David Maltête

Amyloid-β Protein Precursor Gene Expression in Alzheimer's Disease and Other Conditions

Several lines of evidence suggest that AβPP gene expression could influence risk for Alzheimers disease (AD). Using a highly sensitive multiplex fluorescent RT-PCR assay, we compared peripheral blood cells expression of AβPP mRNA among sporadic AD patients (n = 133), autosomal dominant early-onset AD cases (ADEOAD, n = 21), Down syndrome patients (n = 21), AD patients with AβPP duplication (n = 9), patients with recent ischemic stroke (n = 25), and healthy controls (n = 58). Compared to healthy controls (median = 0.98), AβPP expression was not increased in sporadic AD patients (median = 1.01, p = 0.42) nor in ADEOAD patients (median = 0.96, p = 0.26). Down syndrome patients as well as patients with AβPP duplication had significantly increased levels of AβPP mRNA compared to controls (median = 1.48 and median = 1.36, p < 0.0001 and p = 0.0007, respectively). A weaker but significant increase in relative amount of AβPP transcripts in patients who suffered from recent stroke was observed (median = 1.14, p = 0.0007). Our results do not support a pathogenic role of AβPP overexpression in sporadic AD although a small subset of patients displays AβPP overexpression in the same range as Down syndrome patients.

Acute genital pain during non-motor fluctuations improved by apomorphine

Unit of Occupational Rehabilitation and Ergonomics, Scientific Institute of Veruno, Fondazione Salvatore Maugeri, Istituto di Ricovero e Cura a Carattere Scientifico, Veruno, Italy; Department of Physical Medicine and Rehabilitation, University of Turin, Turin, Italy; Department of Neurorehabilitation, Scientific Institute of Veruno, Fondazione Salvatore Maugeri, Istituto di Ricovero e Cura a Carattere Scientifico, Veruno, Italy; Department of Surgical Science, University of Turin, Turin, Italy

Neuromyelitis optica with very late onset.

more activity. Single cases cannot prove whether these changes led to the observed improvements. Large riskfactor studies on dementia identified activity as being protective against clinical dementia but not against Alzheimer’s-type pathology. Proof of well-documented cases of reversible AD would be important. Health services would have to make AD diagnoses as early as possible to favor the secondary prevention of AD.

Management and outcome of cerebral venous thrombosis after head trauma: A case series

Cerebral venous thrombosis (CVT) is an underdiagnosed complication of head trauma. To date, initiation of anticoagulation is still a matter of debate because of the risk of worsening traumatic hemorrhage. This report describes a case series of five patients admitted for head injury complicated by CVT. The main associated radiological signs were skull fractures crossing the venous sinus and adjacent traumatic hematoma. In four patients, anticoagulation was introduced within 48-72h of CVT diagnosis, with no subsequent hemorrhagic complications. The present report and data from the literature raise the question of systematic additional venoscans when confronted by associated radiological features of post-traumatic CVT. The safety of anticoagulation in selected patients is also discussed.

In-hospital delays to stroke thrombolysis: Out of hours versus regular hours and reduction in treatment times through the creation of a 24/7 mobile thrombolysis team

BACKGROUND The main aim of this study was to evaluate the impact of the implementation of a mobile thrombolysis team (MTT) on time to thrombolysis treatment depending on patient admission time: regular hours (RH) or out of hours (OH). METHODS 504 consecutive patients treated with IV tPA or with combined IV tPA and mechanical thrombectomy for acute ischemic stroke were retrospectively included between 1st January 2013 and 31st December 2017. Three sub-periods were identified: 2013-2014, 2015-2016, and 2017 during which patients were treated with the usual care (UC), by the MTT or with UC according to their time of admission, or by the MTT, in the three time periods respectively. We compared in-hospital delays according to patient admission time. RESULTS In 2013-2014, 133 patients were included. Both median door-to-needle (DTN) and imaging to needle (ITN) times were shorter for patients admitted during RH than OH, respectively 75 min versus 85 min and 52 min versus 57 min (P < 0.05), and the proportion of patients with DTN ≤ 60 min was 23% versus 9% (P < 0.05), respectively. In 2015-2016, 223 patients were included. DTN and ITN times were shorter for patients admitted during RH and treated by the MTT than during OH with UC, respectively 54 min versus 78 min and 24 min versus 47 min (P < 0.001), and the proportion of patients with DTN ≤ 60 min was 64% versus 21% (P < 0.001), respectively. In 2017, there was no difference concerning in-hospital delays regardless of patient admission time (P > 0.05). DISCUSSION DTN time was significantly longer for patients admitted OH. We suggest that the implementation of an around-the-clock MTT would allow a reduction of in-hospital delays and similar times to thrombolysis treatment regardless of admission time.

Migraine-like headache and ocular malformations may herald Moyamoya syndrome.

Fig. 1 – a: retinochoroidal coloboma; b: maximum Intensity Pro reconstructions showing bilateral lenticulostriate (arrow) and ab with development of compensatory collateral vessels from cere sagittal view, showing hypoplasia of the internal carotid artery artery (white arrow). a : colobome chorio-rétinien ; b : angioscanner cérébral (reconstructi (flèche) et l’absence du deuxième segment de l’artère cérébrale postér artères cérébelleuses (flèche fine) ; c : Angioscanner cervico-encéphal de l’artère carotide interne (pointe de flèche) et du canal carotidien e ophthalmologic featuring (Kuroda and Houkin, 2008). We report the association of ophthalmologic abnormalities and migraine-like headache that revealed a Moyamoya syndrome. A 13-year-old girl was admitted for alteration of consciousness and left hemiparesis with brutal onset. Medical past history consisted in right retinochoroidal coloboma (Fig. 1a) and since she was 3 years old migraine without aura according to the International Headache Society classification, without familial history. For a few days, she has suffered from recurrent nonlateralized thunderclap headache (TCH), spontaneous or triggered by effort, one episode followed by