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Daghi M, Lakhdar A, El Otmani H. Deep brain stimulation for movement disorders treatment in Africa: The current status, outcomes, and challenges. Clin Neurol Neurosurg 2024; 236:108113. [PMID: 38232609 DOI: 10.1016/j.clineuro.2023.108113] [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: 11/04/2023] [Revised: 12/29/2023] [Accepted: 12/31/2023] [Indexed: 01/19/2024]
Abstract
Movement disorders (MDs), a diverse group of neurological conditions characterized by abnormal and involuntary movements, have a profound impact on individuals, families, and healthcare systems. Deep Brain Stimulation (DBS) has emerged as a promising therapeutic intervention, offering relief from symptoms and improved quality of life. By implanting electrodes in specific brain regions and connecting them to a pulse generator, DBS modulates aberrant neural activity underlying these disorders. While DBS has gained recognition globally, its utilization in African countries remains limited. This comprehensive article presents the results of a literature review on the status of DBS therapy for MDs in Africa. The review assesses treatment outcomes, patient demographics, and challenges tied to implementing DBS in the African context. The findings reveal promising developments in DBS therapy across several African countries, particularly in treating Parkinson's disease and dystonia. However, challenges related to awareness, access to specialized care, and a scarcity of expertise still impede broader adoption. The article underscores the urgent need for collaborative efforts, policy changes, and increased training to expand the reach of DBS therapy, thus mitigating the burden of MDs on the African continent.
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Affiliation(s)
- Mohamed Daghi
- Research Laboratory of Nervous System Diseases, Neurosensory Disorders & Disability, Faculty of Medicine and Pharmacy, Hassan II University of Casablanca, Morocco.
| | - Abdelhakim Lakhdar
- Research Laboratory of Nervous System Diseases, Neurosensory Disorders & Disability, Faculty of Medicine and Pharmacy, Hassan II University of Casablanca, Morocco; Neurosurgery Department, Ibn Rochd University Hospital Center, Casablanca, Morocco
| | - Hicham El Otmani
- Neurology Department, Ibn Rochd University Hospital Center, Casablanca, Morocco; Laboratory of Genetics and Molecular Pathology, Faculty of Medicine and Pharmacy, Hassan II University of Casablanca, Morocco
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El Otmani H, Daghi M, Maghfour M, Haddouali K, Bellakhdar S, El Moutawakil B, Tahiri Jouti N, Rafai MA. RBD and hyposmia in Moroccan patients with a synucleinopathy: prevalence and the timing of occurrence in a large cohort. Acta Neurol Belg 2023; 123:2229-2233. [PMID: 37046132 PMCID: PMC10096100 DOI: 10.1007/s13760-023-02262-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 04/04/2023] [Indexed: 04/14/2023]
Abstract
INTRODUCTION Rapid Eye Movement Sleep Behavior Disorder (RBD) and hyposmia are common in synucleinopathies and they tend to occur in connection to the prodromal development of these disorders. In this study, we sought to determine the prevalence of RBD and hyposmia and the timeline of their occurrence in a large cohort of Moroccan patients. METHODS We recruited 774 consecutive patients with synucleinopathy and tauopathy at Ibn Rochd University Hospital of Casablanca. A group of 100 healthy controls was also recruited. We relied on a questionnaire to collect general characteristics and clinical data filled by the patient and his companion under the supervision of a qualified health professional. RESULTS The study included 697 patients with PD, 37 with DLB and 40 had a tauopathy disorder (PSP or CBD). The proportion of patients who have RBD was 52% in PD, 100% in DLB, 0% in tauopathies and 12% among healthy controls. Hyposmia symptom was found in 47% of patients with PD, 68% in patients with DLB, 0% in tauopathy patients and in 10% of healthy controls. Moreover, 46% of PD patients and 75% of DLB patients developed RBD during the prodromal phase. Meanwhile, hyposmia occurred in association with the prodromal phase among 67% of PD cases and 85% of DLB patients. CONCLUSION RBD and hyposmia are both prevalent among Moroccan patients with synucleinopathy and they occur frequently during the prodromal phase. Identifying these premotor signs will improve early and differential diagnosis and enhance our understanding of how a specific synucleinopathy progresses.
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Affiliation(s)
- Hicham El Otmani
- Neurology Department, Ibn Rochd University Hospital Center, Casablanca, Morocco
- Laboratory of Genetic and Molecular Pathology, Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco
- Laboratory of Cellular and Molecular Inflammatory, Degenerative and Oncologic Pathophysiology, Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco
| | - Mohamed Daghi
- Research Laboratory of Nervous System Diseases, Neurosensory Disorders & Disability, Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco
| | - Manal Maghfour
- Neurology Department, Ibn Rochd University Hospital Center, Casablanca, Morocco
| | - Kamal Haddouali
- Neurology Department, Ibn Rochd University Hospital Center, Casablanca, Morocco
| | - Salma Bellakhdar
- Neurology Department, Ibn Rochd University Hospital Center, Casablanca, Morocco
| | - Bouchra El Moutawakil
- Neurology Department, Ibn Rochd University Hospital Center, Casablanca, Morocco
- Laboratory of Genetic and Molecular Pathology, Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco
| | - Nadia Tahiri Jouti
- Laboratory of Cellular and Molecular Inflammatory, Degenerative and Oncologic Pathophysiology, Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco
| | - Mohammed Abdoh Rafai
- Neurology Department, Ibn Rochd University Hospital Center, Casablanca, Morocco
- Research Laboratory of Nervous System Diseases, Neurosensory Disorders & Disability, Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco
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El Otmani H, Daghi M, Maghfour M, Haddouali K, Bellakhdar S, El Moutawakil B, Tahiri Jouti N, Rafai MA. Correction to: RBD and hyposmia in Moroccan patients with a synucleinopathy: prevalence and the timing of occurrence in a large cohort. Acta Neurol Belg 2023; 123:2447. [PMID: 37563504 DOI: 10.1007/s13760-023-02308-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/12/2023]
Affiliation(s)
- Hicham El Otmani
- Neurology Department, Ibn Rochd University Hospital Center, Casablanca, Morocco.
- Laboratory of Genetic and Molecular Pathology, Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco.
- Laboratory of Cellular and Molecular Inflammatory, Degenerative and Oncologic Pathophysiology, Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco.
| | - Mohamed Daghi
- Research Laboratory of Nervous System Diseases, Neurosensory Disorders & Disability, Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco
| | - Manal Maghfour
- Neurology Department, Ibn Rochd University Hospital Center, Casablanca, Morocco
| | - Kamal Haddouali
- Neurology Department, Ibn Rochd University Hospital Center, Casablanca, Morocco
| | - Salma Bellakhdar
- Neurology Department, Ibn Rochd University Hospital Center, Casablanca, Morocco
| | - Bouchra El Moutawakil
- Neurology Department, Ibn Rochd University Hospital Center, Casablanca, Morocco
- Laboratory of Genetic and Molecular Pathology, Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco
| | - Nadia Tahiri Jouti
- Laboratory of Cellular and Molecular Inflammatory, Degenerative and Oncologic Pathophysiology, Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco
| | - Mohammed Abdoh Rafai
- Neurology Department, Ibn Rochd University Hospital Center, Casablanca, Morocco
- Research Laboratory of Nervous System Diseases, Neurosensory Disorders & Disability, Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco
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El Otmani H, Daghi M, Tahiri Jouti N, Lesage S. An overview of the worldwide distribution of LRRK2 mutations in Parkinson's disease. Neurodegener Dis Manag 2023; 13:335-350. [PMID: 38305913 DOI: 10.2217/nmt-2023-0025] [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] [Indexed: 02/03/2024] Open
Abstract
Parkinson's disease (PD) is a neurodegenerative disorder with significant genetic influence. The LRRK2 gene is a major genetic contributor, particularly the Gly2019Ser mutation. This focused review investigates the global distribution of LRRK2 mutations, with emphasis on Gly2019Ser and other pathogenic variants. Prevalence rates of Gly2019Ser are highest in North Africa and the Ashkenazi-Jewish population, indicating a potential common ancestor and founder effect. Other LRRK2 mutations, including Asn1437His, Arg1441Gly/Cys/His, Tyr1699Cys and Ile2020Thr, exhibit varying global prevalences. Understanding these distributions enhances our knowledge of PD genetics and aids personalized medicine. Further research is crucial to unravel clinical implications and develop targeted therapies for LRRK2 mutation carriers.
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Affiliation(s)
- Hicham El Otmani
- Laboratory of Medical Genetics & Molecular Pathology. Faculty of Medicine and Pharmacy, Hassan II University, 20250, Casablanca, Morocco
- Laboratory of Cellular and Molecular Inflammatory, Degenerative & Oncologic Pathophysiology. Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, 20250, Morocco
- Department of Neurology. Ibn Rochd University Hospital, Casablanca, 20360, Morocco
| | - Mohamed Daghi
- Research Laboratory of Nervous System Diseases, Neurosensory Disorders & Disability. Faculty of Medicine & Pharmacy, Hassan II University, Casablanca, 20250, Morocco
| | - Nadia Tahiri Jouti
- Laboratory of Cellular and Molecular Inflammatory, Degenerative & Oncologic Pathophysiology. Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, 20250, Morocco
| | - Suzanne Lesage
- Sorbonne University, Institut du Cerveau-Paris Brain Institute, ICM, INSERM, CNRS, Assistance Publique-Hôpitaux de Paris, Paris, 75013, France
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El Otmani H, El Moutawakil B, Daghi M, Fadili O, Slassi I, El Azhari A, Essodegui F, Barrou L, Rafai MA, Lakhdar A. Deep Brain Stimulation for Dystonia: Experience of a Moroccan University Hospital. Pediatr Neurol 2023; 148:23-27. [PMID: 37651973 DOI: 10.1016/j.pediatrneurol.2023.08.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 07/17/2023] [Accepted: 08/02/2023] [Indexed: 09/02/2023]
Abstract
BACKGROUND Deep brain stimulation (DBS) is a well-established procedure that provides long-term symptom control of the third most common movement disorder: dystonia. In this study, we aim to report the experience of Ibn Rochd University Hospital in the treatment of dystonia using DBS of the globus pallidus internus, which represents an exceptional challenge for a developing country such as Morocco. METHODS Since 2013, we selected five eligible candidates for DBS surgery at the university hospital Ibn Rochd. A genetic assessment had been performed in four cases. Their motor and mental states were prospectively monitored using several validated scales, including Burke-Fahn-Marsden Dystonia Rating Scale, Mini Mental State Examination, 36-Item Short Form Survey, and Zarit scale. RESULTS Our sample had two clinical phenotypes of dystonia: isolated dystonia (in two patients) and combined dystonia (in three patients). Patients were aged 14 to 32 years, and their mean onset age ranged from 7 to 13 years with a mean progression duration of 9 years. Our results indicate successful treatment of patients with dystonia using DBS. Scores from the Burke-Fahn-Marsden Dystonia Rating Scale confirm improvements ranging from 40% to 95%. However, some potentially surgery-related complications could occur such as lead infection, which, in our experience, was reported in one case. CONCLUSION The experience of the university hospital Ibn Rochd regarding the use of DBS in treating dystonia was largely positive. However, the procedure faces challenges due to its complexity, specifically concerning its multidisciplinary nature, its genetic test costs, and the reluctance of pediatricians to get involved.
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Affiliation(s)
- Hicham El Otmani
- Neurology Department, Ibn Rochd University Hospital Center, Casablanca, Morocco; Laboratory of Genetics and Molecular Pathology, Faculty of Medicine and Pharmacy, Hassan II University of Casablanca, Casablanca, Morocco.
| | - Bouchra El Moutawakil
- Neurology Department, Ibn Rochd University Hospital Center, Casablanca, Morocco; Laboratory of Genetics and Molecular Pathology, Faculty of Medicine and Pharmacy, Hassan II University of Casablanca, Casablanca, Morocco
| | - Mohamed Daghi
- Research Laboratory of Nervous System Diseases, Neurosensory Disorders & Disability, Faculty of Medicine and Pharmacy, Hassan II University of Casablanca, Casablanca, Morocco
| | - Omar Fadili
- Neurology Department, Ibn Rochd University Hospital Center, Casablanca, Morocco
| | - Ilham Slassi
- Neurology Department, Ibn Rochd University Hospital Center, Casablanca, Morocco
| | - Abdessamad El Azhari
- Neurosurgery Department, Ibn Rochd University Hospital Center, Casablanca, Morocco
| | - Fatiha Essodegui
- Radiology Department, Ibn Rochd University Hospital Center, Casablanca, Morocco
| | - Lahoucine Barrou
- Anesthesia and Critical Care Department, Ibn Rochd University Hospital Center, Casablanca, Morocco
| | - Mohammed Abdoh Rafai
- Neurology Department, Ibn Rochd University Hospital Center, Casablanca, Morocco; Research Laboratory of Nervous System Diseases, Neurosensory Disorders & Disability, Faculty of Medicine and Pharmacy, Hassan II University of Casablanca, Casablanca, Morocco
| | - Abdelhakim Lakhdar
- Research Laboratory of Nervous System Diseases, Neurosensory Disorders & Disability, Faculty of Medicine and Pharmacy, Hassan II University of Casablanca, Casablanca, Morocco; Neurosurgery Department, Ibn Rochd University Hospital Center, Casablanca, Morocco
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El Otmani H, Daghi M, Tahiri Jouti N, Lakhdar A. Severe and Reversible Exacerbation of Primary Dystonia Associated With Hypothyroidism. J Clin Neurol 2023; 19:501-502. [PMID: 37635428 PMCID: PMC10471553 DOI: 10.3988/jcn.2023.0050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 05/09/2023] [Accepted: 06/19/2023] [Indexed: 08/29/2023] Open
Affiliation(s)
- Hicham El Otmani
- Department of Neurology, Ibn Rochd University Hospital Center, Casablanca, Morocco
- Laboratory of Genetics and Molecular Pathology, Faculty of Medicine and Pharmacy, Hassan II University of Casablanca, Casablanca, Morocco.
| | - Mohamed Daghi
- Research Laboratory of Nervous System Diseases, Neurosensory Disorders & Disability, Faculty of Medicine and Pharmacy, Hassan II University of Casablanca, Casablanca, Morocco
| | - Nadia Tahiri Jouti
- Laboratory of Cellular and Molecular Inflammatory, Degenerative and Oncologic Pathophysiology, Faculty of Medicine and Pharmacy, Hassan II University of Casablanca, Casablanca, Morocco
| | - Abdelhakim Lakhdar
- Research Laboratory of Nervous System Diseases, Neurosensory Disorders & Disability, Faculty of Medicine and Pharmacy, Hassan II University of Casablanca, Casablanca, Morocco
- Department of Neurosurgery, Ibn Rochd University Hospital Center, Casablanca, Morocco
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Daghi M, Lakhdar A, Otmani HE. Parkinson's disease research in Morocco: a review. Neurodegener Dis Manag 2023; 13:129-139. [PMID: 36803100 DOI: 10.2217/nmt-2022-0021] [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: 02/23/2023] Open
Abstract
Aim: To quantify and provide an overview on the scientific productivity made by Moroccan academics in the research on Parkinson's disease (PD) and parkinsonism. Materials & methods: Scientific articles, in either English or French, were gathered from published literature in three recognized databases: PubMed, ScienceDirect and Scopus. Results: We identified 95 published papers from which 39 articles have been extracted after removing inadequate publications and duplications between databases. All articles were published between 2006 and 2021. The selected articles were subdivided into five categories. Conclusion: The Moroccan academia is presently facing a low productivity issues and a lack of research laboratories focusing on PD research. We anticipate that providing more budgetary funds will significantly improve the productivity of PD research.
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Affiliation(s)
- Mohamed Daghi
- Research Laboratory of Nervous System Diseases, Neurosensory Disorders & Disability, Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, 20250, Morocco
| | - Abdelhakim Lakhdar
- Research Laboratory of Nervous System Diseases, Neurosensory Disorders & Disability, Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, 20250, Morocco.,Department of Neurosurgery, Ibn Rochd University Hospital, Casablanca, 20360, Morocco
| | - Hicham El Otmani
- Laboratory of Medical Genetics & Molecular Pathology, Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, 20250, Morocco.,Department of Neurology, Ibn Rochd University Hospital, Casablanca, 20360, Morocco
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El Kherchi O, Aquil A, El Khoudri N, Mouallif M, Daghi M, Guerroumi M, Saad EM, Benider A, Jayakumar AR, Elgot A. Anxiety and Depression Comorbidities in Moroccan Patients With Breast Cancer. Front Psychiatry 2020; 11:584907. [PMID: 33510655 PMCID: PMC7835395 DOI: 10.3389/fpsyt.2020.584907] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Accepted: 11/25/2020] [Indexed: 11/23/2022] Open
Abstract
Background: Breast cancer is the leading cause of cancer death in women worldwide with more than 1. 7 million new cases annually. Major advances have been made in the therapeutic management of this condition in many countries. However, neuropsychiatric disorders in patients with breast cancer constitute a significant concern due to their negative impact on patient's life and on the success of therapy itself. Methodology: In this study we aimed to evaluate psychological disorders in a population of 212 Moroccan women treated for breast cancer within the Mohammed VI Center for the Treatment of Cancers of Casablanca. A questionnaire was designed to this end on the basis of different validated scales, including the Hospital Anxiety Depression Scale (HADS), the Pittsburgh Sleep Quality Index (PSQI), and the Body Image Scale (BIS). Results: Data analysis has shown that 69.3% of participants had significant sleep disorders; 87% suffer from an anxiety-depressive syndrome (ADS), and 83.0% had significant body image dissatisfaction. A positive correlation was shown between ADS and both patients' national health insurance coverage and patients or husbands' education. Analysis further revealed that anxiety and depression were negatively correlated with different types of treatment. Similarly, both BIS and PSQI scores were positively associated with anxiety and depression disorders. Conclusion: The present investigation highlights the need to generalize and strengthen the psychological approach of patients treated for breast cancer in Morocco. We anticipate that such a strategy will alleviate suffering and promote therapy success in these patients and will diminish or prevent conjugal and familial impacts of the illness.
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Affiliation(s)
- Ouassil El Kherchi
- Epidemiology and Biomedical Unit, Laboratory of Sciences and Health Technologies, Higher Institute of Health Sciences, Hassan First University of Settat, Settat, Morocco
| | - Amina Aquil
- Epidemiology and Biomedical Unit, Laboratory of Sciences and Health Technologies, Higher Institute of Health Sciences, Hassan First University of Settat, Settat, Morocco
| | - Noureddine El Khoudri
- Epidemiology and Biomedical Unit, Laboratory of Sciences and Health Technologies, Higher Institute of Health Sciences, Hassan First University of Settat, Settat, Morocco
| | - Mustapha Mouallif
- Epidemiology and Biomedical Unit, Laboratory of Sciences and Health Technologies, Higher Institute of Health Sciences, Hassan First University of Settat, Settat, Morocco
| | - Mohamed Daghi
- Epidemiology and Biomedical Unit, Laboratory of Sciences and Health Technologies, Higher Institute of Health Sciences, Hassan First University of Settat, Settat, Morocco
| | - Maroua Guerroumi
- Epidemiology and Biomedical Unit, Laboratory of Sciences and Health Technologies, Higher Institute of Health Sciences, Hassan First University of Settat, Settat, Morocco
| | - El Madani Saad
- Epidemiology and Biomedical Unit, Laboratory of Sciences and Health Technologies, Higher Institute of Health Sciences, Hassan First University of Settat, Settat, Morocco
| | - Abdellatif Benider
- Mohammed VI Center for the Treatment of Cancers, Ibn Rochd University Hospital Center Casablanca, Casablanca, Morocco
| | - Arumugam R Jayakumar
- Neuropathology Research Unit, Miami VA Medical Center and Department of Obstetrics, Gynecology and Reproductive Sciences University of Miami Miller School of Medicine, Miami, FL, United States
| | - Abdeljalil Elgot
- Epidemiology and Biomedical Unit, Laboratory of Sciences and Health Technologies, Higher Institute of Health Sciences, Hassan First University of Settat, Settat, Morocco
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