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Bazin B, Frija-Masson J, Benzaquen H, Maruani J, Micoulaud Franchi JA, Lopez R, Philip P, Bourgin P, Lejoyeux M, d'Ortho MP, Geoffroy PA. Major depressive disorder with hypersomnolence complaint: A comparison study with non-depressed individuals examining objective biomarkers. J Affect Disord 2024; 352:422-428. [PMID: 38364977 DOI: 10.1016/j.jad.2024.02.056] [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: 08/26/2023] [Revised: 02/03/2024] [Accepted: 02/14/2024] [Indexed: 02/18/2024]
Abstract
BACKGROUND Hypersomnolence is common in major depressive disorder (MDD), associated with more severe episodes, suicide and antidepressant resistance. Nevertheless, few studies used polysomnography (PSG) and multiple sleep latency test (MSLT) to characterize these patients. In this context, we compared patients visiting a sleep center for hypersomnolence complaint with MDD (HSC/MDD+) and without MDD (HSC/MDD-). METHODS HSC/MDD+ and HSC/MDD- groups were defined according to DSM-5 criteria and CES-D scale, and had a 30 h-PSG with ad libitum-sleep and PSG followed by MLST. RESULTS HSC/MDD+ had an increased self-declared total sleep time (sTST) of about 10 h30 similar to HSC/MDD- (630.8 ± 17.3 min-vs-616.5 ± 18.1 min, respectively, p = 0.39). Nevertheless, their objective TST (oTST) on ad libitum PSG was significantly longer and about 10 h50 (648.6 ± 23.9 min-vs-587.4 ± 19.0 min, respectively, p = 0.038). HSC/MDD+ also significantly better estimated their sleep duration, with a lower difference between their sTST and oTST compared to HSC/MDD- (10.0 ± 1.7 %-vs-17.4 ± 2.1 %, respectively, p = 0.009) and confirmed significantly more frequently the hypersomnia diagnosis -i.e. oTST>10H- (82.6 ± 8.1 %-vs-54.6 ± 10.9 %, respectively, p = 0.046). Using the Kupfer index (KI), we confirmed a reduced REM sleep latency in patients MDD/HSC+ (15.2 ± 10.0 %-vs-2.3 ± 2.3 %, respectively, p = 0.039). Both groups had comparable increased diurnal sleepiness assessed with the Epworth scale (14.1 ± 1.1-vs-14.8 ± 1.1, respectively, p = 0.65). HSC/MDD+ had less MSLT sleep latency <8 min (9.1 ± 5.1 %-vs-27.3 ± 6.8 %, respectively, p = 0.048). LIMITATIONS Retrospective cross-sectional study. CONCLUSIONS HSC/MDD+ accurately estimated their sleep duration, objectively confirmed hypersomnia and may specifically had a decreased Kupfer index.
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Affiliation(s)
- Balthazar Bazin
- GHU Paris - Psychiatry & Neurosciences, 1 rue Cabanis, 75014 Paris, France.
| | - Justine Frija-Masson
- Université Paris Cité, Inserm, NeuroDiderot, FHU I2-D2, F-75019 Paris, France; Service de Physiologie Explorations Fonctionnelles et Centre du Sommeil, Assistance Publique-Hôpitaux de Paris, Hopital Bichat - Claude Bernard, F-75018 Paris, France
| | - Helene Benzaquen
- Service de Physiologie Explorations Fonctionnelles et Centre du Sommeil, Assistance Publique-Hôpitaux de Paris, Hopital Bichat - Claude Bernard, F-75018 Paris, France
| | - Julia Maruani
- GHU Paris - Psychiatry & Neurosciences, 1 rue Cabanis, 75014 Paris, France; Université Paris Cité, Inserm, NeuroDiderot, FHU I2-D2, F-75019 Paris, France; Département de psychiatrie et d'addictologie, Assistance Publique-Hôpitaux de Paris, GHU Paris Nord, DMU Neurosciences, Hopital Bichat - Claude Bernard, F-75018 Paris, France
| | - Jean-Arthur Micoulaud Franchi
- CNRS, SANPSY, UMR 6033, Bordeaux, France; CHU de Bordeaux, Centre Hypersomnies Rares, Bordeaux, France; INSERM CIC1401, Université de Bordeaux, CHU de Bordeaux, Bordeaux, France
| | - Régis Lopez
- Department of Neurology, Sleep Disorders Center, Gui-de-Chauliac Hospital, CHU Montpellier, F-34000 Montpellier, France; Inserm, U1061, Université Montpellier 1, F-34000 Montpellier, France
| | - Pierre Philip
- CNRS, SANPSY, UMR 6033, Bordeaux, France; CHU de Bordeaux, Centre Hypersomnies Rares, Bordeaux, France; INSERM CIC1401, Université de Bordeaux, CHU de Bordeaux, Bordeaux, France; Sleep, Addiction and Neuropsychiatry, University of Bordeaux, Bordeaux, France
| | - Patrice Bourgin
- Sleep Disorders Center - CIRCSom (International Research Center for ChronoSomnology), University Hospital of Strasbourg 1, Strasbourg, France; CNRS UPR 3212 & Strasbourg University, Institute for Cellular and Integrative Neurosciences, Strasbourg, France
| | - Michel Lejoyeux
- GHU Paris - Psychiatry & Neurosciences, 1 rue Cabanis, 75014 Paris, France; Université Paris Cité, Inserm, NeuroDiderot, FHU I2-D2, F-75019 Paris, France; Département de psychiatrie et d'addictologie, Assistance Publique-Hôpitaux de Paris, GHU Paris Nord, DMU Neurosciences, Hopital Bichat - Claude Bernard, F-75018 Paris, France
| | - Marie-Pia d'Ortho
- Université Paris Cité, Inserm, NeuroDiderot, FHU I2-D2, F-75019 Paris, France; Service de Physiologie Explorations Fonctionnelles et Centre du Sommeil, Assistance Publique-Hôpitaux de Paris, Hopital Bichat - Claude Bernard, F-75018 Paris, France
| | - Pierre A Geoffroy
- GHU Paris - Psychiatry & Neurosciences, 1 rue Cabanis, 75014 Paris, France; Université Paris Cité, Inserm, NeuroDiderot, FHU I2-D2, F-75019 Paris, France; Département de psychiatrie et d'addictologie, Assistance Publique-Hôpitaux de Paris, GHU Paris Nord, DMU Neurosciences, Hopital Bichat - Claude Bernard, F-75018 Paris, France; CNRS UPR 3212, Institute for Cellular and Integrative Neurosciences, F-67000 Strasbourg, France
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Martin VP, Gauld C, Taillard J, Peter-Derex L, Lopez R, Micoulaud-Franchi JA. Sleepiness should be reinvestigated through the lens of clinical neurophysiology: A mixed expertal and big-data Natural Language Processing approach. Neurophysiol Clin 2024; 54:102937. [PMID: 38401240 DOI: 10.1016/j.neucli.2023.102937] [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: 10/21/2023] [Revised: 12/14/2023] [Accepted: 12/15/2023] [Indexed: 02/26/2024] Open
Abstract
Historically, the field of sleep medicine has revolved around electrophysiological tools. However, the use of these tools as a neurophysiological method of investigation seems to be underrepresented today, from both international recommendations and sleep centers, in contrast to behavioral and psychometric tools. The aim of this article is to combine a data-driven approach and neurophysiological and sleep medicine expertise to confirm or refute the hypothesis that neurophysiology has declined in favor of behavioral or self-reported dimensions in sleep medicine for the investigation of sleepiness, despite the use of electrophysiological tools. Using Natural Language Processing methods, we analyzed the abstracts of the 18,370 articles indexed by PubMed containing the terms 'sleepiness' or 'sleepy' in the title, abstract, or keywords. For this purpose, we examined these abstracts using two methods: a lexical network, enabling the identification of concepts (neurophysiological or clinical) related to sleepiness in these articles and their interconnections; furthermore, we analyzed the temporal evolution of these concepts to extract historical trends. These results confirm the hypothesis that neurophysiology has declined in favor of behavioral or self-reported dimensions in sleep medicine for the investigation of sleepiness. In order to bring sleepiness measurements closer to brain functioning and to reintroduce neurophysiology into sleep medicine, we discuss two strategies: the first is reanalyzing electrophysiological signals collected during the standard sleep electrophysiological test; the second takes advantage of the current trend towards dimensional models of sleepiness to situate clinical neurophysiology at the heart of the redefinition of sleepiness.
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Affiliation(s)
- Vincent P Martin
- Deep Digital Phenotyping Research Unit, Department of Precision Health, Luxembourg Institute of Health, L-1445 Strassen, Luxembourg; Univ. Bordeaux, CNRS, Bordeaux INP, LaBRI, UMR 5800, F-33400 Talence, France; Univ. Bordeaux, CNRS, SANPSY, UMR 6033, F-33000 Bordeaux, France
| | - Christophe Gauld
- Service Psychopathologie du Développement de l'Enfant et de l'Adolescent, Hospices Civils de Lyon & Université de Lyon 1, France; Institut des Sciences Cognitives Marc Jeannerod, UMR 5229 CNRS & Université Claude Bernard Lyon 1, France
| | - Jacques Taillard
- Univ. Bordeaux, CNRS, SANPSY, UMR 6033, F-33000 Bordeaux, France
| | - Laure Peter-Derex
- Lyon Neuroscience Research Centre, INSERM U1028, CNRS UMR 5292, Lyon, France; Centre for Sleep Medicine and Respiratory Diseases, Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon 1 University, Lyon, France
| | - Régis Lopez
- National Reference Centre for Orphan Diseases, Narcolepsy-Rare hypersomnias, Sleep Unit, Department of Neurology, CHU de Montpellier, University of Montpellier, Montpellier, France; Institute for Neurosciences of Montpellier (INM), University of Montpellier, Inserm, Montpellier, France
| | - Jean-Arthur Micoulaud-Franchi
- Univ. Bordeaux, CNRS, SANPSY, UMR 6033, F-33000 Bordeaux, France; University Sleep Clinic, University Hospital of Bordeaux, Place Amélie Raba-Leon, 33 076 Bordeaux, France.
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Micoulaud-Franchi JA, Lopez R, McGonigal A, Nobili L. Toward an electroclinical approach for neurophysiological hypersomnolence in sleep medicine. Neurophysiol Clin 2024; 54:102958. [PMID: 38489950 DOI: 10.1016/j.neucli.2024.102958] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 02/19/2024] [Revised: 02/20/2024] [Accepted: 02/20/2024] [Indexed: 03/17/2024] Open
Affiliation(s)
- Jean-Arthur Micoulaud-Franchi
- Sleep Medicine Unit, University Hospital of Bordeaux, Place Amélie Raba-Leon, 33 076 Bordeaux, France; UMR CNRS 6033 SANPSY, University Hospital of Bordeaux, 33 076 Bordeaux, France.
| | - Régis Lopez
- National Reference Centre for Orphan Diseases, Narcolepsy - Rare hypersomnias, Sleep Unit, Department of Neurology, CHU Montpellier, Univ Montpellier, Montpellier, France; Institute for Neurosciences of Montpellier INM, Univ Montpellier, INSERM, Montpellier, France
| | - Aileen McGonigal
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD 4067, Australia; Mater Research Institute, Faculty of Medicine, The University of Queensland, Brisbane, QLD 4067, Australia; Mater Epilepsy Unit, Department of Neurosciences, Mater Hospital, Brisbane, QLD 4101, Australia
| | - Lino Nobili
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy; Istituto G. Gaslini, Genoa, Italy
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Gauld C, Baillieul S, Martin VP, Richaud A, Lopez R, Pelou M, Abi-Saab P, Coelho J, Philip P, Pépin JL, Micoulaud-Franchi JA. Symptom content analysis of OSA questionnaires: time to identify and improve relevance of diversity of OSA symptoms? J Clin Sleep Med 2024. [PMID: 38420966 DOI: 10.5664/jcsm.11086] [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: 03/02/2024]
Abstract
STUDY OBJECTIVES Obstructive sleep apnea (OSA) is a heterogeneous condition covering many clinical phenotypes in terms of the diversity of symptoms. Patient-based OSA screening questionnaires used in routine practice contain significantly varying contents that can impact the reliability and validity of the screening. We investigated to what extent common patient-based OSA screening questionnaires differ or overlap in their item content by conducting a rigorous, methodical, and quantified content overlap analysis. METHODS We conducted an item content analysis of 11 OSA screening questionnaires validated in adult populations and characterized their overlap using a four-step approach: i) selection of OSA screening questionnaires; ii) item extraction and selection; iii) extraction of symptoms from items; iv) assessment of content overlap with the Jaccard Index (from 0: no overlap to 1: full overlap). RESULTS We extracted 72 items that provided 25 distinct symptoms from 11 selected OSA questionnaires. The overlap between them was weak (mean Jaccard Index 0.224, ranging from 0.138 to 0.329). All questionnaires contained symptoms of the "OSA symptom" dimension (e.g., snoring or witnessed apneas). The STOP-BANG (0.329) and the Berlin (0.280) questionnaires exhibited the highest overlap content. Ten symptoms (40%) were investigated in only one questionnaire. CONCLUSIONS The heterogeneity of content and the low overlap across these questionnaires reflect the challenges of screening OSA. The different OSA questionnaires potentially capture varying aspects of the disorder, with the risk of biased results in studies. Suggestions are made for better OSA screening and refinement of clinical OSA phenotypes.
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Affiliation(s)
- Christophe Gauld
- Service Psychopathologie du Développement de l'Enfant et de l'Adolescent, Hospices Civils de Lyon & Université de Lyon 1, France
- Institut des Sciences Cognitives Marc Jeannerod, UMR 5229 CNRS & Université Claude Bernard Lyon 1, France
| | - Sébastien Baillieul
- University Grenoble Alpes, Inserm, U1300, CHU Grenoble Alpes, Service Universitaire de Pneumologie Physiologie, Grenoble, France
| | - Vincent P Martin
- University Bordeaux, CNRS, Bordeaux INP, LaBRI, UMR 5800, Talence, France
- University Bordeaux, CNRS, SANPSY, UMR 6033, Bordeaux, France
| | | | - Régis Lopez
- Institut des Neurosciences de Montpellier (INM), University Montpellier, Montpellier, France
- Unité des Troubles du Sommeil, Département de Neurologie, CHU Montpellier, Montpellier, France
| | - Marie Pelou
- University Bordeaux, CNRS, SANPSY, UMR 6033, Bordeaux, France
| | - Poeiti Abi-Saab
- University Bordeaux, CNRS, SANPSY, UMR 6033, Bordeaux, France
| | - Julien Coelho
- University Bordeaux, CNRS, SANPSY, UMR 6033, Bordeaux, France
- University Sleep Clinic, University Hospital of Bordeaux, Place Amélie Raba-Leon, Bordeaux, France
| | - Pierre Philip
- University Bordeaux, CNRS, SANPSY, UMR 6033, Bordeaux, France
- University Sleep Clinic, University Hospital of Bordeaux, Place Amélie Raba-Leon, Bordeaux, France
| | - Jean Louis Pépin
- University Grenoble Alpes, Inserm, U1300, CHU Grenoble Alpes, Service Universitaire de Pneumologie Physiologie, Grenoble, France
| | - Jean-Arthur Micoulaud-Franchi
- University Bordeaux, CNRS, SANPSY, UMR 6033, Bordeaux, France
- University Sleep Clinic, University Hospital of Bordeaux, Place Amélie Raba-Leon, Bordeaux, France
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5
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Lopez R, Dauvilliers Y. Challenges in diagnosing NREM parasomnias: Implications for future diagnostic classifications. Sleep Med Rev 2024; 73:101888. [PMID: 38150767 DOI: 10.1016/j.smrv.2023.101888] [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: 08/28/2023] [Revised: 11/22/2023] [Accepted: 11/22/2023] [Indexed: 12/29/2023]
Abstract
NREM parasomnias are frequent and potentially disabling sleep disorders characterized by recurrent abnormal behaviors emerging from NREM sleep. Recently, several studies provided more detailed clinical and polysomnographic characterization of NREM parasomnia which may enhance the diagnostic process. Several revisions of the diagnostic criteria have been proposed in the classification of sleep disorders, the latest being ICSD-3-TR in 2023 with no changes on NREM parasomnias since ICSD-3 published in 2014. We performed an extensive literature review to assess the evidence on the procedure of its diagnosis. We dissected the inconsistencies and shortcomings in the ICSD-3-TR to propose a revision of the current diagnostic criteria. We highlighted the limits of several clinical criteria which should rather be supportive features than mandatory criteria. Infrared cameras with video-recordings with are promising tools to precisely characterize home episodes. Sensitive and specific polysomnographic markers of NREM parasomnias have been identified and should be considered in future revisions. We also suggest the use of diagnostic specifiers (clinical subtypes, clinical significance, levels of severity, age effect, levels of certainty) to define homogeneous subgroups of patients for therapeutic intervention and research purposes. In conclusion, we advocate for significant changes in the current diagnostic criteria of NREM parasomnias for future classification.
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Affiliation(s)
- Régis Lopez
- National Reference Centre for Orphan Diseases, Narcolepsy- Rare hypersomnias, Sleep Unit, Department of Neurology, CHU Montpellier, Univ Montpellier, Montpellier, France; Institute for Neurosciences of Montpellier INM, Univ Montpellier, INSERM, Montpellier, France.
| | - Yves Dauvilliers
- National Reference Centre for Orphan Diseases, Narcolepsy- Rare hypersomnias, Sleep Unit, Department of Neurology, CHU Montpellier, Univ Montpellier, Montpellier, France; Institute for Neurosciences of Montpellier INM, Univ Montpellier, INSERM, Montpellier, France.
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Coelho J, Sanchez-Ortuño MM, Martin VP, Gauld C, Richaud A, Lopez R, Pelou M, Abi-Saab P, Philip P, Geoffroy PA, Palagini L, Micoulaud-Franchi JA. Content analysis of insomnia questionnaires: A step to better evaluate the complex and multifaceted construct of insomnia disorder. Psychiatry Res 2023; 330:115584. [PMID: 37944205 DOI: 10.1016/j.psychres.2023.115584] [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: 08/25/2023] [Revised: 10/26/2023] [Accepted: 10/28/2023] [Indexed: 11/12/2023]
Abstract
Insomnia disorder is a mental disorder that includes various types of symptoms (e.g., insomnia initiating, worries, mood disturbances) and impairments (e.g., distress related to sleep alterations). Self-report questionnaires are the most common method for assessing insomnia but no systematic quantified analysis of their content and overlap has been carried out. We used content analysis and a visualization method to better identify the different types of clinical manifestations that are investigated by nine commonly used insomnia questionnaires for adults and the Jaccard index to quantify the degree to which they overlap. Content analysis found and visualized 16 different clinical manifestations classified into five dimensions ("Insomnia symptoms", "Insomnia-related symptoms", "Daytime symptoms", "Insomnia-related impairments", "Sleep behaviors"). The average Jaccard Index was 0.409 (moderate overlap in content). There is a lack of distinction between symptoms and impairments, and the assessment of sleep duration and hyperarousal symptoms remains overlooked. This preliminary analysis makes it possible to visualize the content of each of the nine questionnaires and to select the most appropriate questionnaire based on the issue to be addressed. Suggestions are made regarding the development of future questionnaires to better distinguish symptoms and impairments, and the different phenotypes of insomnia disorder.
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Affiliation(s)
- Julien Coelho
- University Bordeaux, CNRS, SANPSY, UMR 6033, Bordeaux F-33000, France; University Sleep Clinic, University Hospital of Bordeaux, Place Amélie Raba-Leon, Bordeaux 33 076, France.
| | - Maria Montserrat Sanchez-Ortuño
- University Bordeaux, CNRS, SANPSY, UMR 6033, Bordeaux F-33000, France; Department of Nursing, School of Nursing, University of Murcia, Murcia, Spain
| | - Vincent P Martin
- University Bordeaux, CNRS, SANPSY, UMR 6033, Bordeaux F-33000, France; University Bordeaux, CNRS, Bordeaux INP, LaBRI, UMR 5800, Talence F-33400, France
| | - Christophe Gauld
- Service Psychopathologie du Développement de l'Enfant et de l'Adolescent, Hospices Civils de Lyon & Université de Lyon 1, France; Institut des Sciences Cognitives Marc Jeannerod, UMR 5229 CNRS & Université Claude Bernard Lyon, France
| | - Alexandre Richaud
- University Sleep Clinic, University Hospital of Bordeaux, Place Amélie Raba-Leon, Bordeaux 33 076, France
| | - Régis Lopez
- Institut des Neurosciences de Montpellier (INM), University Montpellier, Montpellier 34000, France; Unité des Troubles du Sommeil, Département de Neurologie, CHU Montpellier, Montpellier 34000, France
| | - Marie Pelou
- University Bordeaux, CNRS, SANPSY, UMR 6033, Bordeaux F-33000, France
| | - Poeiti Abi-Saab
- University Bordeaux, CNRS, SANPSY, UMR 6033, Bordeaux F-33000, France
| | - Pierre Philip
- University Bordeaux, CNRS, SANPSY, UMR 6033, Bordeaux F-33000, France; University Sleep Clinic, University Hospital of Bordeaux, Place Amélie Raba-Leon, Bordeaux 33 076, France
| | - Pierre-Alexis Geoffroy
- Département de Psychiatrie et D'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hopital Bichat-Claude Bernard, Paris 75018, France; GHU Paris-Psychiatry & Neurosciences, 1 Rue Cabanis, Université de Paris, NeuroDiderot, Inserm, Paris 75019, France
| | - Laura Palagini
- Psychiatric Clinic, Department of Clinical and Experimental Medicine, Azienda Ospedaliero Universitaria Pisana AUOP, Pisa 56126, Italy; Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara, Ferrara 44121, Italy
| | - Jean-Arthur Micoulaud-Franchi
- University Bordeaux, CNRS, SANPSY, UMR 6033, Bordeaux F-33000, France; University Sleep Clinic, University Hospital of Bordeaux, Place Amélie Raba-Leon, Bordeaux 33 076, France
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Geoffroy PA, Stern E, Maruani J, Cornic R, Bazin B, Clerici E, Ambar Akkaoui M, Lopez R, Frija Masson J, d'Ortho MP, Lejoyeux M, Micoulaud Franchi JA, Couffignal C. The nightmare severity index (NSI): A short new multidimensional tool for assessing nightmares. J Sleep Res 2023:e14065. [PMID: 37846776 DOI: 10.1111/jsr.14065] [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: 07/14/2023] [Revised: 09/14/2023] [Accepted: 09/24/2023] [Indexed: 10/18/2023]
Abstract
This psychometric pilot study aims to evaluate a new multidimensional simple scale, named the nightmare severity index (NSI) - close to the existing insomnia (ISI) and hypersomnia (HSI) severity indexes. The NSI encompasses all main dimensions of nightmare disorder, evaluating four subdimensions: frequency, emotional impact, diurnal impact, and nocturnal impact of nightmares. The NSI was completed by a total of 102 patients. The majority of the population consisted of women (64%) and outpatient individuals (76%) diagnosed with mood disorders such as depression (31%) and bipolar disorder (41%). Comorbidity with post-traumatic stress disorder (PTSD) was prevalent (44%), and psychotropic medications were commonly used (47%). Internal validity analyses indicated that the NSI was well suited for exploratory factor analysis. All items demonstrated satisfactory correlations with the factors, and the questionnaire exhibited good internal consistency (Cronbach's alpha >0.7). Higher NSI scores were observed among individuals experiencing nightmare symptoms considering the DSM-5/ICSD-3 criteria. In summary, the NSI proves to be a promising and valuable tool for clinical practice, demonstrating good acceptability, internal validity, and the ability to assess nightmare severity.
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Affiliation(s)
- Pierre A Geoffroy
- Département de psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hôpital Bichat - Claude Bernard, Paris, France
- Centre ChronoS, GHU Paris - Psychiatry & Neurosciences, Paris, France
- NeuroDiderot, Inserm, FHU I2-D2, Université Paris Cité, Paris, France
- Institute for Cellular and Integrative Neurosciences, CNRS UPR 3212, Strasbourg, France
| | - Emilie Stern
- Centre ChronoS, GHU Paris - Psychiatry & Neurosciences, Paris, France
| | - Julia Maruani
- Département de psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hôpital Bichat - Claude Bernard, Paris, France
- Centre ChronoS, GHU Paris - Psychiatry & Neurosciences, Paris, France
- NeuroDiderot, Inserm, FHU I2-D2, Université Paris Cité, Paris, France
| | - Renaud Cornic
- Département d'Epidémiologie, Biostatistique et Recherche Clinique AP-HP, DMU PRISME, Hôpital Bichat - Claude Bernard, Paris, France
| | - Balthazar Bazin
- Département de psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hôpital Bichat - Claude Bernard, Paris, France
- Centre ChronoS, GHU Paris - Psychiatry & Neurosciences, Paris, France
- NeuroDiderot, Inserm, FHU I2-D2, Université Paris Cité, Paris, France
| | | | - Marine Ambar Akkaoui
- Centre ChronoS, GHU Paris - Psychiatry & Neurosciences, Paris, France
- NeuroDiderot, Inserm, FHU I2-D2, Université Paris Cité, Paris, France
- Centre Psychiatrique d'Orientation et d'Accueil (CPOA), GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte Anne, Paris, France
| | - Régis Lopez
- Universite de Montpellier Faculte de Medecine Montpellier-Nimes, Montpellier, France
| | - Justine Frija Masson
- NeuroDiderot, Inserm, FHU I2-D2, Université Paris Cité, Paris, France
- Département de Physiologie - Explorations Fonctionnelles et Centre du Sommeil AP-HP, DMU DREAM, Hôpital Bichat - Claude Bernard, Paris, France
| | - Marie-Pia d'Ortho
- NeuroDiderot, Inserm, FHU I2-D2, Université Paris Cité, Paris, France
- Département de Physiologie - Explorations Fonctionnelles et Centre du Sommeil AP-HP, DMU DREAM, Hôpital Bichat - Claude Bernard, Paris, France
| | - Michel Lejoyeux
- Département de psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hôpital Bichat - Claude Bernard, Paris, France
- Centre ChronoS, GHU Paris - Psychiatry & Neurosciences, Paris, France
- NeuroDiderot, Inserm, FHU I2-D2, Université Paris Cité, Paris, France
| | - Jean-Arthur Micoulaud Franchi
- University Sleep Medicine Department, University Hospital of Bordeaux, Bordeaux, France
- 2 UMR CNRS 6033 SANPSY, University Hospital of Bordeaux, Bordeaux, France
| | - Camille Couffignal
- Département d'Epidémiologie, Biostatistique et Recherche Clinique AP-HP, DMU PRISME, Hôpital Bichat - Claude Bernard, Paris, France
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Lopez R, Micoulaud-Franchi JA, Peter-Derex L, Dauvilliers Y. Nocturnal agitation: From sleep state dissociation to sleep-related dissociative state. Rev Neurol (Paris) 2023; 179:675-686. [PMID: 37625976 DOI: 10.1016/j.neurol.2023.07.003] [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: 07/20/2023] [Revised: 07/26/2023] [Accepted: 07/26/2023] [Indexed: 08/27/2023]
Abstract
Nocturnal agitation refers to a broad spectrum of symptoms from simple movements to aggressive behaviors with partial or complete loss of awareness. An accurate identification of its etiology is critical for appropriate therapeutic intervention. In children and young adults, distinguishing between non-rapid eye movement (NREM) sleep parasomnias and psychogenic non-parasomniac manifestations, a condition known as sleep-related dissociative disorder (SRDD), can be challenging. This review aims to summarize current clinical, neurophysiological, and epidemiological knowledge on NREM parasomnia and SRDD, and to present the pathophysiological hypotheses underlying these nocturnal manifestations. Sleepwalking, sleep terror and confusional arousals are the three main presentations of NREM parasomnias and share common clinical characteristics. Parasomniac episodes generally occur 30minutes to three hours after sleep-onset, they are usually short, lasting no more than few minutes and involve non-stereotyped, clumsy behaviors with frequent amnesia. The prevalence of NREM parasomnia decreases from 15-30% in children to 2-4% in adults. Parasomniac episodes are incomplete awakening from the deepest NREM sleep and are characterized by a dissociated brain activity, with a wake-like activation in motor and limbic structures and a preserved sleep in the fronto-parietal regions. SRDD is a less known condition characterized by dramatic, often very long episodes with frequent aggressive and potentially dangerous behaviors. SRDD episodes frequently occur in quiet wakefulness before falling asleep. These dissociative manifestations are frequently observed in the context of psychological trauma. The pathophysiology of SRDD is poorly understood but could involve transient changes in brain connectivity due to labile sleep-wake boundaries in predisposed individuals. We hypothesize that SRDD and NREM parasomnia are forms of sleep-related dissociative states favored by a sleep-wake state dissociation during sleep-onset and awakening process, respectively.
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Affiliation(s)
- R Lopez
- National Reference Centre for Orphan Diseases, Narcolepsy-Rare hypersomnias, Sleep Unit, Department of Neurology, CHU de Montpellier, University of Montpellier, Montpellier, France; Institute for Neurosciences of Montpellier (INM), University of Montpellier, Inserm, Montpellier, France.
| | - J-A Micoulaud-Franchi
- Service Universitaire de médecine du Sommeil, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France; UMR CNRS 6033 SANPSY, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - L Peter-Derex
- Center for Sleep Medicine and Respiratory Diseases, Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon 1 University, Lyon, France; Lyon Neuroscience Research Center, PAM Team, Inserm U1028, CNRS UMR 5292, Lyon, France
| | - Y Dauvilliers
- National Reference Centre for Orphan Diseases, Narcolepsy-Rare hypersomnias, Sleep Unit, Department of Neurology, CHU de Montpellier, University of Montpellier, Montpellier, France; Institute for Neurosciences of Montpellier (INM), University of Montpellier, Inserm, Montpellier, France
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Peter-Derex L, Micoulaud-Franchi JA, Lopez R, Barateau L. Evaluation of hypersomnolence: From symptoms to diagnosis, a multidimensional approach. Rev Neurol (Paris) 2023; 179:715-726. [PMID: 37563022 DOI: 10.1016/j.neurol.2023.07.004] [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: 07/02/2023] [Revised: 07/22/2023] [Accepted: 07/24/2023] [Indexed: 08/12/2023]
Abstract
Hypersomnolence is a major public health issue given its high frequency, its impact on academic/occupational functioning and on accidentology, as well as its heavy socio-economic burden. The positive and aetiological diagnosis is crucial, as it determines the therapeutic strategy. It must consider the following aspects: i) hypersomnolence is a complex concept referring to symptoms as varied as excessive daytime sleepiness, excessive need for sleep, sleep inertia, or drowsiness, all of which warrant specific dedicated investigations; ii) the boundary between physiological and abnormal hypersomnolence is blurred, since most symptoms can be encountered in the general population to varying degrees without being considered as pathological, meaning that their severity, frequency, context of occurrence and related impairment need to be carefully assessed; iii) investigation of hypersomnolence relies on scales/questionnaires as well as behavioural and neurophysiological tests, which measure one or more dimensions, keeping in mind the possible discrepancy between objective and subjective assessment; iv) aetiological reasoning is driven by knowledge of the main sleep regulation mechanisms, epidemiology, and associated symptoms. The need to assess hypersomnolence is growing, both for its management, and for assessing the efficacy of treatments. The landscape of tools available for investigating hypersomnolence is constantly evolving, in parallel with research into sleep physiology and technical advances. These investigations face the challenges of reconciling subjective perception and objective data, making tools accessible to as many people as possible and predicting the risk of accidents.
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Affiliation(s)
- L Peter-Derex
- Centre for Sleep Medicine and Respiratory Diseases, Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon 1 University, Lyon, France; Lyon Neuroscience Research Centre, PAM Team, INSERM U1028, CNRS UMR 5292, Lyon, France.
| | - J-A Micoulaud-Franchi
- Service Universitaire de médecine du Sommeil, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France; UMR CNRS 6033 SANPSY, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - R Lopez
- National Reference Centre for Orphan Diseases, Narcolepsy, Idiopathic Hypersomnia, and Kleine-Levin Syndrome, Montpellier, France; Sleep-Wake Disorders Unit, Department of Neurology, Gui-de-Chauliac Hospital, CHU Montpellier, Montpellier, France; Institute of Neurosciences of Montpellier, University of Montpellier, INSERM, Montpellier, France
| | - L Barateau
- National Reference Centre for Orphan Diseases, Narcolepsy, Idiopathic Hypersomnia, and Kleine-Levin Syndrome, Montpellier, France; Sleep-Wake Disorders Unit, Department of Neurology, Gui-de-Chauliac Hospital, CHU Montpellier, Montpellier, France; Institute of Neurosciences of Montpellier, University of Montpellier, INSERM, Montpellier, France
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Pozzi SA, He Z, Hutchinson J, Jovanovic I, Lopez R, Ogren K, Nattress J, Shy D, Clarke SD. Detecting and characterizing special nuclear material for nuclear nonproliferation applications. Sci Rep 2023; 13:10432. [PMID: 37369729 DOI: 10.1038/s41598-023-36171-8] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 05/26/2023] [Indexed: 06/29/2023] Open
Abstract
There is an urgent need for new, better instrumentation and techniques for detecting and characterizing special nuclear material (SNM), i.e., highly enriched uranium and plutonium. The development of improved instruments and techniques requires experiments performed with the SNM itself, which is of limited availability. This paper describes the findings of experiments performed at the National Criticality Experiments Research Center conducted using new instruments and techniques on unclassified, kg-quantity SNM objects. These experiments, performed in the framework of the Department of Energy, National Nuclear Security Administration Consortium for Monitoring, Technology, and Verification, focused on detecting, characterizing, and localizing SNM samples with masses ranging from 3.3 to 13.8 kg, including plutonium and highly enriched uranium using prototype detectors and techniques. The work demonstrates SNM detection and characterization using recently-developed prototype detection systems. Specifically, we present new results in passive detection and imaging of plutonium and uranium objects using gamma-ray and dual particle (fast neutron and gamma-ray) imaging. We also present a new analysis of the delayed neutron emissions during active interrogation of uranium using a neutron generator.
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Affiliation(s)
- S A Pozzi
- Department of Nuclear Engineering and Radiological Sciences, University of Michigan, Ann Arbor, MI, 48109, USA.
| | - Z He
- Department of Nuclear Engineering and Radiological Sciences, University of Michigan, Ann Arbor, MI, 48109, USA
| | - J Hutchinson
- Los Alamos National Laboratory, Los Alamos, NM, 87545, USA
| | - I Jovanovic
- Department of Nuclear Engineering and Radiological Sciences, University of Michigan, Ann Arbor, MI, 48109, USA
| | - R Lopez
- Department of Nuclear Engineering and Radiological Sciences, University of Michigan, Ann Arbor, MI, 48109, USA
| | - K Ogren
- Los Alamos National Laboratory, Los Alamos, NM, 87545, USA
| | - J Nattress
- Oak Ridge National Laboratory, Oak Ridge, TN, 37830, USA
| | - D Shy
- Department of Nuclear Engineering and Radiological Sciences, University of Michigan, Ann Arbor, MI, 48109, USA
| | - S D Clarke
- Department of Nuclear Engineering and Radiological Sciences, University of Michigan, Ann Arbor, MI, 48109, USA
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Lewetag RD, Nimani S, Alerni N, Hornyik T, Jacobi SF, Moss R, Menza M, Pilia N, Walz TP, HajiRassouliha A, Perez-Feliz S, Zehender M, Seemann G, Zgierski-Johnston CM, Lopez R, Odening KE. Mechano-electrical interactions and heterogeneities in wild-type and drug-induced long QT syndrome rabbits. J Physiol 2023. [PMID: 37082830 DOI: 10.1113/jp284604] [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: 02/27/2023] [Accepted: 04/18/2023] [Indexed: 04/22/2023] Open
Abstract
BACKGROUND Electromechanical reciprocity - comprising electro-mechanical (EMC) and mechano-electric coupling (MEC) - provides cardiac adaptation to changing physiological demands. Understanding electromechanical reciprocity and its impact on function and heterogeneity in pathological conditions - such as (drug-induced) acquired long QT syndrome (aLQTS) - might lead to novel insights in arrhythmogenesis. Our aim is to investigate how electrical changes impact on mechanical function (EMC) and vice versa (MEC) under physiological conditions and in aLQTS. METHODS To measure regional differences in EMC and MEC in vivo, we used tissue phase mapping cardiac MRI and 24-lead ECG vest in healthy (control) and IKr -blocker E-4031-induced aLQTS rabbit hearts. MEC was studied in vivo by acutely increasing cardiac preload, and ex vivo by using voltage optical mapping in beating hearts at different preloads. RESULTS In aLQTS, electrical repolarization (heart rate corrected RT-interval, RTn370) was prolonged compared to control (p<0.0001) with increased spatial and temporal RT heterogeneity (p<0.01). Changing electrical function (in aLQTS) resulted in significantly reduced diastolic mechanical function and prolonged contraction duration (EMC), causing increased apico-basal mechanical heterogeneity. Increased preload acutely prolonged RTn370 in both control and aLQTS hearts (MEC). This effect was more pronounced in aLQTS (p<0.0001). Additionally, regional RT-dispersion increased in aLQTS. Motion-correction allowed to determine APD-prolongation in beating aLQTS hearts, but limited motion correction accuracy upon preload-changes prevented a clear analysis of MEC ex vivo. CONCLUSION Mechano-induced RT-prolongation and increased heterogeneity were more pronounced in aLQTS than in healthy hearts. Acute MEC effects may play an additional role in LQT-related arrhythmogenesis, warranting further mechanistic investigations. KEY POINT SUMMARY Electromechanical reciprocity - comprising excitation-contraction coupling (EMC) and mechano-electric feedback loops (MEC) - is essential for physiological cardiac function. Alterations in electrical and/or mechanical heterogeneity are known to have potentially pro-arrhythmic effects. In this study, we aimed to investigate how electrical changes impact on the mechanical function (EMC) and vice versa (MEC) - both under physiological conditions (control) and in acquired long QT syndrome (aLQTS). We show that changing the electrical function (in aLQTS) results in significantly altered mechanical heterogeneity via EMC and - vice versa - that increasing the preload acutely prolongs repolarization duration and increases electrical heterogeneity, particularly in aLQTS as compared to control. Our results substantiate the hypothesis that LQTS is an 'electro-mechanical' - rather than a 'purely electrical' - disease and suggest that acute MEC effects may play an additional role in LQT-related arrhythmogenesis. Abstract figure legend Electromechanical reciprocity in healthy (control) and acquired long QT syndrome (aLQTS) rabbit hearts. A.-B. Electrical alteration in aLQTS. A. Exemplary ECG traces demonstrating IKr -blocker E-4031-induced RT prolongation in aLQTS. B. Visualization of heart rate corrected RTn370 (each color-coded scale includes 20ms) on rabbits' torso in aLQTS compared to control (n = 6 each). C. Electro-mechanical coupling (EMC). Exemplary myocardial longitudinal velocity curve in base (cm/s) during cardiac cycle in control (blue) and aLQTS (red). Indicated are peak amplitudes (AMPsys, AMPdia) and time-to-diastolic peak (TTPdia). D. Mechano-electrical coupling (MEC). Box plots of preload induced changes in repolarization. Comparison between the timepoints baseline (15 sec before increase in preload) and time of the maximal RTn370 increase peak-preload (around 20 sec after NaCl bolus injection). Heart rate corrected RTn370 demonstrates more pronounced RT-changes in aLQTS compared to control (n = 13 each). This article is protected by copyright. All rights reserved.
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Affiliation(s)
- R D Lewetag
- Department of Cardiology and Angiology I, University Heart Center Freiburg, University Medical Center Freiburg, Freiburg, Germany
- Institute for Experimental Cardiovascular Medicine, University Heart Center Freiburg - Bad Krozingen and Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - S Nimani
- Translational Cardiology, Department of Cardiology and Department of Physiology, University Hospital Bern, Bern, Switzerland
| | - N Alerni
- Translational Cardiology, Department of Cardiology and Department of Physiology, University Hospital Bern, Bern, Switzerland
| | - T Hornyik
- Department of Cardiology and Angiology I, University Heart Center Freiburg, University Medical Center Freiburg, Freiburg, Germany
- Institute for Experimental Cardiovascular Medicine, University Heart Center Freiburg - Bad Krozingen and Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Translational Cardiology, Department of Cardiology and Department of Physiology, University Hospital Bern, Bern, Switzerland
| | - S F Jacobi
- Institute for Experimental Cardiovascular Medicine, University Heart Center Freiburg - Bad Krozingen and Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Department of Congenital Heart Defects and Pediatric Cardiology, University Heart Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - R Moss
- Institute for Experimental Cardiovascular Medicine, University Heart Center Freiburg - Bad Krozingen and Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Fraunhofer Institute for High-Speed Dynamics, Ernst-Mach-Institute EMI, Freiburg, Germany
| | - M Menza
- Department of Radiology, Medical Physics, University Hospital Freiburg, and Faculty of Medicine, University of Freiburg, Germany
| | - N Pilia
- Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - T Puig Walz
- Institute for Experimental Cardiovascular Medicine, University Heart Center Freiburg - Bad Krozingen and Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Fraunhofer Institute for High-Speed Dynamics, Ernst-Mach-Institute EMI, Freiburg, Germany
| | | | - S Perez-Feliz
- Institute for Experimental Cardiovascular Medicine, University Heart Center Freiburg - Bad Krozingen and Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - M Zehender
- Department of Cardiology and Angiology I, University Heart Center Freiburg, University Medical Center Freiburg, Freiburg, Germany
| | - G Seemann
- Institute for Experimental Cardiovascular Medicine, University Heart Center Freiburg - Bad Krozingen and Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - C M Zgierski-Johnston
- Institute for Experimental Cardiovascular Medicine, University Heart Center Freiburg - Bad Krozingen and Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - R Lopez
- Translational Cardiology, Department of Cardiology and Department of Physiology, University Hospital Bern, Bern, Switzerland
| | - K E Odening
- Department of Cardiology and Angiology I, University Heart Center Freiburg, University Medical Center Freiburg, Freiburg, Germany
- Translational Cardiology, Department of Cardiology and Department of Physiology, University Hospital Bern, Bern, Switzerland
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Lopez R, Barateau L, Chenini S, Rassu AL, Dauvilliers Y. Home nocturnal infrared video to record non-rapid eye movement sleep parasomnias. J Sleep Res 2023; 32:e13732. [PMID: 36122661 DOI: 10.1111/jsr.13732] [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: 07/22/2022] [Revised: 08/26/2022] [Accepted: 09/02/2022] [Indexed: 11/29/2022]
Abstract
To assess the feasibility, the acceptability and the usefulness of home nocturnal infrared video in recording the frequency and the complexity of non-rapid eye movement sleep parasomnias in adults, and in monitoring the treatment response. Twenty adult patients (10 males, median age 27.5 years) with a diagnosis of non-rapid eye movement parasomnia were consecutively enrolled. They had a face-to-face interview, completed self-reported questionnaires to assess clinical characteristics and performed a video-polysomnography in the Sleep Unit. Patients were then monitored at home during at least five consecutive nights using infrared-triggered cameras. They completed a sleep diary and questionnaires to evaluate the number of parasomniac episodes at home and the acceptability of the home nocturnal infrared video recording. Behavioural analyses were performed on home nocturnal infrared video and video-polysomnography recordings. Eight patients treated by clonazepam underwent a second home nocturnal infrared video recording during five consecutive days. All patients had at least one parasomniac episode during the home nocturnal infrared video monitoring, compared with 75% during the video-polysomnography. A minimum of three consecutive nights with home nocturnal infrared video was required to record at least one parasomniac episode. Most patients underestimated the frequency of episodes on the sleep diary compared with home nocturnal infrared video. Episodes recorded at home were often more complex than those recorded during the video-polysomnography. The user-perceived acceptability of the home nocturnal infrared video assessment was excellent. The frequency and the complexity of the parasomniac episodes decreased with clonazepam. Home nocturnal infrared video has good feasibility and acceptability, and may improve the evaluation of the phenotype and severity of the non-rapid eye movement parasomnias and of the treatment response in an ecological setting.
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Affiliation(s)
- Régis Lopez
- National Reference Centre for Orphan Diseases, Narcolepsy - Rare Hypersomnias, Sleep Unit, Department of Neurology, CHU Montpellier, Univ Montpellier, Montpellier, France.,Institute for Neurosciences of Montpellier INM, Univ Montpellier, INSERM, Montpellier, France
| | - Lucie Barateau
- National Reference Centre for Orphan Diseases, Narcolepsy - Rare Hypersomnias, Sleep Unit, Department of Neurology, CHU Montpellier, Univ Montpellier, Montpellier, France.,Institute for Neurosciences of Montpellier INM, Univ Montpellier, INSERM, Montpellier, France
| | - Sofiène Chenini
- National Reference Centre for Orphan Diseases, Narcolepsy - Rare Hypersomnias, Sleep Unit, Department of Neurology, CHU Montpellier, Univ Montpellier, Montpellier, France
| | - Anna Laura Rassu
- National Reference Centre for Orphan Diseases, Narcolepsy - Rare Hypersomnias, Sleep Unit, Department of Neurology, CHU Montpellier, Univ Montpellier, Montpellier, France
| | - Yves Dauvilliers
- National Reference Centre for Orphan Diseases, Narcolepsy - Rare Hypersomnias, Sleep Unit, Department of Neurology, CHU Montpellier, Univ Montpellier, Montpellier, France.,Institute for Neurosciences of Montpellier INM, Univ Montpellier, INSERM, Montpellier, France
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Veraza R, Andrijauskaite K, Lopez R, Cano I, Cisneros E, Jessop I, Watt M, Morales Garza M, Elgalad A, Bunegin L. Preclinical Evaluation of the VP.S ENCORE™ Cardiac Preservation Device. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.885] [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: 04/05/2023] Open
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Coelho J, Taillard J, Bernard A, Lopez R, Fond G, Boyer L, Lucas G, Alla F, Buysse DJ, Wallace ML, Verdun-Esquer C, Geoffroy PA, d’Incau E, Philip P, Micoulaud-Franchi JA. Emotional Exhaustion, a Proxy for Burnout, Is Associated with Sleep Health in French Healthcare Workers without Anxiety or Depressive Symptoms: A Cross-Sectional Study. J Clin Med 2023; 12:jcm12051895. [PMID: 36902682 PMCID: PMC10004252 DOI: 10.3390/jcm12051895] [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: 12/22/2022] [Revised: 02/14/2023] [Accepted: 02/22/2023] [Indexed: 03/04/2023] Open
Abstract
Burnout is frequent among healthcare workers, and sleep problems are suspected risk factors. The sleep health framework provides a new approach to the promotion of sleep as a health benefit. The aim of this study was to assess good sleep health in a large sample of healthcare workers and to investigate its relationship with the absence of burnout among healthcare workers while considering anxiety and depressive symptoms. A cross-sectional Internet-based survey of French healthcare workers was conducted in summer 2020, at the end of the first COVID-19 lockdown in France (March to May 2020). Sleep health was assessed using the RU-SATED v2.0 scale (RegUlarity, Satisfaction, Alertness, Timing, Efficiency, Duration). Emotional exhaustion was used as a proxy for overall burnout. Of 1069 participating French healthcare workers, 474 (44.3%) reported good sleep health (RU-SATED > 8) and 143 (13.4%) reported emotional exhaustion. Males and nurses had a lower likelihood of emotional exhaustion than females and physicians, respectively. Good sleep health was associated with a 2.5-fold lower likelihood of emotional exhaustion and associations persisted among healthcare workers without significant anxiety and depressive symptoms. Longitudinal studies are needed to explore the preventive role of sleep health promotion in terms of the reduction in burnout risk.
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Affiliation(s)
- Julien Coelho
- SANPSY, UMR 6033, University of Bordeaux, F-33000 Bordeaux, France
- SANPSY, UMR 6033, CNRS, F-33000 Bordeaux, France
- Service Universitaire de Médecine du Sommeil, CHU Bordeaux, F-33000 Bordeaux, France
- Correspondence: ; Tel.: +33-64570-6212
| | - Jacques Taillard
- SANPSY, UMR 6033, University of Bordeaux, F-33000 Bordeaux, France
- SANPSY, UMR 6033, CNRS, F-33000 Bordeaux, France
| | - Adèle Bernard
- SANPSY, UMR 6033, University of Bordeaux, F-33000 Bordeaux, France
- SANPSY, UMR 6033, CNRS, F-33000 Bordeaux, France
- Service Universitaire de Médecine du Sommeil, CHU Bordeaux, F-33000 Bordeaux, France
| | - Régis Lopez
- Department of Neurology, Sleep Disorders Center, Gui-de-Chauliac Hospital, CHU Montpellier, F-34000 Montpellier, France
- Inserm, U1061, Université Montpellier 1, F-34000 Montpellier, France
| | - Guillaume Fond
- CEReSS-Health Service Research and Quality of Life Center, Assistance Publique des Hôpitaux de Marseille, Aix-Marseille University, 27, Boulevard Jean -Moulin, F-13000 Marseille, France
- Fondation FondaMental, F-94000 Créteil, France
| | - Laurent Boyer
- CEReSS-Health Service Research and Quality of Life Center, Assistance Publique des Hôpitaux de Marseille, Aix-Marseille University, 27, Boulevard Jean -Moulin, F-13000 Marseille, France
- Fondation FondaMental, F-94000 Créteil, France
| | - Guillaume Lucas
- CEReSS-Health Service Research and Quality of Life Center, Assistance Publique des Hôpitaux de Marseille, Aix-Marseille University, 27, Boulevard Jean -Moulin, F-13000 Marseille, France
| | - François Alla
- Pôle de Santé Publique, CHU Bordeaux, F-33000 Bordeaux, France
| | - Daniel J. Buysse
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA 15260, USA
| | - Meredith L. Wallace
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA 15260, USA
| | | | - Pierre-Alexis Geoffroy
- Département de Psychiatrie et D’addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hopital Bichat—Claude Bernard, F-75018 Paris, France
- GHU Paris—Psychiatry & Neurosciences, 1 Rue Cabanis, F-75014 Paris, France
- Inserm, FHU I2-D2, Université de Paris, NeuroDiderot, F-75019 Paris, France
| | - Emmanuel d’Incau
- SANPSY, UMR 6033, University of Bordeaux, F-33000 Bordeaux, France
- SANPSY, UMR 6033, CNRS, F-33000 Bordeaux, France
- Service Universitaire de Médecine du Sommeil, CHU Bordeaux, F-33000 Bordeaux, France
| | - Pierre Philip
- SANPSY, UMR 6033, University of Bordeaux, F-33000 Bordeaux, France
- SANPSY, UMR 6033, CNRS, F-33000 Bordeaux, France
- Service Universitaire de Médecine du Sommeil, CHU Bordeaux, F-33000 Bordeaux, France
| | - Jean-Arthur Micoulaud-Franchi
- SANPSY, UMR 6033, University of Bordeaux, F-33000 Bordeaux, France
- SANPSY, UMR 6033, CNRS, F-33000 Bordeaux, France
- Service Universitaire de Médecine du Sommeil, CHU Bordeaux, F-33000 Bordeaux, France
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Martin VP, Lopez R, Dauvilliers Y, Rouas JL, Philip P, Micoulaud-Franchi JA. Sleepiness in adults: An umbrella review of a complex construct. Sleep Med Rev 2023; 67:101718. [PMID: 36455433 DOI: 10.1016/j.smrv.2022.101718] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [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: 04/08/2022] [Revised: 10/21/2022] [Accepted: 11/10/2022] [Indexed: 11/21/2022]
Abstract
Sleepiness involves many dimensions that require investigation. Since sleepiness is often defined operationally, we exhaustively inventoried all the assessment tools designed to measure it in an umbrella review, without any preconceptions, i.e. a review of reviews. We included all reviews and systematic reviews related to sleepiness assessment tools published up to March 2021. Three investigators independently assessed the eligibility of studies for inclusion and identified 36 relevant reviews. In total, 99 tools were identified and classified into 8 categories. We classified them depending on their category, their publication year and the number of mentions in the 36 included reviews. The 6 most frequently cited were the Epworth sleepiness scale, the multiple sleep latency test, the maintenance of wakefulness test, the Stanford sleepiness scale, the Karolinska sleepiness scale, and the psychomotor vigilance task. Despite the limitation that we may have missed some recently developed tools, this historical perspective on sleepiness measurement is a first step toward a better delineation of the different dimensions underlying the constructs of sleepiness, and will serve as a basis for further discussion in the clinical and research sleep community.
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Affiliation(s)
- Vincent P Martin
- Univ. Bordeaux, CNRS, Bordeaux INP, LaBRI, UMR 5800, F-33400, Talence, France; Université de Bordeaux, SANPSY UMR 6033, F-33000, Bordeaux, France.
| | - Régis Lopez
- National Reference Center for Orphan Diseases, Narcolepsy, Idiopathic Hypersomnia and Kleine-Levin Syndrome, Sleep Disorders Center, Department of Neurology, Gui-de-Chauliac Hospital, CHU Montpellier, France; Institute for Neurosciences of Montpellier (INM), Montpellier University, INSERM, Montpellier, France
| | - Yves Dauvilliers
- National Reference Center for Orphan Diseases, Narcolepsy, Idiopathic Hypersomnia and Kleine-Levin Syndrome, Sleep Disorders Center, Department of Neurology, Gui-de-Chauliac Hospital, CHU Montpellier, France; Institute for Neurosciences of Montpellier (INM), Montpellier University, INSERM, Montpellier, France
| | - Jean-Luc Rouas
- Univ. Bordeaux, CNRS, Bordeaux INP, LaBRI, UMR 5800, F-33400, Talence, France
| | - Pierre Philip
- Service de Médecine Universitaire du sommeil, CHU de Bordeaux, Place Amélie Raba-Leon, Bordeaux, France; Université de Bordeaux, SANPSY UMR 6033, F-33000, Bordeaux, France
| | - Jean-Arthur Micoulaud-Franchi
- Service de Médecine Universitaire du sommeil, CHU de Bordeaux, Place Amélie Raba-Leon, Bordeaux, France; Université de Bordeaux, SANPSY UMR 6033, F-33000, Bordeaux, France.
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Vieyra O, Santiago R, Delgado A, Martinez A, Perez R, Osornio V, Garza G, Lopez R, Trujillo L. Laparoscopic resection of colovesical fistula secondary to diverticular disease in sigmoid colon. Technical aspects of one-stage surgery. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)01422-7] [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: 02/12/2023]
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Gauld C, Martin VP, Richaud A, Baillieul S, Vicente L, Perromat JL, Zreik I, Taillard J, Geoffroy PA, Lopez R, Micoulaud-Franchi JA. Systematic Item Content and Overlap Analysis of Self-Reported Multiple Sleep Disorder Screening Questionnaires in Adults. J Clin Med 2023; 12:jcm12030852. [PMID: 36769500 PMCID: PMC9918039 DOI: 10.3390/jcm12030852] [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: 12/27/2022] [Revised: 01/15/2023] [Accepted: 01/19/2023] [Indexed: 01/25/2023] Open
Abstract
Sleep disorders are defined on the basis of diagnostic criteria presented in medical classifications. However, no consensus has emerged on the exact list of operational symptoms that should be systematically investigated in the field of sleep medicine. We propose a systematic analysis of sleep symptoms that figure in a set of self-reported multiple sleep disorder screening questionnaires for adult populations, to identify the content overlap of symptoms that probe the presence of central sleep symptoms, and to highlight the potential level of heterogeneity among sleep disorder questionnaires. The method comprises three steps: (i) the selection of self-reported multiple sleep disorder screening questionnaires; (ii) item extraction and selection; (iii) the extraction of symptoms from items. Frequency of sleep symptoms and content overlap (Jaccard Index) are analyzed. We extracted 469 items that provide 60 different symptoms from 12 questionnaires. Insomnia, somnolence, and sleep-related breathing symptoms were found in all the questionnaires. The mean overlap among all questionnaires evaluated with the Jaccard Index is 0.44, i.e., moderate similarity. Despite limitations related to the selection of questionnaires and the symptom extraction and harmonization, this study underlines the need to standardize sleep symptom contents for sleep medicine in order to enhance the practicability, reliability, and validity of sleep disorder diagnoses.
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Affiliation(s)
- Christophe Gauld
- Service Psychopathologie du Développement de l’Enfant et de l’Adolescent, Hospices Civils de Lyon & Université de Lyon 1, 69500 Bron, France
- Institut des Sciences Cognitives Marc Jeannerod, UMR 5229 CNRS & Université Claude Bernard Lyon 1, 69500 Bron, France
| | - Vincent P. Martin
- CNRS, Bordeaux INP, LaBRI, UMR 5800, University of Bordeaux, 33400 Talence, France
- CNRS, SANPSY, UMR 6033, University of Bordeaux, 33000 Bordeaux, France
| | - Alexandre Richaud
- University Sleep Clinic, University Hospital of Bordeaux, Place Amélie Raba-Leon, 33076 Bordeaux, France
| | - Sébastien Baillieul
- HP2 Laboratory, INSERM U1042, Grenoble Alpes University, 38400 Grenoble, France
- Pôle Thorax et Vaisseaux, Grenoble Alpes University Hospital, 38700 Grenoble, France
| | - Lucie Vicente
- CNRS, SANPSY, UMR 6033, University of Bordeaux, 33000 Bordeaux, France
| | | | - Issa Zreik
- CNRS, SANPSY, UMR 6033, University of Bordeaux, 33000 Bordeaux, France
| | - Jacques Taillard
- CNRS, SANPSY, UMR 6033, University of Bordeaux, 33000 Bordeaux, France
| | - Pierre Alexis Geoffroy
- Département de Psychiatrie et d’addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hopital Bichat-Claude Bernard, 75018 Paris, France
- GHU Paris-Psychiatry & Neurosciences, 1 Rue Cabanis, 75014 Paris, France
- NeuroDiderot, Inserm, Université de Paris, FHU I2-D2, 75019 Paris, France
- CNRS UPR 3212, Institute for Cellular and Integrative Neurosciences, 67000 Strasbourg, France
| | - Régis Lopez
- Institut des Neurosciences de Montpellier (INM), Université de Montpellier, 34000 Montpellier, France
- Unité des Troubles du Sommeil, Département de Neurologie, CHU Montpellier, 34000 Montpellier, France
| | - Jean-Arthur Micoulaud-Franchi
- CNRS, SANPSY, UMR 6033, University of Bordeaux, 33000 Bordeaux, France
- University Sleep Clinic, University Hospital of Bordeaux, Place Amélie Raba-Leon, 33076 Bordeaux, France
- Correspondence: ; Tel.: +33-622-364-019
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Lopez R, Barateau L, Laura Rassu A, Evangelista E, Chenini S, Scholz S, Jaussent I, Dauvilliers Y. Rapid eye movement sleep duration during the multiple sleep latency test to diagnose hypocretin-deficient narcolepsy. Sleep 2023; 46:6759411. [PMID: 36222741 DOI: 10.1093/sleep/zsac247] [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: 07/12/2022] [Revised: 09/09/2022] [Indexed: 11/07/2022] Open
Abstract
STUDY OBJECTIVES To assess the performances of alternative measures of the multiple sleep latency test (MSLT) to identify hypocretin-deficiency in patients with a complaint of hypersomnolence, including patients with narcolepsy. METHODS MSLT parameters from 374 drug-free patients with hypersomnolence, with complete clinical and polysomnographic (PSG) assessment and cerebrospinal hypocretin-1 measurement were collected. Conventional (sleep latency, number of sleep onset REM-SOREM-periods) and alternative (sleep duration, REM sleep latency and duration, sleep stage transitions) MSLT measures were compared as function of hypocretin-1 levels (≤110 vs > 110 pg/mL). We performed receiver-operating characteristics analyses to determine the best thresholds of MSLT parameters to identify hypocretin-deficiency in the global population and in subgroups of patients with narcolepsy (i.e. typical cataplexy and/or positive PSG/MSLT criteria, n = 223). RESULTS Patients with hypocretin-deficiency had shorter mean sleep and REM sleep latencies, longer mean sleep and REM sleep durations and more direct REM sleep transitions during the MSLT. The current standards of MSLT/PSG criteria identified hypocretin-deficient patients with a sensitivity of 0.87 and a specificity of 0.69, and 0.81/0.99 when combined with cataplexy. A mean REM sleep duration ≥ 4.1 min best identified hypocretin-deficiency in patients with hypersomnolence (AUC = 0.932, sensitivity 0.87, specificity 0.86) and ≥ 5.7 min in patients with narcolepsy (AUC = 0.832, sensitivity 0.77, specificity 0.82). CONCLUSION Compared to the current neurophysiological standard criteria, alternative MSLT parameters would better identify hypocretin-deficiency among patients with hypersomnolence and those with narcolepsy. We highlighted daytime REM sleep duration as a relevant neurophysiological biomarker of hypocretin-deficiency to be used in clinical and research settings.
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Affiliation(s)
- Régis Lopez
- Department of Neurology, Sleep-Wake Disorders Unit, Gui-de-Chauliac Hospital, CHU Montpellier, Montpellier, France.,National Reference Centre for Orphan Diseases, Narcolepsy, Idiopathic Hypersomnia, and Kleine-Levin Syndrome, Montpellier, France.,Institute for Neurosciences of Montpellier (INM), University of Montpellier, INSERM, Montpellier, France
| | - Lucie Barateau
- Department of Neurology, Sleep-Wake Disorders Unit, Gui-de-Chauliac Hospital, CHU Montpellier, Montpellier, France.,National Reference Centre for Orphan Diseases, Narcolepsy, Idiopathic Hypersomnia, and Kleine-Levin Syndrome, Montpellier, France.,Institute for Neurosciences of Montpellier (INM), University of Montpellier, INSERM, Montpellier, France
| | - Anna Laura Rassu
- Department of Neurology, Sleep-Wake Disorders Unit, Gui-de-Chauliac Hospital, CHU Montpellier, Montpellier, France
| | - Elisa Evangelista
- Department of Neurology, Sleep-Wake Disorders Unit, Gui-de-Chauliac Hospital, CHU Montpellier, Montpellier, France.,National Reference Centre for Orphan Diseases, Narcolepsy, Idiopathic Hypersomnia, and Kleine-Levin Syndrome, Montpellier, France.,Institute for Neurosciences of Montpellier (INM), University of Montpellier, INSERM, Montpellier, France.,Sleep Disorders Unit, CHU Nîmes, Nîmes, France
| | - Sofiene Chenini
- Department of Neurology, Sleep-Wake Disorders Unit, Gui-de-Chauliac Hospital, CHU Montpellier, Montpellier, France.,National Reference Centre for Orphan Diseases, Narcolepsy, Idiopathic Hypersomnia, and Kleine-Levin Syndrome, Montpellier, France
| | - Sabine Scholz
- Department of Neurology, Sleep-Wake Disorders Unit, Gui-de-Chauliac Hospital, CHU Montpellier, Montpellier, France.,National Reference Centre for Orphan Diseases, Narcolepsy, Idiopathic Hypersomnia, and Kleine-Levin Syndrome, Montpellier, France
| | - Isabelle Jaussent
- National Reference Centre for Orphan Diseases, Narcolepsy, Idiopathic Hypersomnia, and Kleine-Levin Syndrome, Montpellier, France
| | - Yves Dauvilliers
- Department of Neurology, Sleep-Wake Disorders Unit, Gui-de-Chauliac Hospital, CHU Montpellier, Montpellier, France.,National Reference Centre for Orphan Diseases, Narcolepsy, Idiopathic Hypersomnia, and Kleine-Levin Syndrome, Montpellier, France.,Institute for Neurosciences of Montpellier (INM), University of Montpellier, INSERM, Montpellier, France
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Barateau L, Lopez R, Chenini S, Rassu A, Mouhli L, Dhalluin C, Jaussent I, Dauvilliers Y. Linking clinical complaints and objective measures of Disrupted Nighttime Sleep in Narcolepsy type 1. Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.435] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Marturano M, Ayuso S, Ku D, Raible R, Lopez R, Colavita P, Augenstein V, Heniford BT. OC-011 PREOPERATIVE BOTULINUM TOXIN A INJECTION CAN ACHIEVE SIMILAR OUTCOMES AS COMPONENT SEPARATION TECHNIQUES IN COMPLEX ABDOMINAL WALL RECONSTRUCTION WITH DECREASED MORBIDITY– A PROPENSITY-SCORED MATCHED STUDY. Br J Surg 2022. [DOI: 10.1093/bjs/znac308.023] [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] [Indexed: 11/14/2022]
Abstract
Abstract
Aims
CST have been effective in closing large defects but at the sacrifice of fascia and muscle and often increasing complication rates. Preoperative BTA has emerged as an adjunct to aid in fascial closure. Little data exist comparing pre-operative BTA versus CST, and our aim was to do so in a matched study.
Materials & Methods
A 3:1 propensity matched study of patients from a single institution hernia database undergoing AWR from 2016 to 2021 with BTA versus CST was performed based on BMI, defect width, hernia volume, and CDC wound classification. Demographics, operative characteristics, and outcomes were evaluated.
Results
35 BTA vs 105 CST matched patients were analyzed. Hernia defects and volume were large for both the CST and BTA groups (mean size:286.2+179.9cm2vs289.7+162.4cm2;p=0.73) (mean volume:1498.3+2043.4cm3vs2914.7+6539.4cm3;p=0.35). CDC wound classifications were equivalent (CDC3 and 4–39.1%vs40.0%;p=0.97). CST was more frequently performed in European Hernia Society M1 hernias (21% vs 2.9%;p=0.01). The BTA group had fewer surgical site occurrences (SSO) (32.4%vs11.4%;p=0.02) and surgical site infections (SSI) (11.7%vs0%;p=0.04). There was no difference in fascial closure (90.5%vs100%;p=0.11)) or recurrence (12.4%vs2.9%;p=0.10) with similar median follow-up (22.8+29.7vs 9.8+12.7months;p=0.13). In multivariate analysis, BTA was associated with lower rates of SSO (OR=5.3; 95% CI [1.4–34.4]).
Conclusion
There was no difference in fascial closure rates or in hernia recurrence between the two groups. Pre-operative BTA can thereby achieve similar outcomes as CST while concurrently decreasing the frequency of SSO. This similarity in outcomes is upheld when comparing BTA to both ACST and PCST separately.
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Affiliation(s)
- M Marturano
- Surgery, Carolinas Medical Center , Charlotte , United States
| | - S Ayuso
- Surgery, Carolinas Medical Center , Charlotte , United States
| | - D Ku
- Surgery, Carolinas Medical Center , Charlotte , United States
| | - R Raible
- Radiology, Carolinas Medical Center , Charlotte , United States
| | - R Lopez
- Radiology, Carolinas Medical Center , Charlotte , United States
| | - P Colavita
- Surgery, Carolinas Medical Center , Charlotte , United States
| | - V Augenstein
- Surgery, Carolinas Medical Center , Charlotte , United States
| | - B T Heniford
- Surgery, Carolinas Medical Center , Charlotte , United States
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Boudhabhay I, Lopez R, Zafrani L, Azoulay E, Darmon M, Mariotte E. Impact de l’hypertension artérielle au cours du purpura thrombotique thrombocytopénique chez les patients en réanimation. Nephrol Ther 2022. [DOI: 10.1016/j.nephro.2022.07.252] [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: 10/14/2022]
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22
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Gauld C, Lopez R, Philip P, Taillard J, Morin CM, Geoffroy PA, Micoulaud-Franchi JA. A Systematic Review of Sleep–Wake Disorder Diagnostic Criteria Reliability Studies. Biomedicines 2022; 10:biomedicines10071616. [PMID: 35884924 PMCID: PMC9313077 DOI: 10.3390/biomedicines10071616] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 06/27/2022] [Accepted: 07/04/2022] [Indexed: 12/02/2022] Open
Abstract
The aim of this article is to provide a systematic review of reliability studies of the sleep–wake disorder diagnostic criteria of the international classifications used in sleep medicine. Electronic databases (ubMed (1946–2021) and Web of Science (—2021)) were searched up to December 2021 for studies computing the Cohen’s kappa coefficient of diagnostic criteria for the main sleep–wake disorder categories described in the principal classifications. Cohen’s kappa coefficients were extracted for each main sleep–wake disorder category, for each classification subtype, and for the different types of methods used to test the degree of agreement about a diagnosis. The database search identified 383 studies. Fifteen studies were analyzed in this systematic review. Insomnia disorder (10/15) and parasomnia disorder (7/15) diagnostic criteria were the most studied. The reliability of all sleep–wake disorders presented a Cohen’s kappa with substantial agreement (Cohen’s kappa mean = 0.66). The two main reliability methods identified were “test–retest reliability” (11/15), principally used for International Classification of Sleep Disorders (ICSD), and “joint interrater reliability” (4/15), principally used for Diagnostic and Statistical Manual of Mental Disorders (DSM) subtype diagnostic criteria, in particularl, the DSM-5. The implications in terms of the design of the methods used to test the degree of agreement about a diagnosis in sleep medicine are discussed.
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Affiliation(s)
- Christophe Gauld
- Department of Child Psychiatry, Hospices Civils de Lyon, 69000 Lyon, France;
- UMR CNRS 8590 IHPST, Sorbonne University, 75007 Paris, France
| | - Régis Lopez
- Institut des Neurosciences de Montpellier (INM), University Montpellier, 34000 Montpellier, France;
- Inserm, Unité des Troubles du Sommeil, Département de Neurologie, CHU Montpellier, 34000 Montpellier, France
| | - Pierre Philip
- University Sleep Clinic, Services of Functional Exploration of the Nervous System, University Hospital of Bordeaux, Place Amélie Raba-Léon, 33 076 Bordeaux, France;
- CNRS, SANPSY, Université de Bordeaux, UMR6033, 33000 Bordeaux, France;
| | - Jacques Taillard
- CNRS, SANPSY, Université de Bordeaux, UMR6033, 33000 Bordeaux, France;
| | - Charles M. Morin
- École de Psychologie, Université Laval, 2325 Rue des Bibliothèques, Québec City, QC G1V 0A6, Canada;
- Centre D’étude des Troubles du Sommeil, Université Laval, 2325 Rue des Bibliothèques, Québec City, QC G1V 0A6, Canada
| | - Pierre Alexis Geoffroy
- Département de Psychiatrie et d’addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hopital Bichat—Claude Bernard, 75018 Paris, France;
- GHU Paris—Psychiatry & Neurosciences, 1 Rue Cabanis, 75014 Paris, France
- NeuroDiderot, Inserm, Université de Paris, FHU I2-D2, 75019 Paris, France
- CNRS UPR 3212, Institute for Cellular and Integrative Neurosciences, 67000 Strasbourg, France
| | - Jean-Arthur Micoulaud-Franchi
- University Sleep Clinic, Services of Functional Exploration of the Nervous System, University Hospital of Bordeaux, Place Amélie Raba-Léon, 33 076 Bordeaux, France;
- CNRS, SANPSY, Université de Bordeaux, UMR6033, 33000 Bordeaux, France;
- Correspondence: ; Tel.: +33-(0)5-57-82-01-82
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Barateau L, Lopez R, Chenini S, Rassu AL, Mouhli L, Dhalluin C, Jaussent I, Dauvilliers Y. Linking clinical complaints and objective measures of disrupted nighttime sleep in narcolepsy type 1. Sleep 2022; 45:6547241. [PMID: 35275598 DOI: 10.1093/sleep/zsac054] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [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: 11/27/2021] [Revised: 02/07/2022] [Indexed: 12/31/2022] Open
Abstract
STUDY OBJECTIVES Despite its high frequency in narcolepsy type 1(NT1), disrupted nocturnal sleep (DNS) remains understudied, and its determinants have been poorly assessed. We aimed to determine the clinical, polysomnographic (PSG), and biological variables associated with DNS in a large sample of patients with NT1, and to evaluate the effect of medication on DNS and its severity. METHODS Two hundred and forty-eight consecutive adult patients with NT1 (145 untreated, 103 treated) were included at the National Reference Center for Narcolepsy-France; 51 drug-free patients were reevaluated during treatment. DNS, assessed with the Narcolepsy Severity Scale (NSS), was categorized in four levels (absent, mild, moderate, severe). Clinical characteristics, validated questionnaires, PSG parameters (sleep fragmentation markers: sleep (SB) and wake bouts (WB), transitions), objective sleepiness, and orexin-A levels were assessed. RESULTS In drug-free patients, DNS severity was associated with higher scores on NSS, higher sleepiness, anxiety/depressive symptoms, autonomic dysfunction, worse quality of life (QoL). Patients with moderate/severe DNS (59%) had increased sleep onset REM periods, lower sleep efficiency, longer wake after sleep onset, more N1, SB, WB, sleep instability, transitions. In treated patients, DNS was associated with the same clinical data, and antidepressant use; but only with longer REM sleep latency on PSG. During treatment, sleepiness, NSS scores, depressive symptoms decreased, as well as total sleep time, WB, SB, transitions. DNS improved in 55% of patients, without predictors except more baseline anxiety. CONCLUSION DNS complaint is frequent in NT1, associated with disease severity based on NSS, several PSG parameters, and objective sleepiness in untreated and treated conditions. DNS improves with treatment. We advocate the systematic assessment of this symptom and its inclusion in NT1 management strategy.
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Affiliation(s)
- Lucie Barateau
- Sleep-Wake Disorders Unit, Department of Neurology, Gui-de-Chauliac Hospital, CHU, Montpellier, France.,National Reference Centre for Orphan Diseases, Narcolepsy, Idiopathic Hypersomnia, and Kleine-Levin Syndrome, Montpellier, France.,Institute for Neurosciences of Montpellier (INM), University of Montpellier, INSERM, Montpellier, France
| | - Régis Lopez
- Sleep-Wake Disorders Unit, Department of Neurology, Gui-de-Chauliac Hospital, CHU, Montpellier, France.,National Reference Centre for Orphan Diseases, Narcolepsy, Idiopathic Hypersomnia, and Kleine-Levin Syndrome, Montpellier, France.,Institute for Neurosciences of Montpellier (INM), University of Montpellier, INSERM, Montpellier, France
| | - Sofiene Chenini
- Sleep-Wake Disorders Unit, Department of Neurology, Gui-de-Chauliac Hospital, CHU, Montpellier, France.,National Reference Centre for Orphan Diseases, Narcolepsy, Idiopathic Hypersomnia, and Kleine-Levin Syndrome, Montpellier, France
| | - Anna-Laura Rassu
- Sleep-Wake Disorders Unit, Department of Neurology, Gui-de-Chauliac Hospital, CHU, Montpellier, France.,National Reference Centre for Orphan Diseases, Narcolepsy, Idiopathic Hypersomnia, and Kleine-Levin Syndrome, Montpellier, France
| | - Lytissia Mouhli
- Sleep-Wake Disorders Unit, Department of Neurology, Gui-de-Chauliac Hospital, CHU, Montpellier, France
| | - Cloé Dhalluin
- Sleep-Wake Disorders Unit, Department of Neurology, Gui-de-Chauliac Hospital, CHU, Montpellier, France
| | - Isabelle Jaussent
- Institute for Neurosciences of Montpellier (INM), University of Montpellier, INSERM, Montpellier, France
| | - Yves Dauvilliers
- Sleep-Wake Disorders Unit, Department of Neurology, Gui-de-Chauliac Hospital, CHU, Montpellier, France.,National Reference Centre for Orphan Diseases, Narcolepsy, Idiopathic Hypersomnia, and Kleine-Levin Syndrome, Montpellier, France.,Institute for Neurosciences of Montpellier (INM), University of Montpellier, INSERM, Montpellier, France
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Marsol-Vall A, Ainsa S, Lopez R, Ferreira V. Development and validation of a method for the analysis of halophenols and haloanisoles in cork bark macerates by stir bar sorptive extraction heart-cutting two-dimensional gas chromatography negative chemical ionization mass spectrometry. J Chromatogr A 2022; 1673:463186. [DOI: 10.1016/j.chroma.2022.463186] [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] [Received: 03/15/2022] [Revised: 05/30/2022] [Accepted: 05/30/2022] [Indexed: 11/29/2022]
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25
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Lopez R, Lefevre L, Barateau L, Micoulaud-Franchi JA, Dauvilliers Y, Schenck CH. A series of 8 cases of sleep-related psychogenic dissociative disorders and proposed updated diagnostic criteria. J Clin Sleep Med 2022; 18:563-573. [PMID: 34534064 PMCID: PMC8804993 DOI: 10.5664/jcsm.9654] [Citation(s) in RCA: 6] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
STUDY OBJECTIVES To identify the most relevant clinical and video-polysomnographic characteristics of patients with sleep-related dissociative disorders (SRDDs) and to propose a framework for new diagnostic criteria. METHODS We searched potential SRDD cases from the scientific literature and from a database of patients referred for clinical and video-polysomnographic assessment in a single sleep disorders center for disruptive nocturnal behaviors (n = 731). The most relevant clinical and neurophysiological characteristics of the cases were extracted and a descriptive analysis was performed. RESULTS Twenty-six SRDD cases (8 new and 18 previously published cases) were reviewed. Almost all cases of SRDDs occurred in a context of past traumatic events or abuse and were associated with at least 1 comorbid psychiatric disorder. We highlighted 4 relevant clinical characteristics of SRDD useful for the differential diagnosis with parasomnias: episodes of long duration of more than 1 hour (90.9%), self-inflicted injuries (83.3%), occurrence while awake close to bedtime (35.7%), and the presence of daytime dissociative symptoms (72.7%). The video-polysomnography documented typical episodes of SRDD with prolonged wakefulness before, during, and after the event in 11/26 cases. New diagnostic criteria for SRDD were proposed, with 3 levels of certainty for the diagnosis based on clinical, video-polysomnographic, and homemade video findings. CONCLUSIONS More than 30 years after its formal identification, SRDD is not currently recognized as an official diagnostic entity. We better delineate the clinical and neurophysiological features of SRDD and propose a framework for its reinstatement in the next revisions of the sleep and psychiatric disorders classifications. CITATION Lopez R, Lefevre L, Barateau L, Micoulaud-Franchi J-A, Dauvilliers Y, Schenck CH. A series of 8 cases of sleep-related psychogenic dissociative disorders and proposed updated diagnostic criteria. J Clin Sleep Med. 2022;18(2):563-573.
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Affiliation(s)
- Régis Lopez
- National Reference Centre for Orphan Diseases, Narcolepsy, Rare Hypersomnias, Sleep Unit, Department of Neurology, CHU Montpellier, University of Montpellier, Montpellier, France,Institute for Neurosciences of Montpellier INM, University of Montpellier, INSERM, Montpellier, France,Address correspondence to: Régis Lopez, MD, PhD, Centre national de référence narcolepsie hypersomnies, Département de Neurologie, CHU de Montpellier, Hôpital Gui de Chauliac, 80, avenue Augustin Fliche, 34295 Montpellier Cedex 5, France; Tel: (33) 4 67 33 74 78; Fax: (33) 4 67 33 72 85;
| | - Lou Lefevre
- National Reference Centre for Orphan Diseases, Narcolepsy, Rare Hypersomnias, Sleep Unit, Department of Neurology, CHU Montpellier, University of Montpellier, Montpellier, France
| | - Lucie Barateau
- National Reference Centre for Orphan Diseases, Narcolepsy, Rare Hypersomnias, Sleep Unit, Department of Neurology, CHU Montpellier, University of Montpellier, Montpellier, France,Institute for Neurosciences of Montpellier INM, University of Montpellier, INSERM, Montpellier, France
| | - Jean-Arthur Micoulaud-Franchi
- Sleep Clinic, University Hospital of Bordeaux, Bordeaux, France,USR CNRS 3413 SANPSY, University Hospital of Bordeaux, Bordeaux, France
| | - Yves Dauvilliers
- National Reference Centre for Orphan Diseases, Narcolepsy, Rare Hypersomnias, Sleep Unit, Department of Neurology, CHU Montpellier, University of Montpellier, Montpellier, France,Institute for Neurosciences of Montpellier INM, University of Montpellier, INSERM, Montpellier, France
| | - Carlos H. Schenck
- Minnesota Regional Sleep Disorders Center, Minneapolis, Minnesota,Department of Psychiatry, Hennepin County Medical Center, Minneapolis, Minnesota,Department of Psychiatry, University of Minnesota Medical School, Minneapolis, Minnesota
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Macmurdo M, Lopez R, Udeh BL, Zein J. Beyond tobacco - the secondary impact of substance misuse in chronic obstructive lung disease. J Asthma 2022; 59:223-229. [PMID: 33158365 PMCID: PMC8353598 DOI: 10.1080/02770903.2020.1847932] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 07/01/2020] [Revised: 11/02/2020] [Accepted: 11/04/2020] [Indexed: 10/23/2022]
Abstract
BackgroundChronic obstructive lung disease, specifically chronic asthma and COPD, impacts more than 500 million adults worldwide, and is associated with high healthcare spending and significant disease-related morbidity. While the direct impact of substance use disorder is well documented, little is known about the indirect impact of substance misuse within this patient population. The healthcare cost and indirect morbidity secondary to substance misuse in obstructive lung disease has yet to be quantified.ObjectiveTo determine the indirect impact of substance misuse on disease severity, healthcare utilization and healthcare costs in patients with chronic obstructive lung disease across the United States.MethodsUtilizing data from the 2012-2015 National Readmissions Database (NRD) patients with a diagnosis of COPD or asthma were identified. Documented substance misuse, rates of hospitalization, frequency of hospital readmission, markers of admission severity and cost were assessed utilizing weighted regression analysis.ResultsA total of 1,087,226 patients with an index admission for asthma or COPD were identified. Substance misuse was documented in 4.0% of patients. Substance misuse was associated with a 30% increase in odds of readmission and a higher cost per index admission. The additional index admission costs totaled $24 million for our cohort.Conclusion Substance misuse is associated with an increase in healthcare utilization and healthcare cost in patients with chronic obstructive lung disease. Targeting substance misuse in this patient population has the potential for significant cost savings to the healthcare system.
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Affiliation(s)
- M Macmurdo
- Cleveland Clinic, Respiratory Institute, Cleveland, Ohio, USA
| | - R Lopez
- Center for Populations Health Research, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
- Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
| | - B L Udeh
- Center for Populations Health Research, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
- Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
- Neurological Institute Center for Outcomes Research, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA
| | - J Zein
- Cleveland Clinic, Respiratory Institute, Cleveland, Ohio, USA
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Rassu AL, Evangelista E, Barateau L, Chenini S, Lopez R, Jaussent I, Dauvilliers Y. Idiopathic Hypersomnia Severity Scale to better quantify symptoms severity and their consequences in idiopathic hypersomnia. J Clin Sleep Med 2022; 18:617-629. [PMID: 34596041 PMCID: PMC8805002 DOI: 10.5664/jcsm.9682] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [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: 06/09/2021] [Revised: 09/20/2021] [Accepted: 09/20/2021] [Indexed: 02/03/2023]
Abstract
STUDY OBJECTIVES To assess the responsiveness of the Idiopathic Hypersomnia Severity Scale (IHSS) to medications and estimate the minimum clinically important difference, to report clinically relevant score ranges, and to confirm its psychometric properties and whether items need to be weighted in drug-free and treated patients with idiopathic hypersomnia (IH). METHODS Two-hundred twenty-six (166 drug-free and 60 treated) patients with IH (cross-sectional sample) completed the 14-item IHSS to quantify the severity of the 3 major IH symptoms (excessive daytime sleepiness, prolonged nighttime sleep, and sleep inertia) and consequences; 77 untreated patients were evaluated again after treatment (longitudinal sample). Patients filled in the Epworth Sleepiness Scale, Beck Depression Inventory II, and European Quality of Life questionnaires. RESULTS The IHSS confirmed adequate psychometric properties with a factor analysis indicating a 3-component solution. IHSS total score was lower in treated than untreated patients, with a mean difference of 4-5 points in the cross-sectional and longitudinal samples. Distribution-based methods were used to estimate that 4 points represented the minimum clinically important difference. Four severity levels were defined with between-group differences related to treatment. The probability of having severe sleepiness, depressive symptoms, and low quality of life increased with the severity level. Our results showed that IHSS item-weighting was not necessary. CONCLUSIONS The IHSS is a valid and reliable tool to quantify IH symptoms, with 4 severity score levels of clinical importance. The IHSS has adequate psychometric properties and can detect symptom changes after treatment. These findings should stimulate its use in clinical settings and in research studies. CITATION Rassu AL, Evangelista E, Barateau L, et al. Idiopathic Hypersomnia Severity Scale to better quantify symptoms severity and their consequences in idiopathic hypersomnia. J Clin Sleep Med. 2022;18(2):617-629.
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Affiliation(s)
- Anna Laura Rassu
- CHU Montpellier, Hôpital Gui-de-Chauliac, Service de Neurologie, Unité du Sommeil, Centre National de Référence pour la Narcolepsie, Montpellier, France
- Institute Neurosciences of Montellier, Université de Montpellier, INSERM, Montpellier, France
| | - Elisa Evangelista
- CHU Montpellier, Hôpital Gui-de-Chauliac, Service de Neurologie, Unité du Sommeil, Centre National de Référence pour la Narcolepsie, Montpellier, France
- Institute Neurosciences of Montellier, Université de Montpellier, INSERM, Montpellier, France
| | - Lucie Barateau
- CHU Montpellier, Hôpital Gui-de-Chauliac, Service de Neurologie, Unité du Sommeil, Centre National de Référence pour la Narcolepsie, Montpellier, France
- Institute Neurosciences of Montellier, Université de Montpellier, INSERM, Montpellier, France
| | - Sofiene Chenini
- CHU Montpellier, Hôpital Gui-de-Chauliac, Service de Neurologie, Unité du Sommeil, Centre National de Référence pour la Narcolepsie, Montpellier, France
- Institute Neurosciences of Montellier, Université de Montpellier, INSERM, Montpellier, France
| | - Régis Lopez
- CHU Montpellier, Hôpital Gui-de-Chauliac, Service de Neurologie, Unité du Sommeil, Centre National de Référence pour la Narcolepsie, Montpellier, France
- Institute Neurosciences of Montellier, Université de Montpellier, INSERM, Montpellier, France
| | - Isabelle Jaussent
- Institute Neurosciences of Montellier, Université de Montpellier, INSERM, Montpellier, France
| | - Yves Dauvilliers
- CHU Montpellier, Hôpital Gui-de-Chauliac, Service de Neurologie, Unité du Sommeil, Centre National de Référence pour la Narcolepsie, Montpellier, France
- Institute Neurosciences of Montellier, Université de Montpellier, INSERM, Montpellier, France
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Fournier S, Dauvilliers Y, Warby SC, Labrecque M, Zadra A, Boucetta S, El Gewely M, Kaddioui H, Lopez R, Montplaisir JY, Bareke E, Tétreault M, Desautels A. Does the adenosine deaminase (ADA) gene confer risk of sleepwalking? J Sleep Res 2021; 31:e13537. [PMID: 34913218 DOI: 10.1111/jsr.13537] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 11/04/2021] [Accepted: 12/01/2021] [Indexed: 11/29/2022]
Abstract
Sleepwalking is a common non-rapid eye movement (NREM) parasomnia and a significant cause of sleep-related injuries. While evidence suggest that the occurrence of this condition is partly determined by genetic factors, its pattern of inheritance remains unclear, and few molecular studies have been conducted. One promising candidate is the adenosine deaminase (ADA) gene. Adenosine and the ADA enzyme play an important role in the homeostatic regulation of NREM sleep. In a single sleepwalking family, genome-wide analysis identified a locus on chromosome 20, where ADA lies. In this study, we examined if variants in the ADA gene were associated with sleepwalking. In total, 251 sleepwalking patients were clinically assessed, and DNA samples were compared to those from 94 unaffected controls. Next-generation sequencing of the whole ADA gene was performed. Bio-informatic analysis enabled the identification of variants and assessed variants enrichment in our cohort compared to controls. We detected 25 different coding and non-coding variants, of which 22 were found among sleepwalkers. None were enriched in the sleepwalking population. However, many missense variants were predicted as likely pathogenic by at least two in silico prediction algorithms. This study involves the largest sleepwalking cohort in which the role of a susceptibility gene was investigated. Our results did not reveal an association between ADA gene and sleepwalking, thus ruling out the possibility of ADA as a major genetic factor for this condition. Future work is needed to identify susceptibility genes.
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Affiliation(s)
- Simon Fournier
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur (CIUSSS-NIM), Montréal, Canada.,Department of Neuroscience, Université de Montréal, Montréal, Canada
| | - Yves Dauvilliers
- Sleep Unit, Department of Neurology, National Reference Centre for Orphan Diseases, Narcolepsy-Rare Hypersomnias, CHU Montpellier, Univ Montpellier, Montpellier, France.,Institute for Neurosciences of Montpellier INM, INSERM, Univ Montpellier, Montpellier, France
| | - Simon C Warby
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur (CIUSSS-NIM), Montréal, Canada.,Department of Psychiatry, Université de Montréal, Montréal, Canada
| | - Marjorie Labrecque
- Department of Bioinformatics, Université de Montréal, Montréal, Canada.,CHUM Research Center, Montréal, Canada
| | - Antonio Zadra
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur (CIUSSS-NIM), Montréal, Canada.,Department of Psychology, Université de Montréal, Montréal, Canada
| | - Soufiane Boucetta
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur (CIUSSS-NIM), Montréal, Canada
| | - Maryam El Gewely
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur (CIUSSS-NIM), Montréal, Canada.,Department of Psychiatry, Université de Montréal, Montréal, Canada
| | - Houda Kaddioui
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur (CIUSSS-NIM), Montréal, Canada
| | - Régis Lopez
- Sleep Unit, Department of Neurology, National Reference Centre for Orphan Diseases, Narcolepsy-Rare Hypersomnias, CHU Montpellier, Univ Montpellier, Montpellier, France.,Institute for Neurosciences of Montpellier INM, INSERM, Univ Montpellier, Montpellier, France
| | - Jacques Y Montplaisir
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur (CIUSSS-NIM), Montréal, Canada.,Department of Psychiatry, Université de Montréal, Montréal, Canada
| | | | - Martine Tétreault
- Department of Neuroscience, Université de Montréal, Montréal, Canada.,CHUM Research Center, Montréal, Canada
| | - Alex Desautels
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Cœur (CIUSSS-NIM), Montréal, Canada.,Department of Neuroscience, Université de Montréal, Montréal, Canada
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Postiglione E, Barateau L, Pizza F, Lopez R, Antelmi E, Rassu AL, Vandi S, Chenini S, Mignot E, Dauvilliers Y, Plazzi G. Narcolepsy with intermediate cerebrospinal level of hypocretin-1. Sleep 2021; 45:6460454. [PMID: 34902030 DOI: 10.1093/sleep/zsab285] [Citation(s) in RCA: 13] [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: 07/08/2021] [Revised: 11/19/2021] [Indexed: 11/13/2022] Open
Abstract
STUDY OBJECTIVES To describe the phenotype of narcolepsy with intermediate cerebrospinal hypocretin-1 levels (CSF hcrt-1). METHODS From 1600 consecutive patients with narcolepsy from Bologna and Montpellier sleep centers we selected patients with intermediate CSF hcrt-1 levels (110-200 pg/ml). Clinical, neurophysiological and biological data were contrasted for the presence of cataplexy, HLA-DQB1*06:02, and median CSF hcrt-1 levels (149.34 pg/mL). RESULTS Forty-five (55% males, aged 35 ± 17 years) patients (2.8% of all cases) were included. Thirty-three (73%) were HLA-DQB1*06:02, 29 (64%) reported cataplexy (21, 72.4% with typical features), and 5 (11%) had presumed secondary etiology. Cataplexy was associated with other core narcolepsy symptoms, increased sleep onset REM periods, and nocturnal sleep disruption. Cataplexy and irrepressible daytime sleep were more frequent in HLA DQB1*06:02 positive patients. Lower CSF hcrt-1 levels were associated with hallucinations. CONCLUSION Narcolepsy with intermediate CSF hcrt-1 level is a rare condition with heterogeneous phenotype. HLA DQB1*06:02 and lower CSF hcrt-1 were associated with typical narcolepsy features, calling for future research to distinguish incomplete from secondary narcolepsy forms.
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Affiliation(s)
- Emanuela Postiglione
- Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Bologna, Italy
| | - Lucie Barateau
- Sleep-Wake Disorders Center, Department of Neurology, Gui-de-Chauliac Hospital, University Hospital Center, Montpellier, France.,National Reference Network for Narcolepsy, Gui-de-Chauliac Hospital, University Hospital Center, Montpellier, France.,Institute for Neurosciences of Montpellier INM, INSERM, University of Montpellier, France
| | - Fabio Pizza
- Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Bologna, Italy.,IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Régis Lopez
- Sleep-Wake Disorders Center, Department of Neurology, Gui-de-Chauliac Hospital, University Hospital Center, Montpellier, France.,National Reference Network for Narcolepsy, Gui-de-Chauliac Hospital, University Hospital Center, Montpellier, France.,Institute for Neurosciences of Montpellier INM, INSERM, University of Montpellier, France
| | - Elena Antelmi
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Anna-Laura Rassu
- Sleep-Wake Disorders Center, Department of Neurology, Gui-de-Chauliac Hospital, University Hospital Center, Montpellier, France
| | - Stefano Vandi
- Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Bologna, Italy.,IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Sofiene Chenini
- Sleep-Wake Disorders Center, Department of Neurology, Gui-de-Chauliac Hospital, University Hospital Center, Montpellier, France.,National Reference Network for Narcolepsy, Gui-de-Chauliac Hospital, University Hospital Center, Montpellier, France
| | - Emmanuel Mignot
- Center for Sleep Sciences and Medicine, Stanford University Medical School, Palo Alto, California
| | - Yves Dauvilliers
- Sleep-Wake Disorders Center, Department of Neurology, Gui-de-Chauliac Hospital, University Hospital Center, Montpellier, France.,National Reference Network for Narcolepsy, Gui-de-Chauliac Hospital, University Hospital Center, Montpellier, France.,Institute for Neurosciences of Montpellier INM, INSERM, University of Montpellier, France
| | - Giuseppe Plazzi
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy.,Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio-Emilia, Modena, Italy
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Coelho J, Lopez R, Richaud A, Buysse DJ, Wallace ML, Philip P, Micoulaud-Franchi JA. Toward a multi-lingual diagnostic tool for the worldwide problem of sleep health: The French RU-SATED validation. J Psychiatr Res 2021; 143:341-349. [PMID: 34563876 DOI: 10.1016/j.jpsychires.2021.09.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 03/02/2021] [Revised: 08/24/2021] [Accepted: 09/01/2021] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Sleep health is "a multidimensional pattern of sleep-wakefulness, adapted to individual, social, and environmental demands, that promotes physical and mental well-being". The RU-SATED is a short practical self-reported symptom scale that is a reliable valid tool for the rapid evaluation of sleep health. This study sought to examine the psychometric validity of the French version. METHODS We conducted an observational cross-sectional study. All professionals working in Bordeaux University Hospital were asked to answer an internet-based questionnaire assessing sleep, mental and physical health outcomes. Sleep health was measured using the French RU-SATED scale obtained by a rigorous reverse translation process. Psychometric validity included factor structure, internal structural validity, concurrent validity and external validity of the measure, with sleep, mental and physical health outcomes. RESULTS A total of 1,562 participants were included with 80.5% of women and a mean age of 40.0 (±11.2). Sleep health was within the average range (M = 8.2, SD = 2.4) on the RU-SATED. Confirmatory factor analyses showed acceptable model fit measures. Cronbach's alpha coefficient was 0.57 and ranged from 0.46 to 0.58 when removing each item. The correlation between items with the overall corrected scores ranged from 0.19 to 0.43. The "Efficiency" item showed poor psychometric properties. Most items were highly correlated with their appropriate sleep outcome. All items showed a strong association with positive mental and physical health outcomes. DISCUSSION The French RU-SATED scale is a reliable valid tool for measuring sleep health in adults. Nevertheless, future studies should better evaluate the reliability and validity of the "Efficiency" item. It is also important to explore how the RU-SATED can be used to evaluate the impact of sleep hygiene strategies in promoting public health in accordance with models of sleep behavior change.
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Affiliation(s)
- Julien Coelho
- Univ. Bordeaux, SANPSY, USR 3413, F-33000, Bordeaux, France; CNRS, SANPSY, USR 3413, F-33000, Bordeaux, France; CHU Bordeaux, Service Universitaire de Médecine Du sommeil, F-33000, Bordeaux, France.
| | - Régis Lopez
- Sleep Disorders Center, Department of Neurology, Gui-de-Chauliac Hospital, CHU Montpellier, France; Inserm, U1061, Université Montpellier 1, Montpellier, France
| | - Alexandre Richaud
- Univ. Bordeaux, SANPSY, USR 3413, F-33000, Bordeaux, France; CNRS, SANPSY, USR 3413, F-33000, Bordeaux, France; CHU Bordeaux, Service Universitaire de Médecine Du sommeil, F-33000, Bordeaux, France
| | - Daniel J Buysse
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Pierre Philip
- Univ. Bordeaux, SANPSY, USR 3413, F-33000, Bordeaux, France; CNRS, SANPSY, USR 3413, F-33000, Bordeaux, France; CHU Bordeaux, Service Universitaire de Médecine Du sommeil, F-33000, Bordeaux, France
| | - Jean-Arthur Micoulaud-Franchi
- Univ. Bordeaux, SANPSY, USR 3413, F-33000, Bordeaux, France; CNRS, SANPSY, USR 3413, F-33000, Bordeaux, France; CHU Bordeaux, Service Universitaire de Médecine Du sommeil, F-33000, Bordeaux, France
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Gauld C, Lopez R, Morin CM, Maquet J, Mcgonigal A, Geoffroy PA, Fakra E, Philip P, Dumas G, Micoulaud-Franchi JA. Why do sleep disorders belong to mental disorder classifications? A network analysis of the "Sleep-Wake Disorders" section of the DSM-5. J Psychiatr Res 2021; 142:153-159. [PMID: 34359009 DOI: 10.1016/j.jpsychires.2021.07.050] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 03/02/2021] [Revised: 07/12/2021] [Accepted: 07/31/2021] [Indexed: 10/20/2022]
Abstract
This article proposes to investigate how Sleep disorders have been conceptualized within the DSM-5 through symptom network analysis of the diagnostic criteria of the "Sleep-Wake Disorders" section in the DSM-5. We hypothesize that the analysis of the most central symptoms will allow us to better analyze the position of Sleep disorders in Mental disorders. We thus i) extracted the symptoms of the DSM-5 diagnostic criteria of Sleep-Wake disorders, ii) built the Sleep-Wake disorder DSM-5 network representation, and iii) quantified its structure at local and global levels using classical symptom network analysis. Thirty-four different symptoms were identified among the 53 DSM-5 diagnostic criteria of the 9 main disorders of the "Sleep-Wake Disorders" section. The symptom network structure of this section showed that the most central sleep symptoms are "Daytime Sleepiness", the Insomnia symptoms group ("Insomnia initiating", "Insomnia maintaining" and "Non-restorative sleep"), and Behavioral sleep symptoms (such as "Altered oniric activity", "Ambulation", "Abnormal responsiveness"). This network analysis shown that the belonging of Sleep-Wake disorders in the DSM-5 have been associated with central sleep symptoms considered as "Mental", given their phenomenality (qualitative nature of the experience) and subjectivity (in personal mental lives). Such a symptom network analysis can serve as an organizing framework to better understand the complexity of Sleep-Wake disorders by promoting research to connect the architecture of the symptom network to relevant biological, psychological and sociocultural factors.
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Affiliation(s)
- Christophe Gauld
- Department of Psychiatry, University of Grenoble, Avenue du Maquis du Grésivaudan, 38 000, Grenoble, France; UMR CNRS 8590 IHPST, Sorbonne University, Paris 1, France
| | - Régis Lopez
- Department of Psychiatry and Addictive Medicine, Assistance Publique-Hôpitaux de Paris (AP-HP), University Hospital Bichat, 46 rue Henri Huchard, 75018, Paris, France; Inserm, U1061, Université Montpellier 1, Montpellier, France
| | - Charles M Morin
- École de psychologie, Université Laval, Québec City, Québec, Canada; Centre d'étude des troubles du sommeil, Institut universitaire en santé mentale de Québec, Quebec City, Canada
| | - Julien Maquet
- Service de Médecine Interne, Centre Hospitalier Universitaire de Toulouse, Toulouse, France; Centre d'investigation clinique 1436, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Aileen Mcgonigal
- Aix Marseille Univ, APHM, INSERM, INS, Inst Neurosci Syst, Timone Hospital, Epileptology Department, Marseille, France
| | - Pierre-Alexis Geoffroy
- Département de psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hopital Bichat - Claude Bernard, F-75018, Paris, France; GHU Paris - Psychiatry & Neurosciences, 1 rue Cabanis, 75014, Paris, France; Université de Paris, NeuroDiderot, Inserm, F-75019, Paris, France; CNRS UPR 3212, Institute for Cellular and Integrative Neurosciences, F-67000, Strasbourg, France
| | - Eric Fakra
- Department of Psychiatry, University Hospital of Saint-Etienne, Saint-Etienne, France; INSERM, U1028, CNRS, UMR5292, Lyon Neuroscience Research Center, Psychiatric disorders: neuroscience Research and clinical Research, PSYR2 Team, Lyon, France
| | - Pierre Philip
- University Sleep Clinic, Services of Functional Exploration of the Nervous System, University Hospital of Bordeaux, Place Amélie Raba-Leon, 33 076, Bordeaux, France; USR CNRS 3413 SANPSY, University Hospital of Bordeaux, 33 076, Bordeaux, France
| | - Guillaume Dumas
- Center for Complex Systems and Brain Sciences, Florida Atlantic University, Boca Raton, FL, 33431, USA; Centre de recherche du Centre Hospitalier Universitaire Sainte-Justine, University of Montreal, Montreal, Quebec, Canada
| | - Jean-Arthur Micoulaud-Franchi
- University Sleep Clinic, Services of Functional Exploration of the Nervous System, University Hospital of Bordeaux, Place Amélie Raba-Leon, 33 076, Bordeaux, France; USR CNRS 3413 SANPSY, University Hospital of Bordeaux, 33 076, Bordeaux, France.
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Lopez R, Snair M, Arrigain S, Schold JD, Hustey F, Walker LE, Phelan MP. Sex-based differences in timely emergency department evaluations for patients with drug poisoning. Public Health 2021; 199:57-64. [PMID: 34560476 DOI: 10.1016/j.puhe.2021.08.011] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 07/21/2021] [Accepted: 08/12/2021] [Indexed: 11/18/2022]
Abstract
OBJECTIVES Unintentional poisoning was the leading cause of injury-related death in the United States in 2017. Prescribed and illicit drugs are the most common cause of poisoning, and timely management in the emergency department (ED) is important. Our aim was to identify any disparities in wait times associated with sex for drug poisoning-related ED visits. STUDY DESIGN We examined ED visits using data from the 2009-2017 National Hospital Ambulatory Medical Care Survey (NHAMCS). METHODS Drug poisoning-related visits were identified using the International Classification of Diseases, Ninth or Tenth Revision, Clinical Modification codes. Delayed assessment was defined as wait times exceeding the recommended triage time. Weighted logistic regression was used. RESULTS The average age was 36 years (standard error = 1.1), 54% female, 87% White and 29% had delayed assessment. Most common drugs were psychotropics (45%) and opioids (32%). Adjusting for race, payment source, urgency, multiple drug types and NSAIDs, females who had poisoning by substances other than opioids had 2.1 times higher likelihood of having a delayed assessment compared with males (odds ratio [95% confidence interval]: 2.1 [1.03-4.2]), although there was no difference between sexes among visits with opioid poisoning (P = 0.27). Neither race (P = 0.23) nor payment source (P = 0.22) were associated with delayed assessment, and the sex association was consistent across these groups. CONCLUSIONS Females with non-opioid drug poisoning were more likely to have delayed assessment than men. None of the other demographic factors demonstrated a correlation. Identifying more populations vulnerable to delays in the ED can help guide the development of interventions and policies to expedite care and attenuate existing disparities.
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Affiliation(s)
- R Lopez
- Center for Populations Health Research, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA; Department of Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA.
| | - M Snair
- Center for Populations Health Research, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA; Department of Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
| | - S Arrigain
- Center for Populations Health Research, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA; Department of Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
| | - J D Schold
- Center for Populations Health Research, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA; Department of Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
| | - F Hustey
- Center for Emergency Medicine, Emergency Services Institute, Cleveland Clinic, Cleveland, OH, USA
| | - L E Walker
- Department of Emergency Medicine, Mayo Clinic, Rochester, MN, USA
| | - M P Phelan
- Center for Populations Health Research, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA; Center for Emergency Medicine, Emergency Services Institute, Cleveland Clinic, Cleveland, OH, USA
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Prevost A, Cavallier Z, Alshehri S, Delanoe F, Lauwers F, Lopez R. The external jugular vein axis: a new anatomical landmark for pre-operative prediction of the location of parotid gland tumours. Int J Oral Maxillofac Surg 2021; 51:481-486. [PMID: 34474953 DOI: 10.1016/j.ijom.2021.08.016] [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: 03/05/2021] [Revised: 06/16/2021] [Accepted: 08/11/2021] [Indexed: 11/28/2022]
Abstract
The relationships between parotid tumours and the facial nerve determine duration of surgical procedure and risks involved. As the division of the facial nerve is not visible using standard imaging techniques, other anatomical landmarks are used to determine the pre-operative location of tumours. This retrospective study aimed to evaluate reliability of the 'external jugular vein axis' compared with other landmarks generally used in imaging, such as the retromandibular vein, Conn's arc, the facial nerve line and the Utrecht line. Forty-eight pre-operative imaging exams of patients who underwent parotid benign tumour surgery between 2010 and 2016 were examined. We determined the location of tumour using the five markers. A pre-operative simulation was compared with the description given by the surgeon intraoperatively, in terms of sensitivity and specificity for each marker. External jugular vein axis and retromandibular vein are the most sensitive markers for locating suprafacial tumours (Se = 1). External jugular vein axis and Conn's arc are the most specific markers for locating suprafacial tumours (Spe = 0.92). External jugular vein axis is reproducible and present on all radiological sections, thereby overcoming any anatomical and nomenclature variations. This landmark appears to be the most representative marker of the dividing branches of the facial nerve.
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Affiliation(s)
- A Prevost
- Plastic and Maxillo-facial Surgery Department, University Hospital Center of Toulouse, Toulouse, France.
| | - Z Cavallier
- Plastic and Maxillo-facial Surgery Department, University Hospital Center of Toulouse, Toulouse, France
| | - S Alshehri
- Otolaryngology, Head & Neck Surgery, King Khalid University, Kingdom of Saudi Arabia
| | - F Delanoe
- Plastic and Maxillo-facial Surgery Department, University Hospital Center of Toulouse, Toulouse, France
| | - F Lauwers
- Plastic and Maxillo-facial Surgery Department, University Hospital Center of Toulouse, Toulouse, France
| | - R Lopez
- Anatomy Laboratory, Paul Sabatier-Toulouse III University, Toulouse, France
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Evangelista E, Rassu AL, Lopez R, Biagioli N, Chenini S, Barateau L, Jaussent I, Dauvilliers Y. Sleep inertia measurement with the psychomotor vigilance task in idiopathic hypersomnia. Sleep 2021; 45:6358036. [PMID: 34436617 DOI: 10.1093/sleep/zsab220] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 07/29/2021] [Indexed: 12/31/2022] Open
Abstract
STUDY OBJECTIVES Sleep inertia is a frequent and disabling symptom in idiopathic hypersomnia (IH), but poorly defined and without objective measures. The study objective was to determine whether the psychomotor vigilance task (PVT) can reliably measure sleep inertia in patients with IH or other sleep disorders (non-IH). METHODS Sixty-two (51 women, mean age: 27.7±9.2) patients with IH and 140 (71 women, age: 33.3±12.1) with non-IH (narcolepsy=29, non-specified hypersomnolence NSH=47, obstructive sleep apnea=39, insomnia=25) were included. Sleep inertia and sleep drunkenness in the last month (M-sleep inertia) and on PVT day (D-sleep inertia) were assessed with three items of the Idiopathic Hypersomnia Severity Scale (IHSS), in drug-free conditions. The PVT was performed four times (7:00 PM, and 7:00, 7:30 and 11:00 AM) and three metrics were used: lapses, mean 1/Reaction Time (RT), slowest 10% 1/RT. RESULTS Sleep inertia was more frequent in patients with IH than non-IH (56.5% and 43.6% with severe sleep inertia in the past month, including 24% and 12% with sleep drunkenness). Lapse number increase and slowest 10% 1/RT decrease, particularly at 7:00 and 7:30AM, were proportional with M-sleep inertia severity, but regardless of sleep drunkenness and sleep disorders. Similar results were obtained when PVT results were compared in patients with/without D-sleep inertia, with the largest increase of the lapse number at 7:00 and 7:30AM associated with severe sleep inertia and sleep drunkenness. CONCLUSION PVT is a reliable and objective measure of sleep inertia that might be useful for its characterization, management and follow-up in patients with IH.
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Affiliation(s)
- Elisa Evangelista
- National Reference Centre for Orphan Diseases Narcolepsy Rare Hypersomnias, Sleep Unit, Department of Neurology, CHU Montpellier, Univ Montpellier, Montpellier, France.,Institute for Neurosciences of Montpellier INM, Univ Montpellier, INSERM, Montpellier, France
| | - Anna Laura Rassu
- National Reference Centre for Orphan Diseases Narcolepsy Rare Hypersomnias, Sleep Unit, Department of Neurology, CHU Montpellier, Univ Montpellier, Montpellier, France
| | - Régis Lopez
- National Reference Centre for Orphan Diseases Narcolepsy Rare Hypersomnias, Sleep Unit, Department of Neurology, CHU Montpellier, Univ Montpellier, Montpellier, France.,Institute for Neurosciences of Montpellier INM, Univ Montpellier, INSERM, Montpellier, France
| | - Niccolò Biagioli
- National Reference Centre for Orphan Diseases Narcolepsy Rare Hypersomnias, Sleep Unit, Department of Neurology, CHU Montpellier, Univ Montpellier, Montpellier, France
| | - Sofiène Chenini
- National Reference Centre for Orphan Diseases Narcolepsy Rare Hypersomnias, Sleep Unit, Department of Neurology, CHU Montpellier, Univ Montpellier, Montpellier, France
| | - Lucie Barateau
- National Reference Centre for Orphan Diseases Narcolepsy Rare Hypersomnias, Sleep Unit, Department of Neurology, CHU Montpellier, Univ Montpellier, Montpellier, France.,Institute for Neurosciences of Montpellier INM, Univ Montpellier, INSERM, Montpellier, France
| | - Isabelle Jaussent
- Institute for Neurosciences of Montpellier INM, Univ Montpellier, INSERM, Montpellier, France
| | - Yves Dauvilliers
- National Reference Centre for Orphan Diseases Narcolepsy Rare Hypersomnias, Sleep Unit, Department of Neurology, CHU Montpellier, Univ Montpellier, Montpellier, France.,Institute for Neurosciences of Montpellier INM, Univ Montpellier, INSERM, Montpellier, France
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Gauld C, Lopez R, Geoffroy PA, Morin CM, Guichard K, Giroux É, Dauvilliers Y, Dumas G, Philip P, Micoulaud-Franchi JA. A systematic analysis of ICSD-3 diagnostic criteria and proposal for further structured iteration. Sleep Med Rev 2021; 58:101439. [DOI: 10.1016/j.smrv.2021.101439] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 11/11/2020] [Accepted: 11/11/2020] [Indexed: 12/21/2022]
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Gauld C, Lopez R, Morin C, Geoffroy PA, Maquet J, Desvergnes P, McGonigal A, Dauvilliers Y, Philip P, Dumas G, Micoulaud-Franchi JA. Symptom network analysis of the sleep disorders diagnostic criteria based on the clinical text of the ICSD-3. J Sleep Res 2021; 31:e13435. [PMID: 34269498 DOI: 10.1111/jsr.13435] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 06/08/2021] [Accepted: 06/24/2021] [Indexed: 01/04/2023]
Abstract
The third edition of the International Classification of Sleep Disorders (ICSD-3) is the authoritative clinical text for the diagnosis of sleep disorders. An important issue of sleep nosology is to better understand the relationship between symptoms found in conventional diagnostic manuals and to compare classifications. Nevertheless, to our knowledge, there is no specific exhaustive work on the general structure of the networks of symptoms of sleep disorders as described in diagnostic manuals. The general aim of the present study was to use symptom network analysis to explore the diagnostic criteria in the ICSD-3 manual. The ICSD-3 diagnostic criteria related to clinical manifestations were systematically identified, and the units of analysis (symptoms) were labelled from these clinical manifestation diagnostic criteria using three rules ("Conservation", "Splitting", "Lumping"). A total of 37 of the 43 main sleep disorders with 160 units of analysis from 114 clinical manifestations in the ICSD-3 were analysed. A symptom network representing all individual ICSD-3 criteria and connections between them was constructed graphically (network estimation), quantified with classical metrics (network inference with global and local measures) and tested for robustness. The global measure of the sleep symptoms network shows that it can be considered as a small world, suggesting a strong interconnection between symptoms in the ICSD-3. Local measures show the central role of three kinds of bridge sleep symptoms: daytime sleepiness, insomnia, and behaviour during sleep symptoms. Such a symptom network analysis of the ICSD-3 structure could provide a framework for better systematising and organising symptomatology in sleep medicine.
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Affiliation(s)
- Christophe Gauld
- Department of Psychiatry, University of Grenoble, Grenoble, France.,UMR CNRS 8590 IHPST, Sorbonne University, Paris 1, France
| | - Régis Lopez
- Department of Neurology, Sleep Disorders Center, Gui-de-Chauliac Hospital, CHU Montpellier, Montpellier, France.,Inserm, Université Montpellier 1, Montpellier, U1061, France
| | - Charles Morin
- École de psychologie, Université Laval, Québec City, Québec, Canada.,Centre d'étude des troubles du sommeil, Institut Universitaire en Santé Mentale de Québec, Quebec City, Canada
| | - Pierre A Geoffroy
- Département de Psychiatrie et d'Addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hospital Bichat - Claude Bernard, Paris, France.,GHU Paris - Psychiatry and Neurosciences, Paris, France.,NeuroDiderot, Université de Paris, Paris, Inserm, France.,CNRS UPR 3212, Institute for Cellular and Integrative Neurosciences, Strasbourg, France
| | - Julien Maquet
- Service de Médecine Interne, Centre Hospitalier Universitaire de Toulouse, Toulouse, France.,Centre d'investigation clinique 1436, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Pierre Desvergnes
- University Sleep Clinic, Services of Functional Exploration of the Nervous System, University Hospital of Bordeaux, Bordeaux, France
| | - Aileen McGonigal
- Epileptology Department, APHM, INSERM, INS, Inst Neurosci Syst, Timone Hospital, Aix Marseille University, Marseille, France
| | - Yves Dauvilliers
- Department of Neurology, Sleep Disorders Center, Gui-de-Chauliac Hospital, CHU Montpellier, Montpellier, France.,Inserm, Université Montpellier 1, Montpellier, U1061, France
| | - Pierre Philip
- University Sleep Clinic, Services of Functional Exploration of the Nervous System, University Hospital of Bordeaux, Bordeaux, France.,USR CNRS 3413 SANPSY, University Hospital of Bordeaux, Bordeaux, France
| | - Guillaume Dumas
- Center for Complex Systems and Brain Sciences, Florida Atlantic University, Boca Raton, Florida, USA.,Centre de recherche du Centre Hospitalier Universitaire Sainte-Justine, University of Montreal, Montreal, QC, Canada
| | - Jean-Arthur Micoulaud-Franchi
- University Sleep Clinic, Services of Functional Exploration of the Nervous System, University Hospital of Bordeaux, Bordeaux, France.,USR CNRS 3413 SANPSY, University Hospital of Bordeaux, Bordeaux, France
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Arrighi E, Ruiz de Castilla EM, Peres F, Mejía R, Sørensen K, Gunther C, Lopez R, Myers L, Quijada JG, Vichnin M, Pleasant A. Scoping health literacy in Latin America. Glob Health Promot 2021; 29:78-87. [PMID: 34169760 PMCID: PMC9203673 DOI: 10.1177/17579759211016802] [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] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Studies evaluating the influence of health literacy on patient behavior and outcomes suggest a positive relationship between health literacy and health knowledge, health behaviors, and health status. In Latin American countries, studies assessing health literacy are few, regional, and demonstrate considerable variation, with reported rates of adequate health literacy ranging from 5.0% to 73.3%. In this paper, we examine and explore the state of health literacy and efforts to promote it in Latin America. Key challenges to those efforts include socioeconomic inequality, social/geographic isolation, and cultural-, language-, and policy-related barriers, many of which disproportionately affect indigenous populations and others living in rural areas. Greater use of infographics, videos, and mobile apps may enhance health literacy and patient empowerment, especially when language barriers exist. This paper provides strategies and tools for tailored programming, examples of successful health literacy interventions, and policy recommendations to improve health literacy in Latin America, intending to spur additional discussion and action. Centrally organized collaboration across multiple sectors of society, with community involvement, will enhance health literacy and improve health and well-being across Latin America.
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Affiliation(s)
- E Arrighi
- Escuela de Pacientes, Buenos Aires, Argentina
| | | | - F Peres
- Sergio Arouca National School of Public Health, Rio de Janeiro, Brazil
| | - R Mejía
- Centro de Estudios de Estado y Sociedad, Buenos Aires, Argentina
| | - K Sørensen
- Global Health Literacy Academy, Risskov, Denmark
| | | | - R Lopez
- Merck & Co., Inc., Kenilworth, USA
| | - L Myers
- Merck & Co., Inc., Kenilworth, USA
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Palagini L, Manni R, Aguglia E, Amore M, Brugnoli R, Bioulac S, Bourgin P, Micoulaud Franchi JA, Girardi P, Grassi L, Lopez R, Mencacci C, Plazzi G, Maruani J, Minervino A, Philip P, Royant Parola S, Poirot I, Nobili L, Biggio G, Schroder CM, Geoffroy PA. International Expert Opinions and Recommendations on the Use of Melatonin in the Treatment of Insomnia and Circadian Sleep Disturbances in Adult Neuropsychiatric Disorders. Front Psychiatry 2021; 12:688890. [PMID: 34177671 PMCID: PMC8222620 DOI: 10.3389/fpsyt.2021.688890] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [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: 03/31/2021] [Accepted: 04/29/2021] [Indexed: 12/14/2022] Open
Abstract
Introduction: Insomnia and circadian rhythm disorders, such as the delayed sleep phase syndrome, are frequent in psychiatric disorders and their evaluation and management in early stages should be a priority. The aim of this paper was to express recommendations on the use of exogenous melatonin, which exhibits both chronobiotic and sleep-promoting actions, for the treatment of these sleep disturbances in psychiatric disorders. Methods: To this aim, we conducted a systematic review according to PRISMA on the use of melatonin for the treatment of insomnia and circadian sleep disorders in neuropsychiatry. We expressed recommendations for the use of melatonin in psychiatric clinical practice for each disorder using the RAND/UCLA appropriateness method. Results: We selected 41 studies, which included mood disorders, schizophrenia, substance use disorders, attention deficit hyperactivity disorders, autism spectrum disorders, neurocognitive disorders, and delirium; no studies were found for both anxiety and eating disorders. Conclusion: The administration of prolonged release melatonin at 2-10 mg, 1-2 h before bedtime, might be used in the treatment of insomnia symptoms or comorbid insomnia in mood disorders, schizophrenia, in adults with autism spectrum disorders, neurocognitive disorders and during sedative-hypnotics discontinuation. Immediate release melatonin at <1 mg might be useful in the treatment of circadian sleep disturbances of neuropsychiatric disorders.
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Affiliation(s)
- Laura Palagini
- Psychiatry Division, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Raffaele Manni
- Unit of Sleep Medicine and Epilepsy, Istituto di Ricovero e Cura a Carattere Scientifico Mondino Foundation, Pavia, Italy
| | - Eugenio Aguglia
- Department of Experimental and Clinical Medicine, Psychiatric Clinic University Hospital “Gaspare Rodolico”, University of Catania, Catania, Italy
| | - Mario Amore
- Section of Psychiatry, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy
- Istituto di Ricovero e Cura a Carattere Scientifico Ospedale Policlinico San Martino, Genoa, Italy
| | - Roberto Brugnoli
- Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sant'Andrea University Hospital, Sapienza University, Rome, Italy
| | - Stéphanie Bioulac
- University Sleep Clinic, Services of Functional Exploration of the Nervous System, University Hospital of Bordeaux, and USR CNRS 3413 SANPSY, University Hospital Pellegrin, University of Bordeaux, Bordeaux, France
| | - Patrice Bourgin
- Institut des Neurosciences Cellulaires et Intégratives, CNRS-UPR 3212, Strasbourg, France
- Centre des troubles du sommeil - CIRCSom, Strasbourg University Hospitals, Strasbourg, France
| | - Jean-Arthur Micoulaud Franchi
- University Sleep Clinic, Services of Functional Exploration of the Nervous System, University Hospital of Bordeaux, and USR CNRS 3413 SANPSY, University Hospital Pellegrin, University of Bordeaux, Bordeaux, France
| | - Paolo Girardi
- Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sant'Andrea University Hospital, Sapienza University, Rome, Italy
| | - Luigi Grassi
- Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - Régis Lopez
- Service de Neurologie, Centre National de Référence Narcolepsie Hypersomnies, Unité des Troubles du Sommeil, Hôpital Gui-de-Chauliac Montpellier, Montpellier, France
- PSNREC, Univ Montpellier, INSERM, Montpellier, France
| | - Claudio Mencacci
- Department of Neuroscience, Aziende Socio Sanitarie Territoriali Fatebenefratelli Sacco, Milan, Italy
| | - Giuseppe Plazzi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
- Istituto di Ricovero e Cura a Carattere Scientifico, Institute of Neurological Sciences of Bologna, Bologna, Italy
| | - Julia Maruani
- Département de psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hopital Bichat - Claude Bernard, Paris, France
| | - Antonino Minervino
- Department of Psychiatry, Italian Society of Psychosomatic Medicine (SIMP), Parma, Italy
| | - Pierre Philip
- University Sleep Clinic, Services of Functional Exploration of the Nervous System, University Hospital of Bordeaux, and USR CNRS 3413 SANPSY, University Hospital Pellegrin, University of Bordeaux, Bordeaux, France
| | | | - Isabelle Poirot
- Service de psychiatrie adulte, Hôpital Fontan, CHU de Lille, Lille, France
| | - Lino Nobili
- Department of Neuroscience (DINOGMI), University of Genoa, Genoa, Italy
- Istituto di Ricovero e Cura a Carattere Scientifico, Child Neuropsychiatry Unit, Giannina Gaslini Institute, Genoa, Italy
| | - Giovanni Biggio
- Department of Life and Environmental Sciences, Institute of Neuroscience, CNR, University of Cagliari, Cagliari, Italy
| | - Carmen M. Schroder
- Institut des Neurosciences Cellulaires et Intégratives, CNRS-UPR 3212, Strasbourg, France
- Department of Child and Adolescent Psychiatry, Strasbourg University Hospitals, Strasbourg, France
| | - Pierre A. Geoffroy
- Département de psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hopital Bichat - Claude Bernard, Paris, France
- GHU Paris - Psychiatry & Neurosciences, Paris, France
- CNRS UPR 3212, Institute for Cellular and Integrative Neurosciences, Strasbourg, France
- Université de Paris, NeuroDiderot, Inserm, Paris, France
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Barateau L, Lecendreux M, Chenini S, Rassu AL, Lopez R, Pesenti C, Jaussent I, Béziat S, Dauvilliers Y. Measurement of Narcolepsy Symptoms in School-Aged Children and Adolescents: The Pediatric Narcolepsy Severity Scale. Neurology 2021; 97:e476-e488. [PMID: 34031200 DOI: 10.1212/wnl.0000000000012272] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 04/23/2021] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE We validated the Narcolepsy Severity Scale (NSS) in adults with narcolepsy type 1 (NT1) to quantify the severity, frequency, and consequences of the 5 key narcolepsy symptoms over the last month, and we now developed the Pediatric NSS (NSS-P); thus, the aims of this study were to assess NSS-P psychometric properties, validity, and reliability, and to evaluate its responsiveness to treatment in a well-characterized sample of children and adolescents with NT1. METHODS The NSS was reformulated for children, and the item about driving was removed. The total score of the 14-item NSS-P ranges from 0 to 54, and higher scores reflect more severe disease. Children and adolescents (n = 209, 6-17 years of age) with NT1 diagnosed in 2 Reference Centers for Narcolepsy in France were consecutively asked to fill in the NSS-P. The scale was fully and correctly completed by 160 (10-18 years of age, 68 untreated). Moreover, 65 participants completed it twice (33 before/during treatment, and 32 under the same treatment). The NSS-P psychometric properties, score changes before/during treatment, and convergent validity with other clinical parameters were assessed. RESULTS The NSS-P showed adequate psychometric properties with significant item-total score correlations. Factor analysis indicated a 4-factor solution with good reliability. The NSS-P score was lower in treated than untreated patients with a mean difference of 3.71 ± 1.45, with a minimum clinically important difference between untreated and treated patients in the longitudinal sample estimated at 4 points. Four severity levels were defined (mild, moderate, severe, very severe) with between-group differences related to treatment. The NSS-P total score was associated with self-reported sleepiness, insomnia, and depressive symptoms. Its temporal stability was satisfactory. DISCUSSION We validated a brief instrument to assess NT1 symptom frequency, severity, and consequences in ≥10-year-old children and adolescents with 4 clinically relevant severity score ranges. This scale constitutes a relevant tool to improve and provide guidance for NT1 management in pediatric populations. The ease of administration, its good psychometric properties, and its sensitivity to detect symptom changes after treatment ensure future use of the NSS-P in clinical and research settings.
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Affiliation(s)
- Lucie Barateau
- From the Sleep-Wake Disorders Unit (L.B., S.C., A.L.R., R.L., Y.D.), Department of Neurology, Gui-de-Chauliac Hospital; National Reference Centre for Orphan Diseases, Narcolepsy, Idiopathic Hypersomnia, and Kleine-Levin Syndrome (L.B., S.C., A.L.R., R.L., C.P., Y.D.); INM (L.B., R.L., I.J., S.B., Y.D.), Université de Montpellier; Pediatric Sleep Centre (M.L.), Hospital Robert-Debré; and National Reference Centre for Orphan Diseases, Narcolepsy, Idiopathic Hypersomnia, and Kleine-Levin Syndrome (M.L.), Paris, France.
| | - Michel Lecendreux
- From the Sleep-Wake Disorders Unit (L.B., S.C., A.L.R., R.L., Y.D.), Department of Neurology, Gui-de-Chauliac Hospital; National Reference Centre for Orphan Diseases, Narcolepsy, Idiopathic Hypersomnia, and Kleine-Levin Syndrome (L.B., S.C., A.L.R., R.L., C.P., Y.D.); INM (L.B., R.L., I.J., S.B., Y.D.), Université de Montpellier; Pediatric Sleep Centre (M.L.), Hospital Robert-Debré; and National Reference Centre for Orphan Diseases, Narcolepsy, Idiopathic Hypersomnia, and Kleine-Levin Syndrome (M.L.), Paris, France
| | - Sofiene Chenini
- From the Sleep-Wake Disorders Unit (L.B., S.C., A.L.R., R.L., Y.D.), Department of Neurology, Gui-de-Chauliac Hospital; National Reference Centre for Orphan Diseases, Narcolepsy, Idiopathic Hypersomnia, and Kleine-Levin Syndrome (L.B., S.C., A.L.R., R.L., C.P., Y.D.); INM (L.B., R.L., I.J., S.B., Y.D.), Université de Montpellier; Pediatric Sleep Centre (M.L.), Hospital Robert-Debré; and National Reference Centre for Orphan Diseases, Narcolepsy, Idiopathic Hypersomnia, and Kleine-Levin Syndrome (M.L.), Paris, France
| | - Anna Laura Rassu
- From the Sleep-Wake Disorders Unit (L.B., S.C., A.L.R., R.L., Y.D.), Department of Neurology, Gui-de-Chauliac Hospital; National Reference Centre for Orphan Diseases, Narcolepsy, Idiopathic Hypersomnia, and Kleine-Levin Syndrome (L.B., S.C., A.L.R., R.L., C.P., Y.D.); INM (L.B., R.L., I.J., S.B., Y.D.), Université de Montpellier; Pediatric Sleep Centre (M.L.), Hospital Robert-Debré; and National Reference Centre for Orphan Diseases, Narcolepsy, Idiopathic Hypersomnia, and Kleine-Levin Syndrome (M.L.), Paris, France
| | - Régis Lopez
- From the Sleep-Wake Disorders Unit (L.B., S.C., A.L.R., R.L., Y.D.), Department of Neurology, Gui-de-Chauliac Hospital; National Reference Centre for Orphan Diseases, Narcolepsy, Idiopathic Hypersomnia, and Kleine-Levin Syndrome (L.B., S.C., A.L.R., R.L., C.P., Y.D.); INM (L.B., R.L., I.J., S.B., Y.D.), Université de Montpellier; Pediatric Sleep Centre (M.L.), Hospital Robert-Debré; and National Reference Centre for Orphan Diseases, Narcolepsy, Idiopathic Hypersomnia, and Kleine-Levin Syndrome (M.L.), Paris, France
| | - Carole Pesenti
- From the Sleep-Wake Disorders Unit (L.B., S.C., A.L.R., R.L., Y.D.), Department of Neurology, Gui-de-Chauliac Hospital; National Reference Centre for Orphan Diseases, Narcolepsy, Idiopathic Hypersomnia, and Kleine-Levin Syndrome (L.B., S.C., A.L.R., R.L., C.P., Y.D.); INM (L.B., R.L., I.J., S.B., Y.D.), Université de Montpellier; Pediatric Sleep Centre (M.L.), Hospital Robert-Debré; and National Reference Centre for Orphan Diseases, Narcolepsy, Idiopathic Hypersomnia, and Kleine-Levin Syndrome (M.L.), Paris, France
| | - Isabelle Jaussent
- From the Sleep-Wake Disorders Unit (L.B., S.C., A.L.R., R.L., Y.D.), Department of Neurology, Gui-de-Chauliac Hospital; National Reference Centre for Orphan Diseases, Narcolepsy, Idiopathic Hypersomnia, and Kleine-Levin Syndrome (L.B., S.C., A.L.R., R.L., C.P., Y.D.); INM (L.B., R.L., I.J., S.B., Y.D.), Université de Montpellier; Pediatric Sleep Centre (M.L.), Hospital Robert-Debré; and National Reference Centre for Orphan Diseases, Narcolepsy, Idiopathic Hypersomnia, and Kleine-Levin Syndrome (M.L.), Paris, France
| | - Séverine Béziat
- From the Sleep-Wake Disorders Unit (L.B., S.C., A.L.R., R.L., Y.D.), Department of Neurology, Gui-de-Chauliac Hospital; National Reference Centre for Orphan Diseases, Narcolepsy, Idiopathic Hypersomnia, and Kleine-Levin Syndrome (L.B., S.C., A.L.R., R.L., C.P., Y.D.); INM (L.B., R.L., I.J., S.B., Y.D.), Université de Montpellier; Pediatric Sleep Centre (M.L.), Hospital Robert-Debré; and National Reference Centre for Orphan Diseases, Narcolepsy, Idiopathic Hypersomnia, and Kleine-Levin Syndrome (M.L.), Paris, France
| | - Yves Dauvilliers
- From the Sleep-Wake Disorders Unit (L.B., S.C., A.L.R., R.L., Y.D.), Department of Neurology, Gui-de-Chauliac Hospital; National Reference Centre for Orphan Diseases, Narcolepsy, Idiopathic Hypersomnia, and Kleine-Levin Syndrome (L.B., S.C., A.L.R., R.L., C.P., Y.D.); INM (L.B., R.L., I.J., S.B., Y.D.), Université de Montpellier; Pediatric Sleep Centre (M.L.), Hospital Robert-Debré; and National Reference Centre for Orphan Diseases, Narcolepsy, Idiopathic Hypersomnia, and Kleine-Levin Syndrome (M.L.), Paris, France.
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Evangelista E, Rassu AL, Barateau L, Lopez R, Chenini S, Jaussent I, Dauvilliers Y. Characteristics associated with hypersomnia and excessive daytime sleepiness identified by extended polysomnography recording. Sleep 2021; 44:6010320. [PMID: 33249509 DOI: 10.1093/sleep/zsaa264] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 10/19/2020] [Indexed: 12/20/2022] Open
Abstract
STUDY OBJECTIVES Hypersomnolence, defined by excessive daytime sleepiness (EDS) or excessive quantity of sleep (EQS), has been associated with increased morbidity. The aim of this study was to determine the clinical and polysomnographic characteristics associated with EQS and EDS assessed objectively during extended polysomnography recording. METHODS A total of 266 drug-free subjects (201 women; mean age: 26.5 years [16.08; 60.87]) underwent 32-h bed-rest polysomnography recording preceded by polysomnography and modified multiple sleep latency test (mMSLT). Participants were categorized according to their total sleep time (bed-rest TST ≥19 h, hypersomnia), objective EDS (mean sleep latency on MSLT ≤8 min), and self-reported EDS (Epworth sleepiness scale score >10) and EQS (≥9 h/24 h per week). RESULTS Subjects with hypersomnia were often younger, with normal sleep architecture, high nighttime sleep efficiency, and severe objective EDS. No association with sex, body mass index, Epworth sleepiness scale, EQS, and depressive symptoms was detected. Subjects with objective EDS had less EQS, higher sleep efficiency, and increased hypersomnia. Discrepancies were observed between objective and self-reported measures of sleep duration and EDS. Finally, 71 subjects were identified who had objective hypersomnia and/or EDS, no medical and psychiatric conditions and normal polysomnography parameters, and therefore met the stringent criteria of idiopathic hypersomnia, an orphan disorder. CONCLUSIONS Sleep duration and EDS should be quantified using self-reported and objective measures in a controlled procedure to differentiate long sleepers, patients with hypersomnia, and patients with idiopathic hypersomnia. This will help to better understand their biology, to identify specific biomarkers, and to assess related health outcomes.
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Affiliation(s)
- Elisa Evangelista
- Sleep Disorder Unit, Narcolepsy and Hypersomnia National Reference Center, Neurology Department, Gui-de-Chauliac Hospital, University Montpellier, France.,Institute for Neurosciences of Montpellier INM, University Montpellier, INSERM, Montpellier, France
| | - Anna Laura Rassu
- Sleep Disorder Unit, Narcolepsy and Hypersomnia National Reference Center, Neurology Department, Gui-de-Chauliac Hospital, University Montpellier, France
| | - Lucie Barateau
- Sleep Disorder Unit, Narcolepsy and Hypersomnia National Reference Center, Neurology Department, Gui-de-Chauliac Hospital, University Montpellier, France.,Institute for Neurosciences of Montpellier INM, University Montpellier, INSERM, Montpellier, France
| | - Régis Lopez
- Sleep Disorder Unit, Narcolepsy and Hypersomnia National Reference Center, Neurology Department, Gui-de-Chauliac Hospital, University Montpellier, France.,Institute for Neurosciences of Montpellier INM, University Montpellier, INSERM, Montpellier, France
| | - Sofiène Chenini
- Sleep Disorder Unit, Narcolepsy and Hypersomnia National Reference Center, Neurology Department, Gui-de-Chauliac Hospital, University Montpellier, France
| | - Isabelle Jaussent
- Institute for Neurosciences of Montpellier INM, University Montpellier, INSERM, Montpellier, France
| | - Yves Dauvilliers
- Sleep Disorder Unit, Narcolepsy and Hypersomnia National Reference Center, Neurology Department, Gui-de-Chauliac Hospital, University Montpellier, France.,Institute for Neurosciences of Montpellier INM, University Montpellier, INSERM, Montpellier, France
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Gallego Valle J, Gil Manso S, Bernaldo de Quiros E, Lopez R, Martinez-Bonet M, Pita A, Pérez-Caballero R, Pardo C, Gil-Jaurena J, Correa-Rocha R, Pion M. TGF-ß1 and IL-2 cytokines do not induce fully functional and stable regulatory T cells from activated thymocytes ex vivo. Cytotherapy 2021. [DOI: 10.1016/s1465324921004370] [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: 11/17/2022]
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Bernal O, Lopez R, Montoro E, Avedillo P, Westby K, Ghidinelli M. Introduction and scaling up of new drugs for drug-resistant TB: experiences from the Americas. Int J Tuberc Lung Dis 2021; 24:1058-1062. [PMID: 33126939 DOI: 10.5588/ijtld.20.0111] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
The number of multidrug-resistant tuberculosis (MDR-TB) cases reported in the Americas has increased by 21.2%, from 3737 in 2016 to 4791 in 2018. The WHO has been recommending changes on the treatment of DR-TB, moving from long-duration treatment with injectables to a short oral regimen with new drugs such as bedaquiline (BDQ) and delamanid (DLM), in selected cases and only under programmatic conditions. Injectables are no longer recommended by the WHO due to lower efficacy and the increasing seriousness of adverse events. The introduction of new oral drugs for DR-TB received a boost with a global donation of BDQ to some eligible countries, which continues with the countries purchasing drugs through the Pan American Health Organization Strategic Fund. The main challenges in the scaling up of new drugs for DR-TB include low DR-TB detection rate, the slow pace in transitioning to molecular testing and delays in the introduction of new oral short regimens for MDR-TB. The Americas need to accelerate the scale up of new oral treatments, improve detection rates, increase molecular diagnosis of resistance, and ensure the registration and introduction of the shorter treatment regimen in national MDR-TB guidelines.
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Affiliation(s)
- O Bernal
- Communicable Diseases and Environmental Determinants of Health Department, Pan American Health Organization, Washington DC, USA
| | - R Lopez
- Communicable Diseases and Environmental Determinants of Health Department, Pan American Health Organization, Washington DC, USA
| | - E Montoro
- Communicable Diseases and Environmental Determinants of Health Department, Pan American Health Organization, Washington DC, USA
| | - P Avedillo
- Communicable Diseases and Environmental Determinants of Health Department, Pan American Health Organization, Washington DC, USA
| | - K Westby
- Communicable Diseases and Environmental Determinants of Health Department, Pan American Health Organization, Washington DC, USA
| | - M Ghidinelli
- Communicable Diseases and Environmental Determinants of Health Department, Pan American Health Organization, Washington DC, USA
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Lopez R, Chenini S, Barateau L, Rassu AL, Evangelista E, Abril B, Fanielle J, Vitello N, Jaussent I, Dauvilliers Y. Sleep-related head jerks: toward a new movement disorder. Sleep 2021; 44:5899039. [PMID: 32860690 DOI: 10.1093/sleep/zsaa165] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 05/10/2020] [Revised: 07/30/2020] [Indexed: 11/14/2022] Open
Abstract
STUDY OBJECTIVES Sleep-related head jerks (SRHJ) are often considered as a physiological motor phenomenon, occurring mainly during rapid eye movement (REM) sleep. Their clinical relevance and links with other sleep parameters are unclear. We characterized the clinical and polysomnographic features of patients with excessive SRHJ and compare them with healthy controls and patients with isolated REM sleep behavior disorder (iRBD). METHODS A total of 30 patients (19 males, 27.5 y.o., 16.0-51.0) with a REM-HJ index >30/h were identified over a period of 5 years. All had a video-polysomnographic (PSG) recording to characterize the SRHJ, to assess associations with other sleep parameters and to quantify phasic and tonic electromyographic activity during REM sleep, compared with 30 healthy controls and 30 patients with iRBD. RESULTS Five among the 30 patients had a primary complaint of involuntary nighttime head movements associated with sleepiness or non-restorative sleep. The mean REM-HJ index was 57.22/h ± 24.42, a nonperiodic pattern, stable across the sleep cycles, and with a low between-test variability (for the nine patients with two PSG assessments in untreated condition). REM-HJs were often associated with arousals (65.2%) and leg movements (38.1%) and less with respiratory events (9.6%), without association with increased phasic and tonic electromyographic activities. SRHJ were also found in 36.7% of controls and 56.7% of iRBD patients, but with a lower index in REM sleep (0.79/h ± 1.59 and 2.76/h ± 4.57). CONCLUSIONS Although SRHJ are frequent in the general population and with uncertain clinical significance, rare severe symptomatic forms should be individualized and eventually be categorized as a new sleep-related movement disorder, distinct from RBD and periodic leg movements.
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Affiliation(s)
- Régis Lopez
- Centre National de Référence Narcolepsie Hypersomnies, Unité des Troubles du Sommeil, Service de Neurologie, Hôpital Gui-de-Chauliac, Montpellier, France.,PSNREC, Univ Montpellier, INSERM, Montpellier, France
| | - Sofiène Chenini
- Centre National de Référence Narcolepsie Hypersomnies, Unité des Troubles du Sommeil, Service de Neurologie, Hôpital Gui-de-Chauliac, Montpellier, France
| | - Lucie Barateau
- Centre National de Référence Narcolepsie Hypersomnies, Unité des Troubles du Sommeil, Service de Neurologie, Hôpital Gui-de-Chauliac, Montpellier, France.,PSNREC, Univ Montpellier, INSERM, Montpellier, France
| | - Anna-Laura Rassu
- Centre National de Référence Narcolepsie Hypersomnies, Unité des Troubles du Sommeil, Service de Neurologie, Hôpital Gui-de-Chauliac, Montpellier, France
| | - Elisa Evangelista
- Centre National de Référence Narcolepsie Hypersomnies, Unité des Troubles du Sommeil, Service de Neurologie, Hôpital Gui-de-Chauliac, Montpellier, France
| | | | - Julien Fanielle
- Centre d'étude des troubles de l'éveil et du sommeil, CHU Liège, Belgium
| | | | | | - Yves Dauvilliers
- Centre National de Référence Narcolepsie Hypersomnies, Unité des Troubles du Sommeil, Service de Neurologie, Hôpital Gui-de-Chauliac, Montpellier, France.,PSNREC, Univ Montpellier, INSERM, Montpellier, France
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Pereira F, Lopez R, Brasas M, Alvarez R, Aller A. Synergism between SEM/EDX microanalysis and multivariate analysis for a suitable classification of Roman and Byzantine papyri. Microchem J 2021. [DOI: 10.1016/j.microc.2020.105688] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Wagner A, Gresh L, Sanchez N, Kuan G, Lopez R, Ojeda S, Balmaseda A, Gordon A. A longitudinal study of influenza among infants in Managua, Nicaragua. Int J Infect Dis 2020. [DOI: 10.1016/j.ijid.2020.09.1145] [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: 12/01/2022] Open
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Gilbert A, Piazza J, Szecel J, Ancion A, Gensburger M, Lopez R, D'Orio V, Ghuysen A. [Management of emergency department inflows during the COVID-19 outbreak in the CHU of Liege : efficiency of an advanced triage center]. Rev Med Liege 2020; 75:11-17. [PMID: 33211417] [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] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
UNLABELLED In March 2020, the COVID-19 pandemic started to spread among the Belgian territory. Our university hospital was confronted to the very need of specific reorganizations guided by the implementation of the Hospital Emergency Plan.This article aims to describe the experience of the University Hospital of Liège (CHU Liège) during the COVID-19 outbreak and demonstrates the efficiency of advanced triage centers to regulate hospital admissions from the emergency department (ED). METHODS since the beginning of March 2020, the CHU of Liège has implemented specific advanced triage centers to manage patients with SARS-CoV-2 suspected symptoms. The first center was organized inside the hospital but the need of outside structures led to the creation of two centers by the end of March. From March 2 to May 3, data from the different visits at the COVID-19 centers were collected (numbers of admissions, rationale for coming, work up and outcome). RESULTS during the study period, 3,094 patients were admitted to the specific COVID-19 centers of the CHU Liège. This represents 3,431 visits among which 337 were classified as readmission visits. The sensitivity and specificity of the triage centers to determine the need for hospitalization were, respectively, estimated at 87,9 % and 93,4 %. CONCLUSION our experience tends to demonstrate the role of specific COVID-19 triage centers located very close to the EDs aimed at managing COVID-19 suspected patients in order to actually determine their need for subsequent hospitalization.
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Affiliation(s)
- A Gilbert
- Service des Urgences, CHU Liège, Belgique
| | - J Piazza
- Service des Urgences, CHU Liège, Belgique
| | - J Szecel
- Service des Urgences, CHU Liège, Belgique
| | - A Ancion
- Service des Urgences, CHU Liège, Belgique
| | | | - R Lopez
- Service des Urgences, CHU Liège, Belgique
| | - V D'Orio
- Service des Urgences, CHU Liège, Belgique
| | - A Ghuysen
- Service des Urgences, CHU Liège, Belgique
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Park JO, Li CP, Chang HM, Shan Y, Bendell J, Garlipp B, Hatoum H, Saez BL, Salminen T, Oettle H, Kocsis J, Lopez R, Dowden S, Karthaus M, Lu B, McGovern D, Banerjee S, Tempero M, Oh DY. 190P Outcomes from the Asian region of the phase III APACT trial of adjuvant nab-paclitaxel plus gemcitabine (nab-P/G) vs gemcitabine (G) alone for patients (pts) with resected pancreatic cancer (PC). Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.10.454] [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: 10/22/2022] Open
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Lopez R, Laganière C, Chenini S, Rassu AL, Evangelista E, Barateau L, Jaussent I, Dauvilliers Y. Video-Polysomnographic Assessment for the Diagnosis of Disorders of Arousal in Children. Neurology 2020; 96:e121-e130. [PMID: 33087493 DOI: 10.1212/wnl.0000000000011091] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 08/12/2020] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES To highlight the slow-wave sleep (SWS) fragmentation and validate the video-polysomnographic (vPSG) criteria and cutoffs for the diagnosis of disorders of arousal (DOA) in children, as already reported in adults. METHODS One hundred children (66 boys, 11.0 ± 3.3 years) with frequent episodes of DOA and 50 nonparasomniac children (32 boys, 10.9 ± 3.9 years) underwent vPSG recording to quantify SWS characteristics (number of N3 sleep interruptions, fragmentation index, slow/mixed and fast arousal ratios, and indexes per hour) and associated behaviors. We compared SWS characteristics in the 2 groups and defined the optimal cutoff values for the diagnosis of DOA using receiver operating characteristic curves. RESULTS Patients with DOA had higher amounts of N3 and REM sleep, number of N3 interruptions, SWS fragmentation, and slow/mixed arousal indexes than controls. The highest area under the curve (AUC) values were obtained for SWS fragmentation and slow/mixed arousal indexes with satisfactory classification performances (AUC 0.80, 95% confidence interval [CI] 0.73-0.87; AUC 0.82, 95% CI 0.75-0.89). SWS fragmentation index cutoff value of 4.1/h reached a sensitivity of 65.0% and a specificity of 84.0%. Slow/mixed arousal index cutoff of 3.8/h reached a sensitivity of 69.0% and a specificity of 82.0%. At least one parasomniac episode was recorded in 63.0% of patients and none of the controls. Combining behavioral component by vPSG increased sensitivity of both biomarkers to 83% and 89%, respectively. CONCLUSIONS We confirmed that SWS fragmentation and slow/mixed arousal indexes are 2 relevant biomarkers for the diagnosis of DOA in children, with different cutoffs obtained than those validated in adults. CLASSIFICATION OF EVIDENCE This study provides Class III evidence that SWS fragmentation and slow/mixed arousal indexes on vPSG accurately identify children with DOA.
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Affiliation(s)
- Régis Lopez
- From Service de Neurologie (R.L., S.C., A.L.R., E.E., L.B., Y.D.), Centre National de Référence Narcolepsie Hypersomnies, Unité des Troubles du Sommeil, Hôpital Gui-de-Chauliac Montpellier; PSNREC (R.L., E.E., L.B., I.J., Y.D.), Univ Montpellier, INSERM, France; Department of Educational and Counselling Psychology (C.L.), McGill University; Douglas Mental Health University Institute (C.L.); and Hôpital en Santé Mentale Rivière-des-Prairies (C.L.), CIUSSS-du-Nord-de-l'île-de-Montréal, Montréal, Canada.
| | - Christine Laganière
- From Service de Neurologie (R.L., S.C., A.L.R., E.E., L.B., Y.D.), Centre National de Référence Narcolepsie Hypersomnies, Unité des Troubles du Sommeil, Hôpital Gui-de-Chauliac Montpellier; PSNREC (R.L., E.E., L.B., I.J., Y.D.), Univ Montpellier, INSERM, France; Department of Educational and Counselling Psychology (C.L.), McGill University; Douglas Mental Health University Institute (C.L.); and Hôpital en Santé Mentale Rivière-des-Prairies (C.L.), CIUSSS-du-Nord-de-l'île-de-Montréal, Montréal, Canada
| | - Sofiène Chenini
- From Service de Neurologie (R.L., S.C., A.L.R., E.E., L.B., Y.D.), Centre National de Référence Narcolepsie Hypersomnies, Unité des Troubles du Sommeil, Hôpital Gui-de-Chauliac Montpellier; PSNREC (R.L., E.E., L.B., I.J., Y.D.), Univ Montpellier, INSERM, France; Department of Educational and Counselling Psychology (C.L.), McGill University; Douglas Mental Health University Institute (C.L.); and Hôpital en Santé Mentale Rivière-des-Prairies (C.L.), CIUSSS-du-Nord-de-l'île-de-Montréal, Montréal, Canada
| | - Anna Laura Rassu
- From Service de Neurologie (R.L., S.C., A.L.R., E.E., L.B., Y.D.), Centre National de Référence Narcolepsie Hypersomnies, Unité des Troubles du Sommeil, Hôpital Gui-de-Chauliac Montpellier; PSNREC (R.L., E.E., L.B., I.J., Y.D.), Univ Montpellier, INSERM, France; Department of Educational and Counselling Psychology (C.L.), McGill University; Douglas Mental Health University Institute (C.L.); and Hôpital en Santé Mentale Rivière-des-Prairies (C.L.), CIUSSS-du-Nord-de-l'île-de-Montréal, Montréal, Canada
| | - Elisa Evangelista
- From Service de Neurologie (R.L., S.C., A.L.R., E.E., L.B., Y.D.), Centre National de Référence Narcolepsie Hypersomnies, Unité des Troubles du Sommeil, Hôpital Gui-de-Chauliac Montpellier; PSNREC (R.L., E.E., L.B., I.J., Y.D.), Univ Montpellier, INSERM, France; Department of Educational and Counselling Psychology (C.L.), McGill University; Douglas Mental Health University Institute (C.L.); and Hôpital en Santé Mentale Rivière-des-Prairies (C.L.), CIUSSS-du-Nord-de-l'île-de-Montréal, Montréal, Canada
| | - Lucie Barateau
- From Service de Neurologie (R.L., S.C., A.L.R., E.E., L.B., Y.D.), Centre National de Référence Narcolepsie Hypersomnies, Unité des Troubles du Sommeil, Hôpital Gui-de-Chauliac Montpellier; PSNREC (R.L., E.E., L.B., I.J., Y.D.), Univ Montpellier, INSERM, France; Department of Educational and Counselling Psychology (C.L.), McGill University; Douglas Mental Health University Institute (C.L.); and Hôpital en Santé Mentale Rivière-des-Prairies (C.L.), CIUSSS-du-Nord-de-l'île-de-Montréal, Montréal, Canada
| | - Isabelle Jaussent
- From Service de Neurologie (R.L., S.C., A.L.R., E.E., L.B., Y.D.), Centre National de Référence Narcolepsie Hypersomnies, Unité des Troubles du Sommeil, Hôpital Gui-de-Chauliac Montpellier; PSNREC (R.L., E.E., L.B., I.J., Y.D.), Univ Montpellier, INSERM, France; Department of Educational and Counselling Psychology (C.L.), McGill University; Douglas Mental Health University Institute (C.L.); and Hôpital en Santé Mentale Rivière-des-Prairies (C.L.), CIUSSS-du-Nord-de-l'île-de-Montréal, Montréal, Canada
| | - Yves Dauvilliers
- From Service de Neurologie (R.L., S.C., A.L.R., E.E., L.B., Y.D.), Centre National de Référence Narcolepsie Hypersomnies, Unité des Troubles du Sommeil, Hôpital Gui-de-Chauliac Montpellier; PSNREC (R.L., E.E., L.B., I.J., Y.D.), Univ Montpellier, INSERM, France; Department of Educational and Counselling Psychology (C.L.), McGill University; Douglas Mental Health University Institute (C.L.); and Hôpital en Santé Mentale Rivière-des-Prairies (C.L.), CIUSSS-du-Nord-de-l'île-de-Montréal, Montréal, Canada.
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Brant A, Batur P, Arrigain S, Lopez R, Farrell R. P55 Demographic and social factors associated with out-of-pocket expenditures for contraceptive prescriptions in the US during medicaid expansion. Contraception 2020. [DOI: 10.1016/j.contraception.2020.07.074] [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: 11/29/2022]
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Barateau L, Lopez R, Chenini S, Pesenti C, Rassu AL, Jaussent I, Dauvilliers Y. Depression and suicidal thoughts in untreated and treated narcolepsy: Systematic analysis. Neurology 2020; 95:e2755-e2768. [PMID: 32963102 DOI: 10.1212/wnl.0000000000010737] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 06/12/2020] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES To assess the frequency and determinants of depressive symptoms and suicidal thoughts in adults with narcolepsy type 1 (NT1) and controls, as well as the changes after NT1 management and the risk factors of major depressive episode (MDE) and suicide risk (SR) in NT1. METHODS Two hundred ninety-seven patients with NT1 (age 39 ± 17 years, 172 drug-free) and 346 controls (age 38 ± 16 years) underwent a comprehensive clinical evaluation including the Beck Depression Inventory-II (BDI-II) self-questionnaire, with 1 item on suicidal thoughts. One hundred one drug-free patients with NT1 completed the BDI-II a second time during treatment. In 162 patients with NT1, the face-to-face Mini International Neuropsychiatric Interview was performed to formally diagnose current MDE and SR. RESULTS BDI-II total scores were higher in patients with NT1 than controls and in untreated than treated patients. Patients with moderate to severe BDI-II scores (24.9%) were less educated, were more frequently obese, and had more severe narcolepsy symptoms, more autonomic dysfunctions, and poorer quality of life. Results were unchanged in models adjusted for NT1 medication intake. Suicidal thoughts were more frequent in untreated patients than controls (22.7% vs 12.4%). Patients with suicidal thoughts were more likely to be men and to have more severe narcolepsy symptoms. After narcolepsy management, BDI-II total score and suicidal thoughts decreased. MDE was diagnosed in 29 (18.1%) and SR in 27 (16.9%) patients. CONCLUSIONS Depression, depressive symptoms, suicidal thoughts, and SR were frequent in patients with NT1, especially those without treatment, and were associated with NT1 severity. Depressive symptoms and suicidal thoughts improved after NT1 management.
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Affiliation(s)
- Lucie Barateau
- From the Sleep-Wake Disorders Unit (L.B., R.L., S.C., A.L.R., Y.D.), Department of Neurology, Gui-de-Chauliac Hospital, and National Reference Network for Narcolepsy (L.B., R.L., S.C., C.P., A.L.R., Y.D.), CHU Montpellier; and PSNREC (L.B., R.L., I.J., Y.D.), Université de Montpellier, INSERM, France.
| | - Régis Lopez
- From the Sleep-Wake Disorders Unit (L.B., R.L., S.C., A.L.R., Y.D.), Department of Neurology, Gui-de-Chauliac Hospital, and National Reference Network for Narcolepsy (L.B., R.L., S.C., C.P., A.L.R., Y.D.), CHU Montpellier; and PSNREC (L.B., R.L., I.J., Y.D.), Université de Montpellier, INSERM, France
| | - Sofiene Chenini
- From the Sleep-Wake Disorders Unit (L.B., R.L., S.C., A.L.R., Y.D.), Department of Neurology, Gui-de-Chauliac Hospital, and National Reference Network for Narcolepsy (L.B., R.L., S.C., C.P., A.L.R., Y.D.), CHU Montpellier; and PSNREC (L.B., R.L., I.J., Y.D.), Université de Montpellier, INSERM, France
| | - Carole Pesenti
- From the Sleep-Wake Disorders Unit (L.B., R.L., S.C., A.L.R., Y.D.), Department of Neurology, Gui-de-Chauliac Hospital, and National Reference Network for Narcolepsy (L.B., R.L., S.C., C.P., A.L.R., Y.D.), CHU Montpellier; and PSNREC (L.B., R.L., I.J., Y.D.), Université de Montpellier, INSERM, France
| | - Anna Laura Rassu
- From the Sleep-Wake Disorders Unit (L.B., R.L., S.C., A.L.R., Y.D.), Department of Neurology, Gui-de-Chauliac Hospital, and National Reference Network for Narcolepsy (L.B., R.L., S.C., C.P., A.L.R., Y.D.), CHU Montpellier; and PSNREC (L.B., R.L., I.J., Y.D.), Université de Montpellier, INSERM, France
| | - Isabelle Jaussent
- From the Sleep-Wake Disorders Unit (L.B., R.L., S.C., A.L.R., Y.D.), Department of Neurology, Gui-de-Chauliac Hospital, and National Reference Network for Narcolepsy (L.B., R.L., S.C., C.P., A.L.R., Y.D.), CHU Montpellier; and PSNREC (L.B., R.L., I.J., Y.D.), Université de Montpellier, INSERM, France
| | - Yves Dauvilliers
- From the Sleep-Wake Disorders Unit (L.B., R.L., S.C., A.L.R., Y.D.), Department of Neurology, Gui-de-Chauliac Hospital, and National Reference Network for Narcolepsy (L.B., R.L., S.C., C.P., A.L.R., Y.D.), CHU Montpellier; and PSNREC (L.B., R.L., I.J., Y.D.), Université de Montpellier, INSERM, France.
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