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See detailNeuromuscular transmission in migraine: a single-fiber EMG study in clinical subgroups.
Ambrosini, Anna; Maertens De Noordhout, Alain ULg; Schoenen, Jean ULg

in Neurology (2001), 56(8), 1038-43

OBJECTIVE: To search for impairment of neuromuscular transmission by single-fiber electromyography (SFEMG) in patients with common forms of migraine. BACKGROUND: P/Q Ca(2+) channels are genetically ... [more ▼]

OBJECTIVE: To search for impairment of neuromuscular transmission by single-fiber electromyography (SFEMG) in patients with common forms of migraine. BACKGROUND: P/Q Ca(2+) channels are genetically abnormal in most cases of familial hemiplegic migraine (International Headache Society [IHS] code 1.2.3) and may be involved in other types of migraine. Besides in the brain, these channels are found in motor nerve endings, where they control stimulation-induced acetylcholine release. If they are functionally abnormal, the neuromuscular transmission might be impaired. METHODS: Sixty-two migraineurs (18 without aura, IHS code 1.1; 19 with typical aura, IHS code 1.2.1; 10 with prolonged aura, IHS code 1.2.2; 15 with and without aura) and 16 healthy control subjects underwent stimulation SFEMG. Results were expressed as the mean value of consecutive differences (MCD) and percentage of single-fiber abnormalities (abnormal jitter or impulse blocking). RESULTS: Average MCD was comparable in control subjects and migraineurs (17.1 +/- 2.6 versus 17.5 +/- 4.7 microsec). By contrast, single-fiber abnormalities were found in 17 patients but in none of the control subjects (p = 0.036). Most of these patients had unilateral sensorimotor symptoms and/or aphasia and/or loss of balance during the aura. SFEMG abnormalities were significantly correlated with the occurrence of these clinical features and with a diagnosis of migraine with prolonged aura. CONCLUSIONS: Stimulation SFEMG shows mild abnormalities of neuromuscular transmission in a subgroup of migraineurs with aura, characterized by clinical features frequently found in human P/Q Ca(2+) channelopathies. These abnormalities might thus be due to genetically modified P/Q Ca(2+) channels. [less ▲]

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See detailNeuromuscular transmission in migraine patients with prolonged aura
Ambrosini, Anna; MAERTENS DE NOORDHOUT, Alain ULg; SCHOENEN, Jean ULg

in Acta Neurologica Belgica (2001), 101(3), 166-70

P/Q Ca2+ channels are genetically abnormal in most cases of familial hemiplegic migraine (FHM) and may be involved in other types of migraine. They are also found at the neuromuscular junctions, where ... [more ▼]

P/Q Ca2+ channels are genetically abnormal in most cases of familial hemiplegic migraine (FHM) and may be involved in other types of migraine. They are also found at the neuromuscular junctions, where they control stimulation-induced acetylcholine release. Prolonged aura is a very frequent clinical feature in FHM patients. The objective of this study was thus to explore neuromuscular transmission in migraine with typical and prolonged aura patients. We performed single fiber electromyography (SFEMG) in such patients and compared them to a group of healthy volunteers. Results were expressed as mean jitter (MCD) and percentage of single endplate abnormalities. Mean MCD was on average comparable in controls and migraineurs. By contrast, single endplate abnormalities were only found in patients (p < 0.01), especially in those with prolonged aura (p < 0.001). These results suggest subtle impairment of neuromuscular transmission in a subgroup of migraineurs characterized by prolonged aura, which might be due to dysfunctioning P/Q Ca(2+)-channels. [less ▲]

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See detailTarget-Controlled Infusion of Propofol and Remifentanil Combined with Bispectral Index Monitoring for Awake Craniotomy
Hans, Pol ULg; Bonhomme, Vincent ULg; Born, J. D. et al

in Anaesthesia (2000), 55(3), 255-9

We describe the target-controlled administration of propofol and remifentanil, combined with monitoring of the bispectral index, during an awake craniotomy for removal of a left temporo-parietal tumour ... [more ▼]

We describe the target-controlled administration of propofol and remifentanil, combined with monitoring of the bispectral index, during an awake craniotomy for removal of a left temporo-parietal tumour near the motor speech centre. Target concentrations of the two drugs were adjusted according to the patient's responses to painful stimuli and surgical events, and the need for speech testing. Allowing the effect-site concentrations of propofol and remifentanil to decrease during surgery allowed the performance of cortical speech mapping and the testing of the patient's ability to speak. Although the bispectral index was not used as a guide for the administration of the drugs, its value correlated better with the patient's responsiveness than did the predicted effect-site concentrations of propofol. Side-effects, comprising hypotension, respiratory depression and airway obstruction, were related to rapid increases in drug infusion rates and were easily managed. [less ▲]

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See detailIpsilateral motor responses to focal TMS in normal man and stroke patients.
ALAGONA G.; DELVAUX, Valérie ULg; Delwaide, Paul ULg et al

in Clinical Neurophysiology (2000), 111(Suppl. 1), 11512-05

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See detailIpsilateral motor responses to focal transcranial magnetic stimulation in normal and stroke patients.
ALAGONA G.; DELVAUX, Valérie ULg; GERARD, Pascale ULg et al

in Journal of Neurology, Neurosurgery & Psychiatry (2000), Neurosurgery and Psychiatry

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See detailEarly thalamic and cortical hypometabolism in adult-onset dementia due to metachromatic leukodystrophy
Salmon, Eric ULg; Van der Linden, Martial ULg; Maertens De Noordhout, Alain ULg et al

in Acta Neurologica Belgica (1999), 99(3), 185-188

A case of early-onset adult dementia with family history of dementia is reported, characterised by neuropsychological deficits, suggesting frontal involvement, with mild non specific white matter ... [more ▼]

A case of early-onset adult dementia with family history of dementia is reported, characterised by neuropsychological deficits, suggesting frontal involvement, with mild non specific white matter abnormalities on CT scan. Familial Alzheimer's disease was suspected but the neuropathological diagnosis on brain biopsy was metachromatic leukodystrophy. 18FDG-PET revealed a very peculiar pattern of metabolic impairment in thalamic areas, in medial and frontopolar regions, and in occipital lobes. Neuropsychological follow-up showed relatively stable difficulties of long-term memory and signs of frontal lobe dysfunction, similar to those observed in subcortical dementias. MRI subsequently showed periventricular leukoencephalopathy. The brain metabolic pattern observed in that case of metachromatic leukodystrophy was quite different from that reported in other types of dementia. [less ▲]

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See detailPosture et mouvement
Delwaide, Paul ULg; Maertens de Noordhout, Alain ULg; WANG, François-Charles ULg

in Held, Jean-Pierre; Dizien, Olivier (Eds.) Traité de Médecine Physique et de Réadaptation (1999)

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See detailDissections artérielles et manipulations cervicales
DELVAUX, Valérie ULg; GERARD, Pascale ULg; DE PASQUA, Victor ULg et al

in Revue Neurologique (1999), 155(Supp 1), 160

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See detailEtude électrophysiologique des mécanismes responsables de la fatigue chronique dans la sclérose en plaques (SEP)
DELVAUX, Valérie ULg; ALAGONA, G.; GERARD, Pascale ULg et al

in Revue Neurologique (1999), 155(1S51, supp. 1),

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See detailTranscranial Magnetic Stimulation in Migraine
Maertens De Noordhout, Alain ULg; Schoenen, Jean ULg

in Paulus, W.; Hallett, M.; Rossini, P. M. (Eds.) et al Transcranial Magnetic Stimulation (1999)

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See detailAbsence of response to early transcranial magnetic stimulation in ischemic stroke patients: prognostic value for hand motor recovery.
Pennisi, Giovanni; Rapisarda, Giuseppe; Bella, R. et al

in Stroke (1999), 30(12), 2666-70

BACKGROUND AND PURPOSE: Transcranial magnetic stimulation (TMS) has been proposed as a prognostic tool in stroke patients. Most of the previous studies agree in considering the presence of motor-evoked ... [more ▼]

BACKGROUND AND PURPOSE: Transcranial magnetic stimulation (TMS) has been proposed as a prognostic tool in stroke patients. Most of the previous studies agree in considering the presence of motor-evoked potentials (MEPs) in the first days after a stroke as an indicator of good outcome. In the present study, we have assessed the prognostic value of the absence of response to early TMS on hand motor recovery in stroke patients with complete hand palsy at onset due to ischemia in the area of the middle cerebral artery. METHODS: Fifteen patients submitted to TMS within 48 hours of stroke onset (defined as day 1) and again after 1 year. They were also evaluated clinically on day 1 by a scale derived from the Medical Research Council (MRC) and by the National Institutes of Health (NIH) stroke scale; they were reevaluated by the same scales and by Barthel Index on day 365. RESULTS: On day 1, all the patients had complete hand palsy and no response to TMS; their NIH scores showed great variability. After 1 year, 6 of 15 patients regained small and prolonged MEPs, together with a very poor and not functionally useful motor recovery. NIH scores were significantly improved. Barthel Index scores showed large interindividual differences and were not correlated with MRC scores. CONCLUSIONS: We conclude that in patients with complete hand palsy, the absence of response to TMS in the first hours is predictive of absent or very poor, not useful, hand motor recovery. [less ▲]

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See detailImpairment of neuromuscular transmission in a subgroup of migraine patients
Ambrosini, Anna; MAERTENS DE NOORDHOUT, Alain ULg; Alagona, Giovanna et al

in Neuroscience Letters (1999), 276(3), 201-3

Neuronal voltage-dependent P/Q Ca2+ channels are genetically abnormal in many cases of familial hemiplegic migraine and possibly associated with the more common forms of migraine with and without aura ... [more ▼]

Neuronal voltage-dependent P/Q Ca2+ channels are genetically abnormal in many cases of familial hemiplegic migraine and possibly associated with the more common forms of migraine with and without aura. Besides the brain, these channels are found in motor nerve endings where they control stimulation-induced acetylcholine release. Using single fiber EMG recordings we were able to demonstrate subclinical abnormalities of neuromuscular transmission in a subgroup of patients suffering from migraine with aura. This could be related to genetic abnormalities of P/Q Ca2+ channels in certain patients suffering from migraine with aura, which needs to be explored by proper genetic analyses. [less ▲]

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See detailApplications of magnetic cortical stimulation.
Rossini, P. M.; Berardelli, A.; Deuschl, G. et al

in Deuschl, G.; Eisen, A. (Eds.) Recommendations for the Practice of Clinical Neurophysiology : guidelines of the International Federation of Clinical Neurophysiology (1999)

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See detailCorticomotoneuronal synaptic connections in normal man. An electrophysiological study.
Maertens de Noordhout, Alain ULg

in Brain : A Journal of Neurology (1999), 122

In order to determine the mono- or oligosynaptic character of connections between pyramidal axons and individual spinal motor neurons, we constructed peri-stimulus time histograms (PSTHs) of the firing ... [more ▼]

In order to determine the mono- or oligosynaptic character of connections between pyramidal axons and individual spinal motor neurons, we constructed peri-stimulus time histograms (PSTHs) of the firing probability of voluntarily activated single motor units (SMUs) of various upper and lower limb muscles upon slightly suprathreshold transcranial anodal electrical stimulations of the motor cortex in normal subjects. Weak anodal cortical stimuli are known to activate preferentially fast-conducting pyramidal axons directly, bypassing cell bodies and cortical interneurons. A narrow bin width (0.1 ms) was chosen to measure precisely the duration of the PSTH excitatory peak, which corresponds to the rise time of the underlying compound excitatory post-synaptic potentials (EPSP). A short duration PSTH peak indicates sharp-rising EPSPs, most commonly encountered in the case of monosynaptic connections. In flexor carpi radialis and soleus SMUs, the PSTHs of built-in responses to anodal cortical stimuli were compared with those produced by 1A afferent stimulation able to elicit a Hoffmann reflex, which is known to be largely monosynaptic. In all upper and lower limb muscles, excitable SMUs responded to anodal cortical stimuli with a highly synchronized peak of increased firing probability. In flexor carpi radialis and soleus SMUs, the mean duration of this peak was significantly narrower than that evoked by 1A afferent stimulation, indicating that monosynaptic corticomotor neuronal transmission dominates low-threshold motor units, even in proximal arm and leg muscles. In the various muscles studied, and particularly in forearm SMUs, we did not observe broad PSTH peaks against the activation of non-monosynaptic corticomotor neuronal pathways, even with near-threshold stimuli. In some triceps and forearm flexor SMUs, subthreshold anodal pulses caused significant inhibition of their voluntary firing, with a latency consistent with activation of 1A inhibitory interneurons by the descending volleys. Measurements of the maximal number of counts in the excitatory PSTH peak upon anodal cortical stimuli provide comparisons of the strength of monosynaptic inputs to various muscles which seems to be maximal for hand and finger extensor muscles, and also for deltoid. [less ▲]

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See detailLe tonus musculaire et ses troubles
MAERTENS DE NOORDHOUT, Alain ULg; DELVAUX, Valérie ULg; Delwaide, Paul ULg

in Encyclopédie Médico-Chirurgicale (1998)

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