Switzerland
- Department of Psychiatry, University of Geneva, Geneva, Switzerland
| | - François R Herrmann
- Department of Rehabilitation and Geriatrics, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Panteleimon Giannakopoulos
- Division of Institutional Measures, Medical Direction, Geneva University Hospitals, Geneva, Switzerland
- Department of Psychiatry, University of Geneva, Geneva, Switzerland
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17
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Mendes A, Serratrice C, Herrmann FR, Gold G, Graf CE, Zekry D, Genton L. Nutritional risk at hospital admission is associated with prolonged length of hospital stay in old patients with COVID-19. Clin Nutr 2022; 41:3085-3088. [PMID: 33933295 PMCID: PMC7985608 DOI: 10.1016/j.clnu.2021.03.017] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 03/08/2021] [Accepted: 03/15/2021] [Indexed: 01/27/2023]
Abstract
BACKGROUND & AIMS To investigate the association of nutritional risk at admission with the length of hospital stay (LOS) and mortality in older patients with COVID-19. METHODS Retrospective monocentric study in an acute geriatric hospital. Data were collected after an extensive review of medical records and the nutritional risk was assessed according to the Nutritional Risk Screening (NRS). Univariate and multivariate (adjusted for age, sex and comorbidity burden) Cox proportional-hazard and linear regression models were used to investigate the association with the above-mentioned outcomes. RESULTS Of a total of 245 patients (86.1 ± 6.4 yrs), 50.6% had a severe nutritional risk with an NRS≥5/7 at admission. Lower BMI, cognitive impairment and swallowing disorders were more prevalent in the patients with a higher NRS. A NRS≥5 was not associated with mortality but prolonged by more than 3 days the LOS among the 173 survivors (β 3.69; 0.71-6.67 95% CI; p = 0.016), with a discharge rate delayed by 1.8 times (HR 0.55; 0.37-0.83 95% CI; p = 0.101). CONCLUSION Among the survivors of COVID-19 in an acute geriatric hospital, a NRS ≥5 at admission was associated with a longer LOS, but not with mortality.
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Affiliation(s)
- Aline Mendes
- Division of Geriatrics, University Hospitals of Geneva and University of Geneva, Chemin du Pont-Bochet 3, Geneva, Switzerland,Corresponding author. Chemin du Pont-Bochet 3, Thônex, Geneva, Switzerland
| | - Christine Serratrice
- Division of Internal Medicine for the Aged, University Hospitals of Geneva and University of Geneva, Chemin du Pont-Bochet 3, Geneva, Switzerland
| | - François R. Herrmann
- Division of Geriatrics, University Hospitals of Geneva and University of Geneva, Chemin du Pont-Bochet 3, Geneva, Switzerland
| | - Gabriel Gold
- Division of Geriatrics, University Hospitals of Geneva and University of Geneva, Chemin du Pont-Bochet 3, Geneva, Switzerland
| | - Christophe E. Graf
- Division of Internal Medicine and Rehabilitation, University Hospitals of Geneva and University of Geneva, Chemin du Pont-Bochet 3, Geneva, Switzerland
| | - Dina Zekry
- Division of Internal Medicine for the Aged, University Hospitals of Geneva and University of Geneva, Chemin du Pont-Bochet 3, Geneva, Switzerland
| | - Laurence Genton
- Clinical Nutrition, University Hospitals of Geneva and University of Geneva, Chemin du Pont-Bochet 3, Geneva, Switzerland
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Follonier C, Tessitore E, Handgraaf S, Carballo D, Achard M, Pechère-Bertschi A, Mach F, Herrmann FR, Girardin FR. Cardiovascular therapy use, modification, and in-hospital death in patients with COVID-19: A cohort study. PLoS One 2022; 17:e0277653. [PMID: 36417470 PMCID: PMC9683559 DOI: 10.1371/journal.pone.0277653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 11/01/2022] [Indexed: 11/25/2022] Open
Abstract
AIMS To assess the associations of exposure and modifications in exposure (i.e., discontinuation on admission, initiation during hospitalization) to eight common cardiovascular therapies with the risk of in-hospital death among inpatients with coronavirus disease 2019 (COVID-19). METHODS In this observational study including 838 hospitalized unvaccinated adult patients with confirmed COVID-19, the use of cardiovascular therapies was assessed using logistic regression models adjusted for potential confounders. RESULTS No cardiovascular therapy used before hospitalization was associated with an increased risk of in-hospital death. During hospitalization, the use of diuretics (aOR 2.59 [1.68-3.98]) was associated with an increase, and the use of agents acting on the renin-angiotensin system (aOR 0.39 [0.23-0.64]) and lipid-lowering agents (aOR 0.41 [0.24-0.68]) was associated with a reduction in the odds of in-hospital death. Exposure modifications associated with decreased survival were the discontinuation of an agent acting on the renin-angiotensin system (aOR 4.42 [2.08-9.37]), a β-blocker (aOR 5.44 [1.16-25.46]), a lipid-modifying agent (aOR 3.26 [1.42-7.50]) or an anticoagulant (aOR 5.85 [1.25-27.27]), as well as the initiation of a diuretic (aOR 5.19 [2.98-9.03]) or an antiarrhythmic (aOR 6.62 [2.07-21.15]). Exposure modification associated with improved survival was the initiation of an agent acting on the renin-angiotensin system (aOR 0.17 [0.03-0.82]). CONCLUSION In hospitalized and unvaccinated patients with COVID-19, there was no detrimental association of the prehospital use of any regular cardiovascular medication with in-hospital death, and these therapies should be continued as recommended.
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Affiliation(s)
- Cédric Follonier
- Division of Cardiology, Department of Medicine, Geneva University Hospitals, Geneva, Switzerland
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Elena Tessitore
- Division of Cardiology, Department of Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Sandra Handgraaf
- Division of Cardiology, Department of Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - David Carballo
- Division of Cardiology, Department of Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Maëlle Achard
- Division of Cardiology, Department of Medicine, Geneva University Hospitals, Geneva, Switzerland
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Antoinette Pechère-Bertschi
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Division of Nephrology and Hypertension, Department of Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - François Mach
- Division of Cardiology, Department of Medicine, Geneva University Hospitals, Geneva, Switzerland
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - François R. Herrmann
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Division of Geriatrics, Department of Rehabilitation and Geriatrics, Geneva University Hospitals, Geneva, Switzerland
| | - François R. Girardin
- Division of Clinical Pharmacology, Department of Laboratory Medicine and Pathology, Lausanne University Hospital, Faculty of Medicine, University of Lausanne, Lausanne, Switzerland
- Division of Clinical Pharmacology and Toxicology, Department of Anaesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, Geneva University Hospitals, Geneva, Switzerland
- * E-mail:
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19
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Lévy L, Robine JM, Rey G, Méndez Turrubiates RF, Quijal-Zamorano M, Achebak H, Ballester J, Rodó X, Herrmann FR. Daylight saving time affects European mortality patterns. Nat Commun 2022; 13:6906. [PMID: 36372798 PMCID: PMC9659560 DOI: 10.1038/s41467-022-34704-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Accepted: 11/03/2022] [Indexed: 11/15/2022] Open
Abstract
Daylight saving time (DST) consists in a one-hour advancement of legal time in spring offset by a backward transition of the same magnitude in fall. It creates a minimal circadian misalignment that could disrupt sleep and homoeostasis in susceptible individuals and lead to an increased incidence of pathologies and accidents during the weeks immediately following both transitions. How this shift affects mortality dynamics on a large population scale remains, however, unknown. This study examines the impact of DST on all-cause mortality in 16 European countries for the period 1998-2012. It shows that mortality decreases in spring and increases in fall during the first two weeks following each DST transition. Moreover, the alignment of time data around DST transition dates revealed a septadian mortality pattern (lowest on Sundays, highest on Mondays) that persists all-year round, irrespective of seasonal variations, in men and women aged above 40.
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Affiliation(s)
- Laurent Lévy
- Medical School of the University of Geneva, Geneva, Switzerland
| | - Jean-Marie Robine
- Institut National de la Santé et de la Recherche Médicale (INSERM), Montpellier, France
- École Pratique des Hautes Études, Paris, France
| | | | | | | | | | | | - Xavier Rodó
- ISGlobal, Barcelona, Spain
- Institució Catalana de Recerca i Estudis Avançats, Barcelona, Catalonia, Spain
| | - François R Herrmann
- Medical School of the University of Geneva, Geneva, Switzerland.
- Division of Geriatrics, Department of Rehabilitation and Geriatrics, Geneva University Hospitals, Thônex, Switzerland.
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20
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Griffa A, Bommarito G, Assal F, Preti MG, Goldstein R, Armand S, Herrmann FR, Van De Ville D, Allali G. CSF tap test in idiopathic normal pressure hydrocephalus: still a necessary prognostic test? J Neurol 2022; 269:5114-5126. [PMID: 35598251 PMCID: PMC9363476 DOI: 10.1007/s00415-022-11168-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 04/29/2022] [Accepted: 05/01/2022] [Indexed: 12/05/2022]
Abstract
Objective To assess whether gait, neuropsychological, and multimodal MRI parameters predict short-term symptom reversal after cerebrospinal fluid (CSF) tap test in idiopathic normal pressure hydrocephalus (iNPH). Methods Thirty patients (79.3 ± 5.9 years, 12 women) with a diagnosis of probable iNPH and 46 healthy controls (74.7 ± 5.4 years, 35 women) underwent comprehensive neuropsychological, quantitative gait, and multimodal MRI assessments of brain morphology, periventricular white-matter microstructure, cortical and subcortical blood perfusion, default mode network function, and white-matter lesion load. Responders were defined as an improvement of at least 10% in walking speed or timed up and go test 24 h after tap test. Univariate and multivariable tap test outcome prediction models were evaluated with logistic regression and linear support vector machine classification. Results Sixteen patients (53%) respondedpositively to tap test. None of the gait, neuropsychological, or neuroimaging parameters considered separately predicted outcome. A multivariable classifier achieved modest out-of-sample outcome prediction accuracy of 70% (p = .028); gait parameters, white-matter lesion load and periventricular microstructure were the main contributors. Conclusions Our negative findings show that short-term symptom reversal after tap test cannot be predicted from single gait, neuropsychological, or MRI parameters, thus supporting the use of tap test as prognostic procedure. However, multivariable approaches integrating non-invasive multimodal data are informative of outcome and may be included in patient-screening procedures. Their value in predicting shunting outcome should be further explored, particularly in relation to gait and white-matter parameters. Supplementary Information The online version contains supplementary material available at 10.1007/s00415-022-11168-x.
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21
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Rodriguez C, Montandon ML, Herrmann FR, Pegna AJ, Giannakopoulos P. Cognitive and Emotional Determinants of Automatic Perspective Taking in Healthy Adults. Front Psychol 2022; 13:883929. [PMID: 35586238 PMCID: PMC9108454 DOI: 10.3389/fpsyg.2022.883929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 04/01/2022] [Indexed: 11/13/2022] Open
Abstract
Previous studies using the dot-perspective task postulated that people automatically take into account others' perspective even when it prevents them from achieving their own goals. This human ability may be of key importance for the ascription of mental states and social interactions. The cognitive and emotional determinants of automatic perspective taking (APT) is still matter of debate. To address this issue, we examined the performance in the Samson et al. APT task in 91 healthy adults who underwent a detailed neuropsychological testing including assessment of their general intelligence (Wechsler Adult Intelligence Scale, WAIS), attention and impulsivity (Conners' Continuous Performance Test-II, CPT-II), alexithymia (Toronto Alexithymia Scale, TAS), and measures of affective empathy and explicit theory of mind (Geneva Social Cognition Scale, GeSoCS, and mini-Social cognition and Emotional Assessment, mini-SEA). Univariate and multiple linear regression models (adjusted for age, gender, and education) were used to explore the association between mean reaction times (respectively, mean number of errors) in the APT task, and the CPT-II parameters, WAIS global score (as well as subscale scores), TAS, and GeSoCS and mini-SEA scores. Only the CPT-II parameters were significantly associated with the mean reaction times. Increased omissions, commissions, and detectability as well as hit reaction time standard error in CPT-II were all related to worse performances both in Self and Other conditions. The mean number of errors was negatively associated with the GeSoCS score. Among the variables studied, only CPT-II parameters had a significant impact on egocentric and altercentric interference. Neither global intelligence nor alexithymia have an effect on dot-perspective task performance. The present findings suggest that people with lower attentional resources and increased impulsivity display worse performances in the APT task and are less responsive to both egocentric and altercentric interference.
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Affiliation(s)
- Cristelle Rodriguez
- Division of Institutional Measures, Medical Direction, Geneva University Hospitals, Geneva, Switzerland
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Marie-Louise Montandon
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Department of Rehabilitation and Geriatrics, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - François R. Herrmann
- Department of Rehabilitation and Geriatrics, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Alan J. Pegna
- School of Psychology, University of Queensland, Brisbane, QLD, Australia
| | - Panteleimon Giannakopoulos
- Division of Institutional Measures, Medical Direction, Geneva University Hospitals, Geneva, Switzerland
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- *Correspondence: Panteleimon Giannakopoulos
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22
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D'Orta I, Guilbert N, Pierrard M, Herrmann FR, Giannakopoulos P. Detained Persons Incarcerated for the First Time and Needing Acute Psychiatric Care: Sociodemographic and Clinical Characteristics. Front Psychiatry 2022; 13:904735. [PMID: 35836658 PMCID: PMC9273735 DOI: 10.3389/fpsyt.2022.904735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 06/06/2022] [Indexed: 11/18/2022] Open
Abstract
Among detained persons, those incarcerated for the first time (FTI: first time incarceration) are known to present long-standing psychological vulnerability but also suffer significant deterioration of their mental health during the first year following imprisonment. Whether the patterns of psychiatric morbidity differ in FTI cases compared to cases with repeated and long term incarceration (RLTI) is still a matter of debate. We examined the sociodemographic and clinical differences between a subgroup of FTI vs. one of RLTI in a series of 139 randomly selected detained persons admitted to an acute psychiatric ward located in the central prison of Geneva, Switzerland. Fisher exact, unpaired Student t and Mann-Whitney U tests were used to explore sociodemographic (age, gender, marital status, religion, knowledge of French, education) and clinical (psychiatric outpatient care, suicidal behavior, psychiatric diagnosis) differences between the two groups. Subsequently, univariate and multiple logistic regression models were used to detect the variables associated with FTI. The proportion of women was significantly higher in the FTI compared to the RLTI group. FTI cases were also more frequently separated or divorced, with less frequent religious affiliation. 16.9% of FTI cases but only 1.3% of RLTI cases had a clinical diagnosis of depression. In multiple regression models, female sex and lower religious affiliation rate were associated with FTI status. Among diagnostic categories, depression was strongly related to FTI status both in univariate and multivariable models. Importantly, this was not the case for adjustment disorders, previous history of psychiatric care and suicidal behavior. Our observations support the assumption that FTI cases with lower affective support, less religious investment and without psychiatric care prior to imprisonment are particularly vulnerable to depressive illness.
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Affiliation(s)
- Isabella D'Orta
- Division of Institutional Measures, Medical Direction, Geneva University Hospitals, Geneva, Switzerland.,Institute of Global Health, University of Geneva, Geneva, Switzerland
| | - Nicolas Guilbert
- Division of Institutional Measures, Medical Direction, Geneva University Hospitals, Geneva, Switzerland
| | - Mathieu Pierrard
- Division of Institutional Measures, Medical Direction, Geneva University Hospitals, Geneva, Switzerland
| | - François R Herrmann
- Department of Rehabilitation and Geriatrics, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Panteleimon Giannakopoulos
- Division of Institutional Measures, Medical Direction, Geneva University Hospitals, Geneva, Switzerland.,Department of Psychiatry, University of Geneva, Geneva, Switzerland
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23
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Giannakopoulos P, Rodriguez C, Montandon ML, Garibotto V, Haller S, Herrmann FR. Personality Impact on Alzheimer's Disease-Signature and Vascular Imaging Markers: A PET-MRI Study. J Alzheimers Dis 2021; 85:1807-1817. [PMID: 34958019 DOI: 10.3233/jad-215062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Several studies postulated that personality is an independent determinant of cognitive trajectories in old age. OBJECTIVE This study explores the impact of personality on widely used Alzheimer's disease (AD) and vascular imaging markers. METHODS We examined the association between personality and three classical AD imaging markers (centiloid-based-amyloid load, MRI volumetry in hippocampus, and media temporal lobe atrophy), and two vascular MRI parameters (Fazekas score and number of cortical microbleeds) assessed at baseline and upon a 54-month-follow-up. Personality was assessed with the Neuroticism Extraversion Openness Personality Inventory-Revised. Regression models were used to identify predictors of imaging markers including sex, personality factors, presence of APOE ɛ4 allele and cognitive evolution over time. RESULTS Cortical GM volumes were negatively associated with higher levels of Conscientiousness both at baseline and follow-up. In contrast, higher scores of Openness were related to better preservation of left hippocampal volumes in these two time points and negatively associated with medial temporal atrophy at baseline. Amyloid load was not affected by personality factors. Cases with higher Extraversion scores displayed higher numbers of cortical microbleeds at baseline. CONCLUSION Personality impact on brain morphometry is detected only in some among the routinely used imaging markers. The most robust associations concern the positive role of high levels of Conscientiousness and Openness on AD-signature MRI markers. Higher extraversion levels are associated with increased vulnerability to cortical microbleeds pointing to the fact that the socially favorable traits may have a detrimental effect on brain integrity in old age.
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Affiliation(s)
- Panteleimon Giannakopoulos
- Department of Psychiatry, University of Geneva, Geneva, Switzerland.,Medical Direction, Geneva University Hospitals, Geneva, Switzerland
| | - Cristelle Rodriguez
- Department of Psychiatry, University of Geneva, Geneva, Switzerland.,Medical Direction, Geneva University Hospitals, Geneva, Switzerland
| | - Marie-Louise Montandon
- Department of Psychiatry, University of Geneva, Geneva, Switzerland.,Department of Rehabilitation and Geriatrics, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Valentina Garibotto
- Department of Nuclear Medicine and Molecular Imaging, Diagnostic Department, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Sven Haller
- CIMC - Centre d'Imagerie Médicale de Cornavin, Geneva, Switzerland.,Department of Surgical Sciences, Radiology, Uppsala University, Uppsala, Sweden.,Faculty of Medicine of the University of Geneva, Geneva, Switzerland.,Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - François R Herrmann
- Department of Rehabilitation and Geriatrics, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
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24
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Genton L, Pruijm M, Teta D, Bassi I, Cani PD, Gaïa N, Herrmann FR, Marangon N, Mareschal J, Muccioli GG, Stoermann C, Suriano F, Wurzner-Ghajarzadeh A, Lazarevic V, Schrenzel J. Gut barrier and microbiota changes with glycine and branched-chain amino acid supplementation in chronic haemodialysis patients. J Cachexia Sarcopenia Muscle 2021; 12:1527-1539. [PMID: 34535959 PMCID: PMC8718035 DOI: 10.1002/jcsm.12781] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 07/22/2021] [Accepted: 08/13/2021] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND We have previously shown that glycine increases fat-free mass in chronic haemodialysis patients with features of malnutrition as compared with branched-chain amino acids (BCAAs). This multicentre randomized double-blind crossover study evaluates the impact of these amino acids on the gut barrier and microbiota. METHODS Haemodialysis patients were included if they had plasma albumin <38 g/L or weight loss >5% of dry body weight, and daily dietary intakes <30 kcal/kg and <1 g protein/kg. They consumed glycine or BCAA (7 g twice daily) for 4 months and underwent a 1 month washout period, before crossover of supplementations. Faecal microbiota (16S rRNA gene sequencing) and immunoglobulin A (IgA), serum levels of cytokines, surrogate markers of intestinal permeability, appetite mediators, and endocannabinoids were obtained at the start and end of each supplementation. Supplementations were compared by multiple mixed linear regression models, adjusted for age, sex, month of supplementation (0 and 4 in each period), and period (Period 1: first 4 months; Period 2: last 4 months). Microbiota comparisons were performed using principal coordinate analysis and permutational multivariate analysis of variance, Shannon diversity index estimate and analysis of composition of microbiomes analysis, and Wilcoxon tests. RESULTS We analysed 27 patients compliant to the supplementations. Multiple mixed linear regression models were significant only for interleukin-6 (P = 0.002), glucagon-like peptide 1 (P = 0.028), cholecystokinin (P = 0.021), and peptide YY (P = 0.002), but not for the other outcomes. The significant models did not show any impact of the type of supplementation (P < 0.05 in all models). Principal coordinate analysis and permutational multivariate analysis of variance (P = 0.0001) showed strong microbiota clustering by subject, but no effect of the amino acids. Bacterial alpha diversity and zero-radius operational taxonomic unit richness remained stable, whatever the supplementation. Lacticaseibacillus paracasei (0.030; Q1-Q3 0.008-0.078 vs. 0.004; Q1-Q3 0.001-0.070) and Bifidobacterium dentium (0.0247; Q1-Q3 0.002-0.191 vs. 0.003; Q1-Q3 0.001-0.086) significantly decreased with the BCAA supplementation. CONCLUSIONS The BCAA and glycine supplementations had no impact on the serum levels of cytokines, appetite mediators, intestinal permeability, endocannabinoids, or faecal IgA. Overall faecal microbiota composition and microbial diversity did not change with the glycine or BCAA supplementation but decreased the abundance of L. paracasei and B. dentium.
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Affiliation(s)
- Laurence Genton
- Unit of Nutrition, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Menno Pruijm
- Service of Nephrology, University Hospitals of Lausanne and University of Lausanne, Lausanne, Switzerland
| | - Daniel Teta
- Service of Nephrology, Cantonal Hospital of Sion, Sion, Switzerland
| | - Isabelle Bassi
- Service of Nephrology, Cantonal Hospital of Sion, Sion, Switzerland
| | - Patrice D Cani
- Louvain Drug Research Institute, Metabolism and Nutrition Research Group, Walloon Excellence in Life Sciences and BIOtechnology (WELBIO), Université catholique de Louvain, Brussels, Belgium
| | - Nadia Gaïa
- Genomic Research Lab and Service of Infectious Diseases, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - François R Herrmann
- Department of Rehabilitation and Geriatrics, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Nicola Marangon
- Service of Nephrology, Geneva University Hospitals and Clinique of Champel, Geneva, Switzerland
| | - Julie Mareschal
- Unit of Nutrition, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Giulio G Muccioli
- Louvain Drug Research Institute, Bioanalysis and Pharmacology of Bioactive Lipids Research Group, Université catholique de Louvain, Brussels, Belgium
| | - Catherine Stoermann
- Service of Nephrology, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Francesco Suriano
- Louvain Drug Research Institute, Metabolism and Nutrition Research Group, Walloon Excellence in Life Sciences and BIOtechnology (WELBIO), Université catholique de Louvain, Brussels, Belgium
| | - Arlene Wurzner-Ghajarzadeh
- Service of Nephrology, University Hospitals of Lausanne and University of Lausanne, Lausanne, Switzerland
| | - Vladimir Lazarevic
- Genomic Research Lab and Service of Infectious Diseases, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Jacques Schrenzel
- Genomic Research Lab and Service of Infectious Diseases, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
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25
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Genton L, Teta D, Pruijm M, Stoermann C, Marangon N, Mareschal J, Bassi I, Wurzner‐Ghajarzadeh A, Lazarevic V, Cynober L, Cani PD, Herrmann FR, Schrenzel J. Glycine increases fat-free mass in malnourished haemodialysis patients: a randomized double-blind crossover trial. J Cachexia Sarcopenia Muscle 2021; 12:1540-1552. [PMID: 34519439 PMCID: PMC8718019 DOI: 10.1002/jcsm.12780] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 03/22/2021] [Accepted: 08/13/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Protein energy wasting is associated with negative outcome in patients under chronic haemodialysis (HD). Branched-chain amino acids (BCAAs) may increase the muscle mass. This post hoc analysis of a controlled double-blind randomized crossover study assessed the impact of BCAAs on nutritional status, physical function, and quality of life. METHODS We included 36 chronic HD patient features of protein energy wasting as plasma albumin <38 g/L, and dietary intakes <30 kcal/kg/day and <1 g protein/kg/day. Patients received either oral BCAA (2 × 7 g/day) or glycine (2 × 7 g/day) for 4 months (Period 1), followed by a washout period of 1 month, and then received the opposite supplement (Period 2). The outcomes were lean body mass measured by dual-energy X-ray absorptiometry, fat-free mass index measured by bioelectrical impedance, resting energy expenditure, dietary intake and appetite rating, physical activity and function, quality of life, and blood parameters. Analyses were performed by multiple mixed linear regressions including type of supplementation, months, period, sex, and age as fixed effects and subjects as random intercepts. RESULTS Twenty-seven patients (61.2 ± 13.7 years, 41% women) were compliant to the supplementations (consumption >80% of packs) and completed the study. BCAA did not affect lean body mass index and body weight, but significantly decreased fat-free mass index, as compared with glycine (coeff -0.27, 95% confidence interval -0.43 to -0.10, P = 0.002, respectively). BCAA and glycine intake had no effect on the other clinical parameters, blood chemistry tests, or plasma amino acids. CONCLUSIONS Branched-chain amino acid did not improve lean body mass as compared with glycine. Unexpectedly, glycine improved fat-free mass index in HD patients, as compared with BCAA. Whether long-term supplementation with glycine improves the clinical outcome remains to be demonstrated.
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Affiliation(s)
- Laurence Genton
- Unit of Clinical NutritionGeneva University Hospitals and University of GenevaGenevaSwitzerland
| | - Daniel Teta
- Service of NephrologyCantonal Hospital of SionSionSwitzerland
| | - Menno Pruijm
- Service of NephrologyUniversity Hospital of Lausanne and University of LausanneLausanneSwitzerland
| | - Catherine Stoermann
- Service of NephrologyGeneva University Hospitals and University of GenevaGenevaSwitzerland
| | - Nicola Marangon
- Service of NephrologyGeneva University Hospitals and Clinique of ChampelGenevaSwitzerland
| | - Julie Mareschal
- Unit of Clinical NutritionGeneva University Hospitals and University of GenevaGenevaSwitzerland
| | - Isabelle Bassi
- Service of NephrologyCantonal Hospital of SionSionSwitzerland
| | | | - Vladimir Lazarevic
- Genomic Research Lab and Service of Infectious DiseasesGeneva University Hospitals and University of GenevaGenevaSwitzerland
| | - Luc Cynober
- EA 4466, Faculty of PharmacyParis University, and Clin Chem Lab, Cochin HospitalParisFrance
| | - Patrice D. Cani
- Louvain Drug Research Institute Metabolism and Nutrition Research Group, Walloon Excellence in Life Sciences and BIOtechnology (WELBIO)Université catholique de LouvainBrusselsBelgium
| | - François R. Herrmann
- Department of Rehabilitation and GeriatricsGeneva University Hospitals and University of GenevaGenevaSwitzerland
| | - Jacques Schrenzel
- Genomic Research Lab and Service of Infectious DiseasesGeneva University Hospitals and University of GenevaGenevaSwitzerland
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Scheffler M, Genton L, Graf CE, Remuinan J, Gold G, Zekry D, Serratrice C, Herrmann FR, Mendes A. Prognostic Role of Subcutaneous and Visceral Adiposity in Hospitalized Octogenarians with COVID-19. J Clin Med 2021; 10:jcm10235500. [PMID: 34884199 PMCID: PMC8658645 DOI: 10.3390/jcm10235500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 11/20/2021] [Accepted: 11/23/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND We investigated the prognostic significance of visceral and subcutaneous adiposity in octogenarians with COVID-19. METHODS This paper presents a monocentric retrospective study that was conducted in acute geriatric wards with 64 hospitalized patients aged 80+ who had a diagnosis of COVID-19 and who underwent a chest CT scan. A quantification of the subcutaneous, visceral, and total fat areas was performed after segmentations on the first abdominal slice caudal to the deepest pleural recess on a soft-tissue window setting. Logistic regression models were applied to investigate the association with in-hospital mortality and the extent of COVID-19 pneumonia. RESULTS The patients had a mean age of 86.4 ± 6.0 years, and 46.9% were male, with a mean BMI of 24.1 ± 4.4Kg/m2 and mortality rate of 32.8%. A higher subcutaneous fat area had a protective effect against mortality (OR 0.416; 0.183-0.944 95% CI; p = 0.036), which remained significant after adjustments for age, sex, and BMI (OR 0.231; 0.071-0.751 95% CI; p = 0.015). Inversely, higher abdominal circumference, total fat area, subcutaneous fat area, and visceral fat were associated with worse COVID-19 pneumonia, with the latter presenting the strongest association after adjustments for age, sex, and BMI (OR 2.862; 1.523-5.379 95% CI; p = 0.001). CONCLUSION Subcutaneous and visceral fat areas measured on chest CT scans were associated with prognosis in octogenarians with COVID-19.
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Affiliation(s)
- Max Scheffler
- Division of Radiology, Diagnostic Department, University Hospitals of Geneva, 1205 Geneva, Switzerland; (M.S.); (J.R.)
| | - Laurence Genton
- Unit of Clinical Nutrition, Faculty of Medicine, University Hospitals of Geneva, 1205 Geneva, Switzerland;
| | - Christophe E. Graf
- Division of Internal Medicine and Rehabilitation, Department of Rehabilitation and Geriatrics, Faculty of Medicine, University Hospitals of Geneva, 1205 Geneva, Switzerland;
| | - Jorge Remuinan
- Division of Radiology, Diagnostic Department, University Hospitals of Geneva, 1205 Geneva, Switzerland; (M.S.); (J.R.)
| | - Gabriel Gold
- Division of Geriatrics, Department of Rehabilitation and Geriatrics, Faculty of Medicine, University Hospitals of Geneva, 1205 Geneva, Switzerland; (G.G.); (F.R.H.)
| | - Dina Zekry
- Division of Internal Medicine for the Aged, Department of Rehabilitation and Geriatrics, Faculty of Medicine, University Hospitals of Geneva, 1205 Geneva, Switzerland; (D.Z.); (C.S.)
| | - Christine Serratrice
- Division of Internal Medicine for the Aged, Department of Rehabilitation and Geriatrics, Faculty of Medicine, University Hospitals of Geneva, 1205 Geneva, Switzerland; (D.Z.); (C.S.)
| | - François R. Herrmann
- Division of Geriatrics, Department of Rehabilitation and Geriatrics, Faculty of Medicine, University Hospitals of Geneva, 1205 Geneva, Switzerland; (G.G.); (F.R.H.)
| | - Aline Mendes
- Division of Geriatrics, Department of Rehabilitation and Geriatrics, Faculty of Medicine, University Hospitals of Geneva, 1205 Geneva, Switzerland; (G.G.); (F.R.H.)
- Correspondence: ; Tel.: +41-079-553-83-65
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Herrmann FR, Montandon ML, Garibotto V, Rodriguez C, Haller S, Giannakopoulos P. Determinants of Cognitive Trajectories in Normal Aging: A Longitudinal PET-MRI Study in a Community-based Cohort. Curr Alzheimer Res 2021; 18:482-491. [PMID: 34602046 DOI: 10.2174/1567205018666210930111806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 04/01/2021] [Accepted: 05/18/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND The determinants of the progressive decrement of cognition in normal aging are still a matter of debate. Alzheimer disease (AD)-signature markers and vascular lesions, but also psychological variables such as personality factors, are thought to have an impact on the longitudinal trajectories of neuropsychological performances in healthy elderly individuals. OBJECTIVE The current research aimed to identify the main determinants associated with cognitive trajectories in normal aging. METHODS We performed a 4.5-year longitudinal study in 90 older community-dwellers coupling two neuropsychological assessments, medial temporal atrophy (MTA), number of cerebral microbleeds (CMB), and white matter hyperintensities (WMH) at inclusion, visual rating of amyloid and FDG PET at follow-up, and APOE genotyping. Personality factors were assessed at baseline using the NEO-PIR. Univariate and backward stepwise regression models were built to explore the association between the continuous cognitive score (CCS) and both imaging and personality variables. RESULTS The number of strictly lobar CMB at baseline (4 or more) was related to a significant increase in the risk of cognitive decrement. In multivariable models, amyloid positivity was associated with a 1.73 unit decrease of the CCS at follow-up. MTA, WMH and abnormal FDG PET were not related to the cognitive outcome. Among personality factors, only higher agreeableness was related to better preservation of neuropsychological performances. CONCLUSION CMB and amyloid positivity are the only imaging determinants of cognitive trajectories in this highly selected series of healthy controls. Among personality factors, higher agreeableness confers a modest but significant protection against the decline of cognitive performances.
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Affiliation(s)
- François R Herrmann
- Department of Rehabilitation and Geriatrics, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Marie-Louise Montandon
- Department of Rehabilitation and Geriatrics, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Valentina Garibotto
- Division of Nuclear Medicine and Molecular Imaging, Diagnostic Department, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | | | - Sven Haller
- CIMC - Centre d'Imagerie Médicale de Cornavin, Geneva, Switzerland
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28
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Montandon ML, Herrmann FR, Garibotto V, Rodriguez C, Haller S, Giannakopoulos P. Microbleeds and Medial Temporal Atrophy Determine Cognitive Trajectories in Normal Aging: A Longitudinal PET-MRI Study. J Alzheimers Dis 2021; 77:1431-1442. [PMID: 32925053 DOI: 10.3233/jad-200559] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
BACKGROUND The cognitive trajectories in normal aging may be affected by medial temporal atrophy (MTA) and amyloid burden, as well as vascular pathologies such as cortical microbleeds (CMB) and white matter hyperintensities (WMH). OBJECTIVE We addressed here the role of imaging markers in their prediction in a real-world situation. METHODS We performed a 4.5-year longitudinal study in 90 older community-dwellers coupling two neuropsychological assessments, MTA estimated with the Schelten's scale, number of CMB, and WMH evaluated with the Fazekas score at inclusion and follow-up, visual rating of amyloid PET and glucose hypometabolism at follow-up, and APOE genotyping. Regression models were built to explore the association between the continuous cognitive score (CCS) and imaging parameters. RESULTS The number of strictly lobar CMB at baseline (4 or more) was related to a 5.5-fold increase of the risk of cognitive decrement. This association persisted in multivariable models explaining 10.6% of the CCS decrease variance. MTA, and Fazekas score at baseline and amyloid positivity or abnormal FDG PET, were not related to the cognitive outcome. The increase of right MTA at follow-up was the only correlate of CCS decrease both in univariate and multivariable models explaining 9.2% of its variance. CONCLUSION The present data show that the accumulation of more than four CMB is associated with significant cognitive decrement over time in highly educated elderly persons. They also reveal that the progressive deterioration of cognitive performance within the age-adjusted norms is also related to the increase of visually assessed MTA.
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Affiliation(s)
- Marie-Louise Montandon
- Department of Rehabilitation and Geriatrics, Geneva University Hospitals and University of Geneva, Switzerland.,Department of Psychiatry, University of Geneva, Switzerland
| | - François R Herrmann
- Department of Rehabilitation and Geriatrics, Geneva University Hospitals and University of Geneva, Switzerland
| | - Valentina Garibotto
- Division of Nuclear Medicine and Molecular Imaging, Diagnostic Department, Geneva University Hospitals and University of Geneva, Switzerland
| | - Cristelle Rodriguez
- Department of Psychiatry, University of Geneva, Switzerland.,Medical Direction, University of Geneva Hospitals, Geneva, Switzerland
| | - Sven Haller
- CIRD - Centre d'Imagerie Rive Droite in Geneva, Switzerland.,Department of Surgical Sciences, Radiology, Uppsala University, Uppsala, Sweden.,Department of Neuroradiology, Faculty of Medicine of the University of Geneva, Geneva, Switzerland
| | - Panteleimon Giannakopoulos
- Department of Psychiatry, University of Geneva, Switzerland.,Medical Direction, University of Geneva Hospitals, Geneva, Switzerland
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Quijal-Zamorano M, Martínez-Solanas È, Achebak H, Petrova D, Robine JM, Herrmann FR, Rodó X, Ballester J. Seasonality reversal of temperature attributable mortality projections due to previously unobserved extreme heat in Europe. Lancet Planet Health 2021; 5:e573-e575. [PMID: 34508677 DOI: 10.1016/s2542-5196(21)00211-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 07/21/2021] [Accepted: 07/27/2021] [Indexed: 06/13/2023]
Affiliation(s)
| | | | | | | | - Jean-Marie Robine
- Institut National de la Santé et de la Recherche Médicale, Montpellier, France; École Pratique des Hautes Études, Paris, France
| | - François R Herrmann
- Division of Geriatrics, Department of Rehabilitation and Geriatrics, Geneva University Hospitals and University of Geneva, Thônex, Switzerland
| | - Xavier Rodó
- ISGlobal, Barcelona 08003, Spain; ICREA, Barcelona, Spain
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Mendes A, Herrmann FR, Périvier S, Gold G, Graf CE, Zekry D. Delirium in Older Patients With COVID-19: Prevalence, Risk Factors, and Clinical Relevance. J Gerontol A Biol Sci Med Sci 2021; 76:e142-e146. [PMID: 33539505 PMCID: PMC7929187 DOI: 10.1093/gerona/glab039] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Indexed: 12/19/2022] Open
Abstract
Background Delirium prevalence increases with age and is associated with poor outcomes. We aimed to investigate the prevalence and risk factors for delirium in older patients hospitalized with COVID-19, as well as its association with length of stay and mortality. Method This was a retrospective study of patients aged 65 years and older hospitalized with COVID-19. Data were collected from computerized medical records and all patients had delirium assessment at admission. Risk factors for delirium as well as the outcomes mentioned above were studied by 2-group comparison, logistic regression, and Cox proportional hazard models. Results Of a total of 235 Caucasian patients, 48 (20.4%) presented with delirium, which was hypoactive in 41.6% of cases, and hyperactive and mixed in 35.4% and 23.0%, respectively. Patients with cognitive impairment had a nearly 4 times higher risk of developing delirium compared to patients who were cognitively normal before SARS-CoV-2 infection (odds ratio 3.7; 95% CI: 1.7–7.9, p = .001). The presence of delirium did not modify the time from symptoms’ onset to hospitalization or the length of stay in acute care, but it was associated with an increased risk of dying (hazard ratio 2.1; 95% CI: 1.2–3.7, p = .0113). Conclusion Delirium was a prevalent condition in older people admitted with COVID-19 and preexisting cognitive impairment was its main risk factor. Delirium was associated with higher in-hospital mortality. These results highlight the importance of early recognition of delirium especially when premorbid cognitive comorbidities are present.
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Affiliation(s)
- Aline Mendes
- Division of Geriatrics, University Hospitals of Geneva, Switzerland
| | | | - Samuel Périvier
- Division of Geriatrics, University Hospitals of Geneva, Switzerland
| | - Gabriel Gold
- Division of Geriatrics, University Hospitals of Geneva, Switzerland
| | - Christophe E Graf
- Division of Internal Medicine and Rehabilitation, University Hospitals of Geneva, Switzerland
| | - Dina Zekry
- Division of Internal Medicine for the Aged, University Hospitals of Geneva, Switzerland
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Giannakopoulos P, Montandon ML, Rodriguez C, Haller S, Garibotto V, Herrmann FR. Prediction of Subtle Cognitive Decline in Normal Aging: Added Value of Quantitative MRI and PET Imaging. Front Aging Neurosci 2021; 13:664224. [PMID: 34322007 PMCID: PMC8313279 DOI: 10.3389/fnagi.2021.664224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 06/21/2021] [Indexed: 11/26/2022] Open
Abstract
Quantitative imaging processing tools have been proposed to improve clinic-radiological correlations but their added value at the initial stages of cognitive decline is still a matter of debate. We performed a longitudinal study in 90 community-dwelling elders with three neuropsychological assessments during a 4.5 year follow-up period, and visual assessment of medial temporal atrophy (MTA), white matter hyperintensities, cortical microbleeds (CMB) as well as amyloid positivity, and presence of abnormal FDG-PET patterns. Quantitative imaging data concerned ROI analysis of MRI volume, amyloid burden, and FDG-PET metabolism in several AD-signature areas. Multiple regression models, likelihood-ratio tests, and areas under the receiver operating characteristic curve (AUC) were used to compare quantitative imaging markers to visual inspection. The presence of more or equal to four CMB at inclusion and slight atrophy of the right MTL at follow-up were the only parameters to be independently related to the worst cognitive score explaining 6% of its variance. This percentage increased to 24.5% when the ROI-defined volume loss in the posterior cingulate cortex, baseline hippocampus volume, and MTL metabolism were also considered. When binary classification of cognition was made, the area under the ROC curve increased from 0.69 for the qualitative to 0.79 for the mixed imaging model. Our data reveal that the inclusion of quantitative imaging data significantly increases the prediction of cognitive changes in elderly controls compared to the single consideration of visual inspection.
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Affiliation(s)
- Panteleimon Giannakopoulos
- Department of Psychiatry, University of Geneva, Geneva, Switzerland.,Medical Direction, Geneva University Hospitals, Geneva, Switzerland
| | - Marie-Louise Montandon
- Department of Psychiatry, University of Geneva, Geneva, Switzerland.,Department of Rehabilitation and Geriatrics, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Cristelle Rodriguez
- Department of Psychiatry, University of Geneva, Geneva, Switzerland.,Medical Direction, Geneva University Hospitals, Geneva, Switzerland
| | - Sven Haller
- Department of Neuroradiology, Faculty of Medicine of the University of Geneva, Geneva, Switzerland.,CIRD-Centre d'Imagerie Rive Droite, Geneva, Switzerland.,Department of Surgical Sciences, Radiology, Uppsala University, Uppsala, Sweden
| | - Valentina Garibotto
- Department of Nuclear Medicine and Molecular Imaging, Diagnostic Department, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - François R Herrmann
- Department of Rehabilitation and Geriatrics, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
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Buchholzer S, Faure F, Tcheremissinoff L, Herrmann FR, Lombardi T, Ng SK, Lopez JM, Borner U, Witt RL, Irvine R, Abboud O, Cernea CR, Ghan S, Matsunobu T, Ahmad Z, Morton R, Anicin A, Magdy EA, Al Abri R, Konstantinidis I, Capaccio P, Klein H, Poorten VV, Lombardi D, Lyons B, Al Rand H, Liao G, Kim JK, Subha S, Su RYX, Su CH, Boselie F, Andre R, Seebach JD, Marchal F. Novel Multidisciplinary Salivary Gland Society (MSGS) Questionnaire: An International Consensus. Laryngoscope 2021; 132:322-331. [PMID: 34236085 PMCID: PMC9291943 DOI: 10.1002/lary.29731] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 05/26/2021] [Accepted: 06/21/2021] [Indexed: 01/01/2023]
Abstract
Objectives First, establishment and validation of a novel questionnaire documenting the burden of xerostomia and sialadenitis symptoms, including quality of life. Second, to compare two versions regarding the answering scale (proposed developed answers Q3 vs. 0–10 visual analogue scale Q10) of our newly developed questionnaire, in order to evaluate their comprehension by patients and their reproducibility in time. Study Design The study is a systematic review regarding the evaluation of the existing questionnaire and a cohort study regarding the validation of our new MSGS questionnaire. Materials and Methods A Multidisciplinary Salivary Gland Society (MSGS) questionnaire consisting of 20 questions and two scoring systems was developed to quantify symptoms of dry mouth and sialadenitis. Validation of the questionnaire was carried out on 199 patients with salivary pathologies (digestive, nasal, or age‐related xerostomia, post radiation therapy, post radioiodine therapy, Sjögren's syndrome, IgG4 disease, recurrent juvenile parotitis, stones, and strictures) and a control group of 66 healthy volunteers. The coherence of the questionnaire's items, its reliability to distinguish patients from healthy volunteers, its comparison with unstimulated sialometry, and the time to fill both versions were assessed. Results The novel MSGS questionnaire showed good internal coherence of the items, indicating its pertinence: the scale reliability coefficients amounted to a Cronbach's alpha of 0.92 for Q10 and 0.90 for Q3. The time to complete Q3 and Q10 amounted, respectively, to 5.23 min (±2.3 min) and 5.65 min (±2.64 min) for patients and to 3.94 min (±3.94 min) and 3.75 min (±2.11 min) for healthy volunteers. The difference between Q3 and Q10 was not significant. Conclusion We present a novel self‐administered questionnaire quantifying xerostomia and non‐tumoral salivary gland pathologies. We recommend the use of the Q10 version, as its scale type is well known in the literature and it translation for international use will be more accurate. Laryngoscope, 132:322–331, 2022
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Affiliation(s)
- Samanta Buchholzer
- Department of Maxillofacial Surgery and Oral Medicine and Pathology, Geneva University Hospitals, Geneva, Switzerland
| | - Frédéric Faure
- Otorhinolaryngology, Head and Neck Surgery Department, Hospices Civils de Lyon, Lyon, France.,ENT Department, Infirmerie Protestante, Caluire, France
| | | | - François R Herrmann
- Division of Geriatrics, Department of Rehabilitation and Geriatrics, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Tommaso Lombardi
- Oral Medicine and Oral and Maxillofacial Pathology Unit, Division of Oral Maxillofacial Surgery, Department of Surgery, Geneva University Hospitals, University of Geneva, Geneva, Switzerland
| | - Siu-Kwan Ng
- Department of Otorhinolaryngology, Head and Neck Surgery, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Jean-Michel Lopez
- Department of Otorhinolaryngology-Head and Neck Surgery, Centre Hospitalier de Perpignan, Perpignan, France
| | - Urs Borner
- Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Robert L Witt
- Christiana Care, Thomas Jefferson University, Philadelphia, Pennsylvania, U.S.A
| | - Robert Irvine
- Division of Otolaryngology, Department of Surgery, University of Calgary, Calgary, Alberta, Canada
| | - Olivier Abboud
- Division of Otolaryngology-Head and Neck Surgery, University of Montreal, Hôpital du Sacré-Coeur de Montréal, Montreal, Canada
| | - Claudio R Cernea
- Department of Surgery, University of São Paulo School of Medicine, São Paulo, Brazil
| | - Shirish Ghan
- Department of Otolaryngology, Deenanath Mangeshkar Hospital and Research Center, Pune, India
| | - Takeshi Matsunobu
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Nipppon Medical School, Tokyo, Japan
| | - Zahoor Ahmad
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Nipppon Medical School, Tokyo, Japan
| | - Randall Morton
- Department of Otolaryngology Head and Neck Surgery, Counties Manukau District Health Board, Auckland, New Zealand
| | - Aleksandar Anicin
- Department of Otorhinolaryngology and Cervicofacial Surgery University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Emad A Magdy
- Department of Otorhinolaryngology-Head & Neck Surgery, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Rashid Al Abri
- Department of Surgery, College of Medicine & Health Sciences, Sultan Qaboos University, Muscat, Oman
| | | | - Pasquale Capaccio
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, ENT Clinic Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Hila Klein
- Faculty of Medicine, Sialendoscopy and Minimal Invasive Surgery Service, Rambam Health Care Campus, Haifa, Israel
| | - Vincent Vander Poorten
- Head and Neck Surgery, University Hospitals Leuven-Department of Oncology, Section Head and Neck Oncology, KU Leuven, Leuven, Belgium
| | - Davide Lombardi
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Brescia, Brescia, Italy
| | - Bernard Lyons
- Director ENT Head and Neck Surgery and Skull Base Surgery, St. Vincent's Hospital, Melbourne, Australia
| | - Hussain Al Rand
- Department of Otorhinolaryngology, Dr. Sulaiman Al Habib Hospital, Dubai, United Arab Emirates
| | - George Liao
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, PR China
| | - Jeong K Kim
- Department of Otolaryngology-Head and Neck Surgery, Catholic University of Daegu School of Medicine, Daegu, Republic of Korea
| | - Sethu Subha
- Department of Otorhinolaryngology, Head & Neck Surgery, Faculty of Medicine & Health Sciences, University Putra Malaysia, Serdang, Malaysia
| | - Richard Y-X Su
- Division of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR
| | - Chin-Hui Su
- Department of Otolaryngology Head and Neck Surgery, Mackay Memorial Hospital, Taipei, Taiwan.,School of Medicine, Mackay Medical College, New Taipei City, Taiwan
| | - Franciscus Boselie
- Department of Otorhinolaryngology-Head and Neck Surgery, Geneva University Hospitals, Geneva, Switzerland
| | - Raphaël Andre
- Department of Dermatology, Geneva University Hospitals, Geneva, Switzerland.,Department of Allergology and Clinical Immunology, Geneva University Hospitals, Geneva, Switzerland
| | - Jörg D Seebach
- Division of Clinical Immunology and Allergy, Department of Medical Specialties, University Hospitals and Medical Faculty, Geneva, Switzerland
| | - Francis Marchal
- Department of Otorhinolaryngology-Head and Neck Surgery, Geneva University Hospitals, Geneva, Switzerland
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Martínez-Solanas È, Quijal-Zamorano M, Achebak H, Petrova D, Robine JM, Herrmann FR, Rodó X, Ballester J. Projections of temperature-attributable mortality in Europe: a time series analysis of 147 contiguous regions in 16 countries. Lancet Planet Health 2021; 5:e446-e454. [PMID: 34245715 DOI: 10.1016/s2542-5196(21)00150-9] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 05/14/2021] [Accepted: 05/27/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Europe has emerged as a major climate change hotspot, both in terms of an increase in seasonal averages and climate extremes. Projections of temperature-attributable mortality, however, have not been comprehensively reported for an extensive part of the continent. Therefore, we aim to estimate the future effect of climate change on temperature-attributable mortality across Europe. METHODS We did a time series analysis study. We derived temperature-mortality associations by collecting daily temperature and all-cause mortality records of both urban and rural areas for the observational period between 1998 and 2012 from 147 regions in 16 European countries. We estimated the location-specific temperature-mortality relationships by using standard time series quasi-Poisson regression in conjunction with a distributed lag non-linear model. These associations were used to transform the daily temperature simulations from the climate models in the historical period (1971-2005) and scenario period (2006-2099) into projections of temperature-attributable mortality. We combined the resulting risk functions with daily time series of future temperatures simulated by four climate models (ie, GFDL-ESM2M, HadGEM2-ES, IPSL-CM5A-LR, and MIROC5) under three greenhouse gas emission scenarios (ie, Representative Concentration Pathway [RCP]2.6, RCP6.0, and RCP8.5), providing projections of future mortality attributable fraction due to moderate and extreme cold and heat temperatures. FINDINGS Overall, 7·17% (95% CI 5·81-8·50) of deaths registered in the observational period were attributed to non-optimal temperatures, cold being more harmful than heat by a factor of ten (6·51% [95% CI 5·14-7·80] vs 0·65% [0·40-0·89]), and with large regional differences across countries-eg, ranging from 4·85% (95% CI 3·75-6·00) in Germany to 9·87% (8·53-11·19) in Italy. The projection of temperature anomalies by RCP scenario depicts a progressive increase in temperatures, more exacerbated in the high-emission scenario RCP8.5 (4·54°C by 2070-2099) than in RCP6.0 (2·89°C) and RCP2.6 (1·67°C). This increase in temperatures was transformed into attributable fraction. Projections consistently indicated that the increase in heat attributable fraction will start to exceed the reduction of cold attributable fraction in the second half of the 21st century, especially in the Mediterranean and in the higher emission scenarios. The comparison between scenarios highlighted the important role of mitigation, given that the total attributable fraction will only remain stable in RCP2.6, whereas the total attributable fraction will rapidly start to increase in RCP6.0 by the end of the century and in RCP8.5 already by the middle of the century. INTERPRETATION The increase in heat attributable fraction will start to exceed the reduction of cold attributable fraction in the second half of the 21st century. This finding highlights the importance of implementing mitigation policies. These measures would be especially beneficial in the Mediterranean, where the high vulnerability to heat will lead to an imbalance between the decreasing cold and increasing heat-attributable mortality. FUNDING None.
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Affiliation(s)
| | | | - Hicham Achebak
- ISGlobal, Barcelona, Spain; Centre for Demographic Studies, Autonomous University of Barcelona, Barcelona, Catalonia, Spain
| | | | - Jean-Marie Robine
- Institut National de la Santé et de la Recherche Médicale (INSERM), Montpellier, France; École Pratique des Hautes Études, Paris, France
| | - François R Herrmann
- Division of Geriatrics, Department of Rehabilitation and Geriatrics, Geneva University Hospitals and University of Geneva, Thônex, Switzerland
| | - Xavier Rodó
- ISGlobal, Barcelona, Spain; ICREA, Barcelona, Spain
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Griffa A, Bommarito G, Assal F, Herrmann FR, Van De Ville D, Allali G. Cover Image. Hum Brain Mapp 2021. [DOI: 10.1002/hbm.25056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Mendes A, Herrmann FR, Genton L, Serratrice C, Carrera E, Vargas MI, Gold G, Graf CE, Zekry D, Scheffler M. Incidence, characteristics and clinical relevance of acute stroke in old patients hospitalized with COVID-19. BMC Geriatr 2021; 21:52. [PMID: 33446113 PMCID: PMC7807227 DOI: 10.1186/s12877-021-02006-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 12/30/2020] [Indexed: 12/28/2022] Open
Abstract
Background Stroke in the course of coronavirus disease (COVID-19) has been shown to be associated with more severe respiratory symptoms and higher mortality, but little knowledge in this regard exists on older populations. We aimed to investigate the incidence, characteristics, and prognosis of acute stroke in geriatric patients hospitalized with COVID-19. Methods A monocentric cross-sectional retrospective study of 265 older patients hospitalized with COVID-19 on acute geriatric wards. 11/265 presented a stroke episode during hospitalization. Mortality rates and two-group comparisons (stroke vs non-stroke patients) were calculated and significant variables added in logistic regression models to investigate stroke risk factors. Results Combined ischemic and hemorrhagic stroke incidence was 4.15%. 72.7% of events occurred during acute care. Strokes presented with altered state of consciousness and/or delirium in 81.8%, followed by a focal neurological deficit in 45.5%. Ischemic stroke was more frequently unilateral (88.8%) and localized in the middle cerebral artery territory (55.5%). Smoking and a history of previous stroke increased by more than seven (OR 7.44; 95% CI 1.75–31.64; p = 0.007) and five times (OR 5.19; 95% CI 1.50–17.92; p = 0.009), respectively, the risk of stroke. Each additional point in body mass index (BMI) reduced the risk of stroke by 14% (OR 0.86; 95% CI 0.74–0.98; p = 0.03). In-hospital mortality (32.1% vs. 27.3%; p > 0.999) and institutionalization at discharge (36.4% vs. 21.1%; p = 0.258) were similar between patients with and without stroke. Conclusion Incident stroke complicating COVID-19 in old patients was associated with active smoking, previous history of stroke, and low BMI. Acute stroke did not influence early mortality or institutionalization rate at discharge. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-021-02006-2.
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Affiliation(s)
- Aline Mendes
- Division of Geriatrics, Department of Rehabilitation and Geriatrics, University Hospitals of Geneva and Faculty of Medicine, Chemin du Pont-Bochet 3, 1226 Thônex, Geneva, Switzerland.
| | - François R Herrmann
- Division of Geriatrics, Department of Rehabilitation and Geriatrics, University Hospitals of Geneva and Faculty of Medicine, Chemin du Pont-Bochet 3, 1226 Thônex, Geneva, Switzerland
| | - Laurence Genton
- Unit of Clinical Nutrition, University Hospitals of Geneva and Faculty of Medicine, Geneva, Switzerland
| | - Christine Serratrice
- Division of Internal Medicine for the Aged, Department of Rehabilitation and Geriatrics, University Hospitals of Geneva and Faculty of Medicine, Geneva, Switzerland
| | - Emmanuel Carrera
- Division of Neurology, Department of Neurosciences, University Hospitals of Geneva and Faculty of Medicine, Geneva, Switzerland
| | - Maria Isabel Vargas
- Division of Neuroradiology, Diagnostic Department, University Hospitals of Geneva and Faculty of Medicine, Geneva, Switzerland
| | - Gabriel Gold
- Division of Geriatrics, Department of Rehabilitation and Geriatrics, University Hospitals of Geneva and Faculty of Medicine, Chemin du Pont-Bochet 3, 1226 Thônex, Geneva, Switzerland
| | - Christophe E Graf
- Division of Internal Medicine and Rehabilitation, Department of Rehabilitation and Geriatrics, University Hospitals of Geneva and Faculty of Medicine, Geneva, Switzerland
| | - Dina Zekry
- Division of Internal Medicine for the Aged, Department of Rehabilitation and Geriatrics, University Hospitals of Geneva and Faculty of Medicine, Geneva, Switzerland
| | - Max Scheffler
- Division of Radiology, Diagnostic Department, University Hospitals of Geneva, Geneva, Switzerland
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D'Orta I, Herrmann FR, Giannakopoulos P. Determinants of Revolving Door in an Acute Psychiatric Ward for Prison Inmates. Front Psychiatry 2021; 12:626773. [PMID: 33935830 PMCID: PMC8081974 DOI: 10.3389/fpsyt.2021.626773] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 03/16/2021] [Indexed: 11/13/2022] Open
Abstract
Among the different types of heavy use of mental health services, frequent inpatient admission in acute care units of individuals unable to return to their usual environment refers to as revolving-door (RD). RD in prisoners is related to increased violence (acted and supported) and suicidal recidivism. We explored the determinants of RD in 200 inmates from the Swiss-French speaking areas who were admitted to the sole acute psychiatric care unit for all of the Swiss-French counties, located in Geneva. The Cuzick's test for trend across ordered groups, Kruskal-Wallis test and oneway ANOVA were used to compare demographic and clinical variables between single (one admission, N = 100), frequent (3-7, N = 69) and RD (more than 8, N = 31) during a 12 months period. In addition, univariate and multivariable ordered logistic regression modes were built to examine the determinants of RD. The sample included 27 women (mean age: 31.2 years) and 173 men (34.5 years) who were admitted during the period 2014-2019. The vast majority were single (65%) with low level of education (<6 years, 78%). Suicidal behavior was the more frequent reason for admission (57%). Psychiatric history was positive in 77.5% of cases and in 54.5% of cases there was at least one episode of inpatient psychiatric care. The more frequent ICD-10 psychiatric diagnosis in the last admission were psychotic disorder (38%), personality disorder (29.5%) and adjustment disorder (19.5%). In contrast, depressive episodes (7%) and bipolar disorder (4.5%) were rare. Group comparison showed that the presence of court-ordered treatments, suicidal behavior, personality and psychotic disorders was associated with significantly increased frequency of RD use. In univariate models, the same factors were positively associated with RD, the highest odds ratio being found for court-ordered treatments (5.77) and personality disorders (2.14). In contrast, the diagnosis of adjustment disorders was related to decreased RD use (OR 0.25). Court-ordered treatments and personality disorders were the only factors to predict RD in multivariable regression models. These findings suggest that acute psychiatric care in these patients did not depend of environmental stressors but rather represents the expression of a long-lasting vulnerability related to their psychological profile and criminal status.
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Affiliation(s)
- Isabella D'Orta
- Division of Institutional Measures, Medical Direction, Geneva University Hospitals, Geneva, Switzerland
| | - François R Herrmann
- Department of Rehabilitation and Geriatrics, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Panteleimon Giannakopoulos
- Division of Institutional Measures, Medical Direction, Geneva University Hospitals, Geneva, Switzerland.,Department of Psychiatry, University of Geneva, Geneva, Switzerland
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Kuntz A, Missonnier P, Prévot A, Favre G, Herrmann FR, Debatisse D, Merlo MCG, Gothuey I. Persistence of Neuronal Alterations in Alcohol-Dependent Patients at Conclusion of the Gold Standard Withdrawal Treatment: Evidence From ERPs. Front Psychiatry 2021; 12:666063. [PMID: 34526916 PMCID: PMC8435667 DOI: 10.3389/fpsyt.2021.666063] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 06/23/2021] [Indexed: 11/24/2022] Open
Abstract
Background: One of the main challenges for clinicians is to ensure that alcohol withdrawal treatment is the most effective possible after discharge. To address this issue, we designed a pilot study to investigate the efficacy of the rehabilitation treatment on the main stages of information processing, using an electroencephalographic method. This topic is of main importance as relapse rates after alcohol withdrawal treatment remain very high, indicating that established treatment methods are not fully effective in all patients in the long run. Method: We examined in alcohol-dependent patients (ADP) the effects of the benzodiazepine-based standard detoxification program on event-related potential components at incoming (D0) and completion (D15) of the treatment, using tasks of increasing difficulty (with and without workload) during an auditory oddball target paradigm. Untreated non-alcohol-dependent-volunteers were used as matching controls. Results: At D0, ADP displayed significantly lower amplitude for all ERP components in both tasks, as compared to controls. At D15, this difference disappeared for the amplitude of the N1 component during the workload-free task, as well as the amplitude of the P3b for both tasks. Meanwhile, the amplitude of the N2 remained lower in both tasks for ADP. At D0, latencies of N2 and P3b in both task conditions were longer in ADP, as compared to controls, whilst the latency of N1 was unchanged. At D15, the N2 latency remained longer for the workload condition only, whereas the P3b latency remained longer for the workload-free task only. Conclusion: The present pilot results provide evidence for a persistence of impaired parameters of ERP components, especially the N2 component. This suggests that neural networks related to attention processing remain dysfunctional. Longitudinal long-term follow-up of these patients is mandatory for further assessment of a link between ERP alterations and a later risk of relapse.
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Affiliation(s)
- André Kuntz
- Mental Health Network Fribourg (RFSM), Sector of Psychiatry and Psychotherapy for Adults, Marsens, Switzerland
| | - Pascal Missonnier
- Mental Health Network Fribourg (RFSM), Sector of Psychiatry and Psychotherapy for Adults, Marsens, Switzerland.,Laboratory for Psychiatric Neuroscience and Psychotherapy, Department of Neuroscience, Faculty of Science and Medicine, University of Fribourg, Fribourg, Switzerland
| | - Anne Prévot
- School of Health Sciences (HEdS-FR), HES-SO University of Applied Sciences and Arts Western Switzerland, Fribourg, Switzerland
| | - Grégoire Favre
- Mental Health Network Fribourg (RFSM), Sector of Psychiatry and Psychotherapy for Adults, Marsens, Switzerland.,Laboratory for Psychiatric Neuroscience and Psychotherapy, Department of Neuroscience, Faculty of Science and Medicine, University of Fribourg, Fribourg, Switzerland
| | - François R Herrmann
- Division of Geriatrics, Department of Rehabilitation and Geriatrics, Geneva University Hospitals and University of Geneva, Thônex, Switzerland
| | - Damien Debatisse
- HELIOS Privatkliniken GmbH - Wuppertal-Universität/Barmen, Wuppertal, Germany.,Department of Neurosurgery, Universität Kliniken der Stadt Köln gGmbH, Krankenhaus Merheim, Cologne, Germany
| | - Marco C G Merlo
- Laboratory for Psychiatric Neuroscience and Psychotherapy, Department of Neuroscience, Faculty of Science and Medicine, University of Fribourg, Fribourg, Switzerland
| | - Isabelle Gothuey
- Mental Health Network Fribourg (RFSM), Sector of Psychiatry and Psychotherapy for Adults, Marsens, Switzerland
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Ferrer Soler C, Cuvelier C, Hars M, Herrmann FR, Charpiot A, Ducharne Wieczorkiewicz C, Bruyère O, Beaudart C, Zekry D, Gold G, Trombetti A. Validation of the Perform-FES: a new fear of falling scale for hospitalized geriatric patients. Aging Clin Exp Res 2021; 33:67-76. [PMID: 33063292 PMCID: PMC7897618 DOI: 10.1007/s40520-020-01726-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 09/26/2020] [Indexed: 11/28/2022]
Abstract
Background Fear of falling is highly prevalent in older adults and associated with numerous negative health events. The main objective of this study was to validate a scale to assess fear of falling, based on performance in real situation (Perform-FES), in a hospitalized geriatric population. Methods In this cross-sectional study, 55 patients (mean age: 85.3 years; 58% women) hospitalized in a geriatric hospital in Geneva (Switzerland) were enrolled. The Perform-FES scale was administered to all patients in conjunction with four other fear of falling scales. We determined the floor and ceiling effects, internal consistency, reliability, construct validity, and discriminative power of the Perform-FES scale. Results The Perform-FES scale did not demonstrate any significant floor or ceiling effect. It had a good internal consistency (Cronbach’s alpha = 0.78) and an excellent reliability (intraclass correlation coefficient = 0.94). Regarding convergent validity, good correlations were shown between the score obtained on the Perform-FES scale and those obtained on other fear of falling scales. Also, the Perform-FES scale was able to discriminate patients with severe functional impairments (area under the ROC curve = 0.81) and had significantly better discriminating performance than other fear of falling scales. Conclusion Findings suggest that the Perform-FES scale has good psychometric properties and may be a relevant tool to assess fear of falling in a geriatric hospitalized population. Future research should focus in particular on assessing the sensitivity to change and the predictive value of this scale in longitudinal studies, and its validity in other populations.
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Affiliation(s)
- Cecilia Ferrer Soler
- Division of Geriatrics, Department of Rehabilitation and Geriatrics, Geneva University Hospitals and Faculty of Medicine, Thônex, Switzerland
| | - Clémence Cuvelier
- Division of Geriatrics, Department of Rehabilitation and Geriatrics, Geneva University Hospitals and Faculty of Medicine, Thônex, Switzerland
| | - Mélany Hars
- Division of Bone Diseases, Department of Medicine, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - François R Herrmann
- Division of Geriatrics, Department of Rehabilitation and Geriatrics, Geneva University Hospitals and Faculty of Medicine, Thônex, Switzerland
- Division of Internal Medicine for the Aged, Department of Rehabilitation and Geriatrics, Geneva University Hospitals and Faculty of Medicine, Thônex, Switzerland
| | - Adrienne Charpiot
- Division of Public Health, Epidemiology and Health Economics, World Health Organization Collaborating Center for Public Health Aspects of Musculoskeletal Health and Ageing, University of Liège, Liège, Belgium
| | - Catherine Ducharne Wieczorkiewicz
- Division of Geriatrics, Department of Rehabilitation and Geriatrics, Geneva University Hospitals and Faculty of Medicine, Thônex, Switzerland
- Division of Internal Medicine for the Aged, Department of Rehabilitation and Geriatrics, Geneva University Hospitals and Faculty of Medicine, Thônex, Switzerland
| | - Olivier Bruyère
- Division of Public Health, Epidemiology and Health Economics, World Health Organization Collaborating Center for Public Health Aspects of Musculoskeletal Health and Ageing, University of Liège, Liège, Belgium
| | - Charlotte Beaudart
- Division of Public Health, Epidemiology and Health Economics, World Health Organization Collaborating Center for Public Health Aspects of Musculoskeletal Health and Ageing, University of Liège, Liège, Belgium
| | - Dina Zekry
- Division of Internal Medicine for the Aged, Department of Rehabilitation and Geriatrics, Geneva University Hospitals and Faculty of Medicine, Thônex, Switzerland
| | - Gabriel Gold
- Division of Geriatrics, Department of Rehabilitation and Geriatrics, Geneva University Hospitals and Faculty of Medicine, Thônex, Switzerland
| | - Andrea Trombetti
- Division of Geriatrics, Department of Rehabilitation and Geriatrics, Geneva University Hospitals and Faculty of Medicine, Thônex, Switzerland.
- Division of Bone Diseases, Department of Medicine, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland.
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Griffa A, Bommarito G, Assal F, Herrmann FR, Van De Ville D, Allali G. Dynamic functional networks in idiopathic normal pressure hydrocephalus: Alterations and reversibility by CSF tap test. Hum Brain Mapp 2020; 42:1485-1502. [PMID: 33296129 PMCID: PMC7927299 DOI: 10.1002/hbm.25308] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 11/02/2020] [Accepted: 11/26/2020] [Indexed: 12/19/2022] Open
Abstract
Idiopathic Normal Pressure Hydrocephalus (iNPH)—the leading cause of reversible dementia in aging—is characterized by ventriculomegaly and gait, cognitive and urinary impairments. Despite its high prevalence estimated at 6% among the elderlies, iNPH remains underdiagnosed and undertreated due to the lack of iNPH‐specific diagnostic markers and limited understanding of pathophysiological mechanisms. INPH diagnosis is also complicated by the frequent occurrence of comorbidities, the most common one being Alzheimer's disease (AD). Here we investigate the resting‐state functional magnetic resonance imaging dynamics of 26 iNPH patients before and after a CSF tap test, and of 48 normal older adults. Alzheimer's pathology was evaluated by CSF biomarkers. We show that the interactions between the default mode, and the executive‐control, salience and attention networks are impaired in iNPH, explain gait and executive disturbances in patients, and are not driven by AD‐pathology. In particular, AD molecular biomarkers are associated with functional changes distinct from iNPH functional alterations. Finally, we demonstrate a partial normalization of brain dynamics 24 hr after a CSF tap test, indicating functional plasticity mechanisms. We conclude that functional changes involving the default mode cross‐network interactions reflect iNPH pathophysiological mechanisms and track treatment response, possibly contributing to iNPH differential diagnosis and better clinical management.
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Affiliation(s)
- Alessandra Griffa
- Department of Clinical Neurosciences, Division of Neurology, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Institute of Bioengineering, Center of Neuroprosthetics, École Polytechnique Fédérale De Lausanne (EPFL), Geneva, Switzerland
| | - Giulia Bommarito
- Department of Clinical Neurosciences, Division of Neurology, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Institute of Bioengineering, Center of Neuroprosthetics, École Polytechnique Fédérale De Lausanne (EPFL), Geneva, Switzerland
| | - Frédéric Assal
- Department of Clinical Neurosciences, Division of Neurology, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - François R Herrmann
- Department of Rehabilitation and Geriatrics, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Dimitri Van De Ville
- Institute of Bioengineering, Center of Neuroprosthetics, École Polytechnique Fédérale De Lausanne (EPFL), Geneva, Switzerland.,Department of Radiology and Medical Informatics, University of Geneva, Geneva, Switzerland
| | - Gilles Allali
- Department of Clinical Neurosciences, Division of Neurology, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Department of Neurology, Division of Cognitive & Motor Aging, Albert Einstein College of Medicine, Yeshiva University, Bronx, New York, USA
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Hars M, Mendes A, Serratrice C, Herrmann FR, Gold G, Graf C, Zekry D, Trombetti A. Sex-specific association between vitamin D deficiency and COVID-19 mortality in older patients. Osteoporos Int 2020; 31:2495-2496. [PMID: 33048168 PMCID: PMC7552596 DOI: 10.1007/s00198-020-05677-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Accepted: 10/07/2020] [Indexed: 01/28/2023]
Affiliation(s)
- M Hars
- Department of Medicine, Division of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Rue Gabrielle-Perret-Gentil 4, CH-1205, Geneva, Switzerland
- Department of Rehabilitation and Geriatrics, Division of Geriatrics, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - A Mendes
- Department of Rehabilitation and Geriatrics, Division of Geriatrics, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - C Serratrice
- Department of Rehabilitation and Geriatrics, Division of Internal Medicine for the Aged, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - F R Herrmann
- Department of Rehabilitation and Geriatrics, Division of Geriatrics, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - G Gold
- Department of Rehabilitation and Geriatrics, Division of Geriatrics, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - C Graf
- Department of Rehabilitation and Geriatrics, Division of Rehabilitation and Internal Medicine, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - D Zekry
- Department of Rehabilitation and Geriatrics, Division of Internal Medicine for the Aged, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - A Trombetti
- Department of Medicine, Division of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Rue Gabrielle-Perret-Gentil 4, CH-1205, Geneva, Switzerland.
- Department of Rehabilitation and Geriatrics, Division of Geriatrics, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland.
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Bellés L, Dimiziani A, Tsartsalis S, Millet P, Herrmann FR, Ginovart N. Dopamine D2/3 Receptor Availabilities and Evoked Dopamine Release in Striatum Differentially Predict Impulsivity and Novelty Preference in Roman High- and Low-Avoidance Rats. Int J Neuropsychopharmacol 2020; 24:239-251. [PMID: 33151278 PMCID: PMC7968620 DOI: 10.1093/ijnp/pyaa084] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 10/09/2020] [Accepted: 10/29/2020] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Impulsivity and novelty preference are both associated with an increased propensity to develop addiction-like behaviors, but their relationship and respective underlying dopamine (DA) underpinnings are not fully elucidated. METHODS We evaluated a large cohort (n = 49) of Roman high- and low-avoidance rats using single photon emission computed tomography to concurrently measure in vivo striatal D2/3 receptor (D2/3R) availability and amphetamine (AMPH)-induced DA release in relation to impulsivity and novelty preference using a within-subject design. To further examine the DA-dependent processes related to these traits, midbrain D2/3-autoreceptor levels were measured using ex vivo autoradiography in the same animals. RESULTS We replicated a robust inverse relationship between impulsivity, as measured with the 5-choice serial reaction time task, and D2/3R availability in ventral striatum and extended this relationship to D2/3R levels measured in dorsal striatum. Novelty preference was positively related to impulsivity and showed inverse associations with D2/3R availability in dorsal striatum and ventral striatum. A high magnitude of AMPH-induced DA release in striatum predicted both impulsivity and novelty preference, perhaps owing to the diminished midbrain D2/3-autoreceptor availability measured in high-impulsive/novelty-preferring Roman high-avoidance animals that may amplify AMPH effect on DA transmission. Mediation analyses revealed that while D2/3R availability and AMPH-induced DA release in striatum are both significant predictors of impulsivity, the effect of striatal D2/3R availability on novelty preference is fully mediated by evoked striatal DA release. CONCLUSIONS Impulsivity and novelty preference are related but mediated by overlapping, yet dissociable, DA-dependent mechanisms in striatum that may interact to promote the emergence of an addiction-prone phenotype.
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Affiliation(s)
- Lidia Bellés
- Department of Psychiatry, University of Geneva, Switzerland,Department of Basic Neurosciences, University of Geneva, Switzerland
| | | | - Stergios Tsartsalis
- Faculty of Medicine, University of Geneva, Switzerland,Division of Adult Psychiatry, Department of Psychiatry, University Hospitals of Geneva, Switzerland
| | - Philippe Millet
- Department of Psychiatry, University of Geneva, Switzerland,Faculty of Medicine, University of Geneva, Switzerland,Division of Adult Psychiatry, Department of Psychiatry, University Hospitals of Geneva, Switzerland
| | - François R Herrmann
- Division of Geriatrics, Department of Rehabilitation and Geriatrics, Geneva University Hospitals, Switzerland
| | - Nathalie Ginovart
- Department of Psychiatry, University of Geneva, Switzerland,Department of Basic Neurosciences, University of Geneva, Switzerland,Correspondence: Nathalie Ginovart, PhD, Departments of Psychiatry and Basic Neurosciences, Faculty of Medicine, Room E07-2550A, University of Geneva, Rue Michel Servet 1, CH-1211 Geneva, Switzerland ()
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Mendes A, Serratrice C, Herrmann FR, Genton L, Périvier S, Scheffler M, Fassier T, Huber P, Jacques MC, Prendki V, Roux X, Di Silvestro K, Trombert V, Harbarth S, Gold G, Graf CE, Zekry D. Predictors of In-Hospital Mortality in Older Patients With COVID-19: The COVIDAge Study. J Am Med Dir Assoc 2020; 21:1546-1554.e3. [PMID: 33138936 PMCID: PMC7491997 DOI: 10.1016/j.jamda.2020.09.014] [Citation(s) in RCA: 75] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 09/09/2020] [Accepted: 09/09/2020] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To determine predictors of in-hospital mortality related to COVID-19 in older patients. DESIGN Retrospective cohort study. SETTING AND PARTICIPANTS Patients aged 65 years and older hospitalized for a diagnosis of COVID-19. METHODS Data from hospital admission were collected from the electronic medical records. Logistic regression and Cox proportional hazard models were used to predict mortality, our primary outcome. Variables at hospital admission were categorized according to the following domains: demographics, clinical history, comorbidities, previous treatment, clinical status, vital signs, clinical scales and scores, routine laboratory analysis, and imaging results. RESULTS Of a total of 235 Caucasian patients, 43% were male, with a mean age of 86 ± 6.5 years. Seventy-six patients (32%) died. Nonsurvivors had a shorter number of days from initial symptoms to hospitalization (P = .007) and the length of stay in acute wards than survivors (P < .001). Similarly, they had a higher prevalence of heart failure (P = .044), peripheral artery disease (P = .009), crackles at clinical status (P < .001), respiratory rate (P = .005), oxygen support needs (P < .001), C-reactive protein (P < .001), bilateral and peripheral infiltrates on chest radiographs (P = .001), and a lower prevalence of headache (P = .009). Furthermore, nonsurvivors were more often frail (P < .001), with worse functional status (P < .001), higher comorbidity burden (P < .001), and delirium at admission (P = .007). A multivariable Cox model showed that male sex (HR 4.00, 95% CI 2.08-7.71, P < .001), increased fraction of inspired oxygen (HR 1.06, 95% CI 1.03-1.09, P < .001), and crackles (HR 2.42, 95% CI 1.15-6.06, P = .019) were the best predictors of mortality, while better functional status was protective (HR 0.98, 95% CI 0.97-0.99, P = .001). CONCLUSIONS AND IMPLICATIONS In older patients hospitalized for COVID-19, male sex, crackles, a higher fraction of inspired oxygen, and functionality were independent risk factors of mortality. These routine parameters, and not differences in age, should be used to evaluate prognosis in older patients.
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Affiliation(s)
- Aline Mendes
- Division of Geriatrics, University Hospitals of Geneva, Geneva, Switzerland.
| | - Christine Serratrice
- Divison of Internal Medicine for the aged, University Hospitals of Geneva, Geneva, Switzerland
| | | | - Laurence Genton
- Clinical Nutrition, University Hospitals of Geneva, Geneva, Switzerland
| | - Samuel Périvier
- Division of Geriatrics, University Hospitals of Geneva, Geneva, Switzerland
| | - Max Scheffler
- Division of Radiology, University Hospitals of Geneva, Geneva, Switzerland
| | - Thomas Fassier
- Divison of Internal Medicine for the aged, University Hospitals of Geneva, Geneva, Switzerland
| | - Philippe Huber
- Division of Geriatrics, University Hospitals of Geneva, Geneva, Switzerland
| | | | - Virginie Prendki
- Divison of Internal Medicine for the aged, University Hospitals of Geneva, Geneva, Switzerland
| | - Xavier Roux
- Divison of Internal Medicine for the aged, University Hospitals of Geneva, Geneva, Switzerland
| | - Katharine Di Silvestro
- Divison of Internal Medicine for the aged, University Hospitals of Geneva, Geneva, Switzerland
| | - Véronique Trombert
- Divison of Internal Medicine for the aged, University Hospitals of Geneva, Geneva, Switzerland
| | - Stephan Harbarth
- Division of Infectious Diseases and Infection Control Program, University Hospitals of Geneva and Faculty of Medicine, Geneva, Switzerland
| | - Gabriel Gold
- Division of Geriatrics, University Hospitals of Geneva, Geneva, Switzerland
| | - Christophe E Graf
- Division of Internal Medicine and Rehabilitation, University Hospitals of Geneva, Geneva, Switzerland
| | - Dina Zekry
- Divison of Internal Medicine for the aged, University Hospitals of Geneva, Geneva, Switzerland
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Haller S, Montandon ML, Lilja J, Rodriguez C, Garibotto V, Herrmann FR, Giannakopoulos P. PET amyloid in normal aging: direct comparison of visual and automatic processing methods. Sci Rep 2020; 10:16665. [PMID: 33028945 PMCID: PMC7542434 DOI: 10.1038/s41598-020-73673-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 09/21/2020] [Indexed: 12/20/2022] Open
Abstract
Assessment of amyloid deposits is a critical step for the identification of Alzheimer disease (AD) signature in asymptomatic elders. Whether the different amyloid processing methods impacts on the quality of clinico-radiological correlations is still unclear. We directly compared in 155 elderly controls with extensive neuropsychological testing at baseline and 4.5 years follow-up three approaches: (i) operator-dependent standard visual reading, (ii) operator-independent automatic SUVR with four different reference regions, and (iii) novel operator and region of reference-independent automatic Aβ-index. The coefficient of variance was used to examine inter-individual variability for each processing method. Using visually-established amyloid positivity as the gold standard, the area under the receiver operating characteristic curve (ROC) was computed. Linear regression models were used to assess the association between changes in continuous cognitive score and amyloid uptake values. In SUVR analyses, the coefficient of variance varied from 1.718 to 1.762 according to the area of reference and was of − 3.045 for the Aβ-index method. Compared to the visual rating, Aβ-index method showed the largest area under the ROC curve [0.9568 (95% CI 0.9252, 0.98833)]. The best cut-off score was of − 0.3359 with sensitivity and specificity values of 0.97 and 0.83, respectively. Only the Aß-index was related to more severe decrement of cognitive performances [regression coefficient: 9.103 (95% CI 1.148, 17.058)]. The Aβ-index is considered as preferred option in asymptomatic elders, since it is operator-independent, avoids the selection of reference area, is closer to established visual scoring and correlates with the evolution of cognitive performances.
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Affiliation(s)
- Sven Haller
- CIRD Centre d'imagerie Rive Droite, Geneva, Switzerland. .,Department of Surgical Sciences, Radiology, Uppsala University, Uppsala, Sweden. .,Faculty of Medicine, University of Geneva, Geneva, Switzerland.
| | - Marie-Louise Montandon
- Department of Rehabilitation and Geriatrics, Geneva University Hospitals and University of Geneva, Geneva, Switzerland.,Department of Psychiatry, University of Geneva, Geneva, Switzerland
| | - Johan Lilja
- Department of Surgical Sciences, Radiology, Uppsala University, Uppsala, Sweden.,Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden.,Hermes Medical Solutions, Stockholm, Sweden
| | - Cristelle Rodriguez
- Department of Psychiatry, University of Geneva, Geneva, Switzerland.,Division of Institutional Measures, Medical Direction, Geneva University Hospitals, Geneva, Switzerland
| | - Valentina Garibotto
- Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Division of Nuclear Medicine and Molecular Imaging, Diagnostic Department, Geneva University Hospitals, Geneva, Switzerland
| | - François R Herrmann
- Department of Rehabilitation and Geriatrics, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Panteleimon Giannakopoulos
- Department of Psychiatry, University of Geneva, Geneva, Switzerland.,Division of Institutional Measures, Medical Direction, Geneva University Hospitals, Geneva, Switzerland
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Caranzano L, Stephan MA, Bedulli M, Herrmann FR, Benninger DH. Peripheral stimulation affects subthreshold Triple Stimulation Technique. J Neurosci Methods 2020; 347:108959. [PMID: 33002507 DOI: 10.1016/j.jneumeth.2020.108959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 08/27/2020] [Accepted: 09/23/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Compared to conventional transcranial magnetic stimulation (TMS), the triple stimulation technique (TST) strongly decrease the effects of desynchronization of descending discharges and accompanying phase cancellation that follow TMS and offers a more sensitive method to quantify motor evoked potentials (MEPs). NEW METHOD Using the TST, we explored as to whether sub-threshold TMS evokes peripheral motor neuron discharges (MNs). We compared the number of MEPs elicited by TMS and by TST in fifteen healthy participants. We used the subthreshold intensity of 80 % resting motor threshold. To control the TST assessment of the corticospinal tract, we included a peripheral stimulation control condition, which consisted of peripheral stimulation alone, in a subgroup of five volunteers. RESULTS Compared to TMS, TST at sub-threshold intensities did not detect significantly more responses unequivocally attributable to the cortical stimulation. In contrast, the peripheral supra-maximal stimuli produced confounding effects in the TST condition that were, in part, indistinguishable from cortical responses. COMPARISON WITH EXISTING METHODS At subthreshold TMS intensities, the TST does not detect more discharges of spinal MNs than conventional TMS and, in addition, it is confounded by effects from peripheral stimulation. CONCLUSION The TST can be useful in assessing the integrity of the MN pool and of the corticospinal tract. However, if used at near threshold intensity, the confounding effects of peripheral stimulation need to be considered; for instance, in paired-pulse stimulation paradigms assessing the cortical physiology.
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Affiliation(s)
- L Caranzano
- Neurology Service, Department of Clinical Neurosciences, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland; Faculté de Biologie et de Médecine, Doctoral School, Université de Lausanne, Lausanne, Switzerland.
| | - M A Stephan
- Neurology Service, Department of Clinical Neurosciences, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
| | - M Bedulli
- Neurology Service, Department of Clinical Neurosciences, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
| | - F R Herrmann
- Division of Geriatrics, Department of Rehabilitation and Geriatrics, University Hospitals and University of Geneva, Geneva, Switzerland.
| | - D H Benninger
- Neurology Service, Department of Clinical Neurosciences, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
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Srinivasan M, Schimmel M, Buser R, Maniewicz S, Herrmann FR, Müller F. Mandibular two-implant overdentures with CAD-CAM milled bars with distal extensions or retentive anchors: A randomized controlled trial. Clin Oral Implants Res 2020; 31:1207-1222. [PMID: 32965052 DOI: 10.1111/clr.13668] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 08/28/2020] [Accepted: 09/11/2020] [Indexed: 01/23/2023]
Abstract
OBJECTIVE This randomized controlled trial (RCT) aimed to demonstrate the non-inferiority of mandibular 2-implant overdentures (IODs) on a CAD-CAM milled bar with long distal extensions (MBDE) against IODs on retentive anchors (RA). METHODS Forty edentulous participants rehabilitated with a maxillary conventional denture and a mandibular 2-IOD participated in this trial. They were randomized into two groups [Control group (CG): RA + gold matrices; Experimental group (EG): MBDE + gold clip]. The outcomes included implant survival rate (ISR), chewing efficiency [quantitative (VoH) and subjective (SA) assessments], peri-implant marginal bone levels (PI-MBL), maximum bite force (MBF), and patient-reported outcomes [oral health impact profile (OHIP-EDENT), and denture satisfaction index (DSI)]. Outcomes were recorded at baseline (BL), two weeks (T0 ), 6 months (T1 ), and at 1 year (T2 ) after the intervention. Intra- and inter-group analyses were performed using regression models with ⍺=0.05. RESULTS 38 participants completed the T2 visit (CG: n = 19, age = 74.7 ± 7.8 years; EG: n = 19, age = 70.3 ± 10.7 years). At T2 , there was no implant loss in either of the groups (ISR = 100%). There were no significant differences between the groups for the PI-MBL changes (p = .754). Improvements occurred faster in the EG than in the CG, but over the observation time, there were no differences between the trial groups for VoH, MBF, OHIP-EDENT, and the DSI, except for SA being significantly better in the EG group (p = .022). CONCLUSIONS The results of this RCT confirm that mandibular 2-IODs with a CAD-CAM milled bar with long distal extensions are not an inferior treatment to the conventional IODs on retentive anchors in the short term (1 year).
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Affiliation(s)
- Murali Srinivasan
- Center of General, Special Care, & Geriatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.,Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Martin Schimmel
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland.,Division of Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Ramona Buser
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Sabrina Maniewicz
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - François R Herrmann
- Division of Geriatrics, Department of Rehabilitation and Geriatics, Geneva University Hospitals, Trois-Chêne, Geneva, Switzerland
| | - Frauke Müller
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland.,Service of Geriatrics, Geneva University Hospitals, Geneva, Switzerland
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Robine JM, Allard M, Herrmann FR, Jeune B. The Real Facts Supporting Jeanne Calment as the Oldest Ever Human. J Gerontol A Biol Sci Med Sci 2020; 74:S13-S20. [PMID: 31529019 DOI: 10.1093/gerona/glz198] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The 122 years and 164 days age claim of Jeanne Calment, the world oldest person who died in 1997, is the most thoroughly validated age claim. Recently the claim that families Calment and Billot organized a conspiracy concerning tax fraud based on identity fraud between mother and daughter gained international media attention. METHODS Here, we reference the original components of the validation as well as additional documentation to address various claims of the conspiracy theory and provide evidence for why these claims are based on inaccurate facts or unrelated to the death of Yvonne Billot-Calment, the daughter of Jeanne Calment, in 1934. RESULTS Also, countering the contention that the occurrence of a 122 year old person is statistically impossible, mathematical models are presented which also supports the hypothesis that though extremely rare, as would be expected for the oldest person ever, Jeanne Calment's age claim is plausible. CONCLUSIONS In total, the quality of the investigation supporting the claim of conspiracy as well as the mathematical analysis aiming to back it do not reach the level expected for a scientific publication.
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Affiliation(s)
- Jean-Marie Robine
- French National Institute of Health and Medical Research (INSERM), École Pratique des Hautes Études (EPHE), Molecular Mechanisms in Neurodegenerative Diseases (MMDN) and Center for research in medicine, science, health, mental health, and society (CERMES 3), Montpellier and Paris, France
| | - Michel Allard
- Former Scientific Director of the IPSEN Foundation, Paris, France
| | - François R Herrmann
- Division of geriatrics, Department of rehabilitation and geriatrics, Geneva University Hospitals and University of Geneva, Switzerland
| | - Bernard Jeune
- Danish Ageing Research Center and Department of Public Health, Epidemiology, Biostatistics and Biodemography, University of Southern Denmark, Odense, Denmark
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Montandon ML, Haller S, Scheffler M, Giannakopoulos P, Herrmann FR, Gold G, Kövari E. Medial temporal lobe volume is associated with neuronal loss but not with hippocampal microinfarcts despite their high frequency in aging brains. Neurobiol Aging 2020; 95:9-14. [PMID: 32739558 DOI: 10.1016/j.neurobiolaging.2020.06.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 06/05/2020] [Accepted: 06/10/2020] [Indexed: 10/24/2022]
Abstract
Medial temporal lobe (MTL) atrophy is an important marker for the clinical diagnosis of Alzheimer's disease at its prodromal stages. Several brain lesions have been associated with MTL atrophy including hippocampal sclerosis, neurodegenerative neuronal loss, and vascular pathology. To better explore the relationship between MTL volume on MRI and age-related degenerative and microvascular hippocampal pathology, we compared MTL volume on postmortem whole brain MRI and stereological estimates of the total number of neurons, cortical microinfarcts (CMIs), and neurofibrillary tangles (NFTs) in a consecutive autopsy series of 21 older individuals (11 females and 10 males, mean age 83.3 ± 5.8; range: 74-93 years, 7 demented and 14 nondemented). Our results revealed a very high percentage of cases with hippocampal CMIs (52%), particularly in the CA1 field. MTL volume was closely related to neuronal loss in both the CA1 area of the hippocampus (p = 0.0109) and the entorhinal cortex (p = 0.0272). MTL volume was not related to total CMI volume or to the total number of NFTs in our sample. In conclusion, hippocampal CMIs are very common in old age. MTL volume is determined essentially by the number of neurons in the hippocampus and does not appear to be related to the presence of NFTs or CMIs in this region.
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Affiliation(s)
- Marie-Louise Montandon
- Department of Rehabilitation and Geriatrics, Geneva University Hospitals and University of Geneva, Thônex, Switzerland; Department of Psychiatry, Geneva University Hospitals and University of Geneva, Chêne-Bourg, Switzerland
| | - Sven Haller
- CIRD Centre d'Imagerie Rive Droite, Geneva, Switzerland; Department of Surgical Sciences, Radiology, Uppsala University, Sweden
| | - Max Scheffler
- Department of Radiology, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Panteleimon Giannakopoulos
- Department of Psychiatry, Geneva University Hospitals and University of Geneva, Chêne-Bourg, Switzerland; Division of Institutional Measures, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - François R Herrmann
- Department of Rehabilitation and Geriatrics, Geneva University Hospitals and University of Geneva, Thônex, Switzerland
| | - Gabriel Gold
- Department of Rehabilitation and Geriatrics, Geneva University Hospitals and University of Geneva, Thônex, Switzerland
| | - Enikö Kövari
- Department of Psychiatry, Geneva University Hospitals and University of Geneva, Chêne-Bourg, Switzerland.
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48
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Genton L, Mareschal J, Norman K, Karsegard VL, Delsoglio M, Pichard C, Graf C, Herrmann FR. Association of phase angle and running performance. Clin Nutr ESPEN 2020; 37:65-68. [DOI: 10.1016/j.clnesp.2020.03.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 03/23/2020] [Indexed: 12/18/2022]
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49
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Maniewicz S, Badoud I, Herrmann FR, Chebib N, Ammann P, Schimmel M, Müller F, Srinivasan M. In vitro retention force changes during cyclic dislodging of three novel attachment systems for implant overdentures with different implant angulations. Clin Oral Implants Res 2020; 31:315-327. [DOI: 10.1111/clr.13567] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 12/10/2019] [Accepted: 12/17/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Sabrina Maniewicz
- Division of Gerodontology and Removable Prosthodontics University Clinics of Dental Medicine University of Geneva Geneva Switzerland
| | - Isabelle Badoud
- Division of Bone Diseases Department of Rehabilitation and Geriatrics University Hospitals of Geneva Geneva Switzerland
| | - François R. Herrmann
- Division of Geriatrics Department of Rehabilitation and Geriatrics University Hospitals of Geneva Thônex Switzerland
| | - Najla Chebib
- Division of Gerodontology and Removable Prosthodontics University Clinics of Dental Medicine University of Geneva Geneva Switzerland
| | - Patrick Ammann
- Division of Bone Diseases Department of Rehabilitation and Geriatrics University Hospitals of Geneva Geneva Switzerland
| | - Martin Schimmel
- Division of Gerodontology School of Dental Medicine University of Bern Bern Switzerland
| | - Frauke Müller
- Division of Gerodontology and Removable Prosthodontics University Clinics of Dental Medicine University of Geneva Geneva Switzerland
- Division of Geriatrics Department of Rehabilitation and Geriatrics University Hospitals of Geneva Thônex Switzerland
| | - Murali Srinivasan
- Division of Gerodontology and Removable Prosthodontics University Clinics of Dental Medicine University of Geneva Geneva Switzerland
- Clinic for General‐, Special Care‐, and Geriatric Dentistry Center of Dental Medicine University of Zurich Zurich Switzerland
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Favre G, Horat SK, Herrmann FR, Gothuey I, Ventura J, Merlo MCG, Missonnier P. False memory production in schizophrenia: A neurophysiological investigation. Schizophr Res Cogn 2020; 20:100174. [PMID: 32154124 PMCID: PMC7052439 DOI: 10.1016/j.scog.2020.100174] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Accepted: 02/17/2020] [Indexed: 11/30/2022]
Abstract
Background The topic of false memory in schizophrenia has been well documented in earlier research contributions. To date, there is no study exploring the implications of specific neural networks during this phenomenon in patients suffering from schizophrenia. Methods We compared 17 patients suffering from psychosis (SCZ) to 33 healthy controls (HC) performing a verbal memory task designed to produce false memories, i.e. the Deese-Roediger-McDermott paradigm (DRM). Electroencephalography was used to specifically analyze the P2 and N400 event-related potentials components. Results The SCZ patients showed a reduced ability to distinguish between true and false memories as assessed by the A' index which was calculated based on the false and true memory rates. The morphology of the P2 differed in frontal electrode region with a lower amplitude in SCZ. In addition, the amplitude of N400 was more pronounced (more negative) in HC than in SCZ in centro-parietal electrode site. Conclusions We suggest that the differences found in P2 amplitude are associated with difficulties of SCZ patients to efficiently compare item-specific features of a mnesic elements to incoming stimuli which impair the subsequent verbal memory information processing reflected by the N400 component amplitude decrease. These results are consistent with the idea that SCZ use a different strategy while they perform the DRM paradigm.
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Affiliation(s)
- Grégoire Favre
- Laboratory for Psychiatric Neuroscience and Psychotherapy, Department of Medicine, Faculty of Science & Medicine, University of Fribourg, Chemin du Musée 5, CH 1700 Fribourg, Switzerland.,Mental Health Network Fribourg (RFSM), Sector of psychiatry and psychotherapy for adults, L'Hôpital 140, Case postale 90, CH 1633 Marsens, Switzerland
| | - Sibylle K Horat
- Laboratory for Psychiatric Neuroscience and Psychotherapy, Department of Medicine, Faculty of Science & Medicine, University of Fribourg, Chemin du Musée 5, CH 1700 Fribourg, Switzerland
| | - François R Herrmann
- Division of geriatrics, Department of rehabilitation and geriatrics, Geneva University Hospitals and University of Geneva, CH 1226 Thônex, Switzerland
| | - Isabelle Gothuey
- Mental Health Network Fribourg (RFSM), Sector of psychiatry and psychotherapy for adults, L'Hôpital 140, Case postale 90, CH 1633 Marsens, Switzerland
| | - Joseph Ventura
- Department of Psychiatry and Biobehavioural Sciences, University of California, Los Angeles, CA, United States
| | - Marco C G Merlo
- Laboratory for Psychiatric Neuroscience and Psychotherapy, Department of Medicine, Faculty of Science & Medicine, University of Fribourg, Chemin du Musée 5, CH 1700 Fribourg, Switzerland
| | - Pascal Missonnier
- Laboratory for Psychiatric Neuroscience and Psychotherapy, Department of Medicine, Faculty of Science & Medicine, University of Fribourg, Chemin du Musée 5, CH 1700 Fribourg, Switzerland.,Mental Health Network Fribourg (RFSM), Sector of psychiatry and psychotherapy for adults, L'Hôpital 140, Case postale 90, CH 1633 Marsens, Switzerland
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