References of "LOMMERS, Emilie"
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See detailRelative Contribution of Walking Speed, Ataxia and Gait asymmetry to the Composition of Gait in Multiple Sclerosis
PHAN BA, Remy ULg; Pierard, Sébastien ULg; LOMMERS, Emilie ULg et al

Poster (2013, October)

Introduction - Objective: Walking speed measured according to the T25FW is the most widely used descriptor of gait in MS clinical research and practice but other dimensions influencing gait variance exist ... [more ▼]

Introduction - Objective: Walking speed measured according to the T25FW is the most widely used descriptor of gait in MS clinical research and practice but other dimensions influencing gait variance exist according to alternative gait analysis methods. The relative importance of these different dimensions of gait relatively to its variance is unknown. Methods: We measured the performances of persons with MS and healthy subjects on the T25FW and the Timed 20-Meter Walk (T20MW) performed in tandem with a new gait analysis system (GAIMS). We performed a factorial analysis of variance to underline the main dimensions influencing gait variance and observed their composition. Findings - Conclusion: The main factor influencing gait variance in conventional walk tests is mostly composed of features related to walking speed. Balance, gait asymmetry and variability also participate to this variance but to a lesser extent. The inverse is observed in tests performed in tandem gait. [less ▲]

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See detailInfluence of the mode of walk on walking speed in multiple sclerosis: are you walking comfortably?
PHAN BA, Remy ULg; DELRUE, Gaël ULg; Pierard, Sébastien ULg et al

Poster (2013, June 10)

Introduction : Walking speed (WS) is the most frequent gait variable taken into account when measuring gait dysfunction in neurological diseases. Influences of the mode of walk instructed to the subject ... [more ▼]

Introduction : Walking speed (WS) is the most frequent gait variable taken into account when measuring gait dysfunction in neurological diseases. Influences of the mode of walk instructed to the subject, i.e. « as fast as possible » (AFAP) or « at a comfortable pace » (PrP) have not been well characterized in multiple sclerosis (MS). Objectives : to compare those 2 mode of walk in a population of persons with MS (pMS) and healthy volunteers (HV). Methods: WS was measured with a new automated device along a 25 foot distance (T25FW) as part of a multimodal evaluation of gait in an MS ambulatory department. Results: Baseline demographics between HV and pMS were comparable. Our first results demonstrate that (i) WS is obviously significantly higher in AFAP than in PrP both for pMS and HV (p < 0.001 for all comparisons) and (ii) the relative difference between AFAP and PrP WS is significantly higher in HV than in pMS (p < 0.001). The AFAP-PrP WS correlation is higher in pMS (r = 0.87, p < 0.001) than in HV (r = 0.51, p < 0.001). Finally, the relative difference between AFAP and PrP WS is significantly and negatively correlated with the PrP WS in HV (r = -0.41, p < 0.001) and pMS with mild to moderate disability (EDSS 0-3.5, r = -0.49, p < 0.01) but not in pMS with high disability (EDSS 4-5.5, r = 0.008). Conclusions : these results suggests that heatlhy subjects have access to a higher range of PrP WS than pMS and questions the regulation of PrP WS that might be under psychological or behavioural influences. The demonstration of a lower PrP-AFAP difference in MS suggests that pMS are either adopting a natural WS closer to their maximum WS, or alternatively that they can’t reach their maximum WS because of neurological impairments. Our results also emphasize the importance of the instructed mode of walk in the quantification of gait disorders both for routine clinical practice and clinical trials. [less ▲]

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See detailMotor fatigue measurement by distance-induced slow down of walking speed in multiple sclerosis
PHAN BA, Remy ULg; CALAY, Philippe ULg; GRODENT, Patrick ULg et al

in PLoS ONE (2012), 7(4), 34744

Background: Motor fatigue and ambulation impairment are prominent clinical features of people with multiple sclerosis (pMS). We hypothesized that a multimodal and comparative assessment of walking speed ... [more ▼]

Background: Motor fatigue and ambulation impairment are prominent clinical features of people with multiple sclerosis (pMS). We hypothesized that a multimodal and comparative assessment of walking speed on short and long distance would allow a better delineation and quantification of gait fatigability in pMS. Objectives: To compare 4 walking paradigms: the timed 25-foot walk (T25FW), a corrected version of the T25FW with dynamic start (T25FW+), the timed 100-meter walk (T100MW) and the timed 500-meter walk (T500MW). Methods: Thirty controls and 81 pMS performed the 4 walking tests in a single study visit. Results: The 4 walking tests were performed with a slower WS in pMS compared to controls even in subgroups with minimal disability. The finishing speed of the last 100-meter of the T500MW was the slowest measurable WS whereas the T25FW+ provided the fastest measurable WS. The ratio between such slowest and fastest WS (Deceleration Index, DI) was significantly lower only in pMS with EDSS 4.0-6.0, a pyramidal or cerebellar functional system score reaching 3 or a maximum reported walking distance !4000m. Conclusion: The motor fatigue which triggers gait deceleration over a sustained effort in pMS can be measured by the WS ratio between performances on a very short distance and the finishing pace on a longer more demanding task. The absolute walking speed is abnormal early in MS whatever the distance of effort when patients are unaware of ambulation impairment. In contrast, the DI-measured ambulation fatigability appears to take place later in the disease course. [less ▲]

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See detailImmune Reconstitution Inflammatory Syndrome in Natalizumab-Associated PML
Phan-Ba, Rémy ULg; LOMMERS, Emilie ULg; Moonen, Gustave ULg et al

in Neurology (2012), 78(1), 73

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See detailA corrected version of the Timed-25 Foot Walk Test with a dynamic start to capture the maximum ambulation speed in multiple sclerosis patients
Phan-Ba, Rémy ULg; CALAY, Philippe ULg; GRODENT, Patrick ULg et al

in NeuroRehabilitation (2012), 30(4), 261-266

Background : No clinical test is currently available and validated to measure the maximum walking speed (WS) of multiple sclerosis (MS) patients. Since the Timed 25-Foot Walk Test (T25FW) is performed ... [more ▼]

Background : No clinical test is currently available and validated to measure the maximum walking speed (WS) of multiple sclerosis (MS) patients. Since the Timed 25-Foot Walk Test (T25FW) is performed with a static start, it takes a significant proportion of the distance for MS patients to reach their maximum pace. Objectives : In order to capture the maximum WS and to quantify the relative impact of the accelerating phase during the first meters, we compared the classical T25FW with a modified version (T25FW+) allowing a dynamic start after a 3 meters run-up. Methods : Sixty-four MS patients and 30 healthy subjects performed successively the T25FW and the T25FW+. Results : The T25FW+ was performed faster than the T25FW for the vast majority of MS and healthy subjects. In the MS population, the mean relative gain of speed due to the dynamic start on T25FW+ was independent from the EDSS and from the level of ambulation impairment. Compared to healthy subjects, the relative difference between dynamic versus static start was more important in the MS population even in patients devoid of apparent gait impairment according to the T25FW. Conclusion : The T25FW+ allows a more accurate measurement of the maximum WS of MS patients, which is a prerequisite to reliably evaluate deceleration over longer distance tests. Indirect arguments suggest that the time to reach the maximum WS may be partially influenced by the cognitive impairment status. The maximum WS and the capacity of MS patients to accelerate on a specific distance may be independently regulated and assessed separately in clinical trials and rehabilitation programs. [less ▲]

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See detailVitamin D tweets light to genes in multiple sclerosis
LOMMERS, Emilie ULg; Lecrompe, Laurence ULg; Moonen, Gustave ULg et al

in Revue Médicale de Liège (2012), 67(5-6), 359-365

The relationship between sunlight exposure and the incidence of multiple sclerosis and the understanding of immunomodulatory effects of vitamin D triggered, in recent years, a broad range of ... [more ▼]

The relationship between sunlight exposure and the incidence of multiple sclerosis and the understanding of immunomodulatory effects of vitamin D triggered, in recent years, a broad range of investigations. Immunological studies performed in vitro and in vivo have demonstrated how tolerogenic vitamin D can be. Epidemiological studies confirmed an increased incidence of multiple sclerosis in vitamin D deficient subjects and signs of increased disease activity in such MS patients. Although small-scale observational studies have suggested a beneficial impact of vitamin D supplementation on the incidence and severity of multiple sclerosis, large scale clinical trials remain warranted to confirm these preliminary results. [less ▲]

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See detailMRI preclinical detection and asymptomatic course of a progressive multifocal leucoencephalopathy (PML) under natalizumab therapy.
Phan-Ba, Rémy ULg; LOMMERS, Emilie ULg; TSHIBANDA, Luaba ULg et al

in Journal of Neurology, Neurosurgery & Psychiatry (2012), 83

Early detection of progressive multifocal leucoencephalopathy (PML) in the setting of natalizumab therapy currently is performed by rapid evaluation of new symptoms occurring in treated patients. The role ... [more ▼]

Early detection of progressive multifocal leucoencephalopathy (PML) in the setting of natalizumab therapy currently is performed by rapid evaluation of new symptoms occurring in treated patients. The role of MR scanning has not been investigated but holds promise since MR detection is highly sensitive for PML lesions. The authors report a case of presymptomatic PML of the posterior fossa detected by MR scans. Immediate suspension of natalizumab and plasma exchanges resulted in a rapid decline of natalizumab serum concentration. Intravenous steroids started together with plasma exchanges followed by an oral tapering course were used to minimise the immune reconstitution inflammatory syndrome. No symptoms (beyond mild headache) developed, and the repeat PCR for JC Virus (JCV) DNA detection performed 10 weeks later was negative. This case suggests that: (1) periodic brain MR scans may detect signs of presymptomatic PML in MS patients treated with natalizumab, (2) corticosteroid management of inflammatory reaction may contribute to optimal control of the immune reconstitution inflammatory syndrome routinely seen with natalizumab-associated PML and (3) early radiological detection of PML can have an excellent outcome even in a clinically critical region and despite prior immunosuppressant exposure. The potential benefit of regular MR scanning just using the T2/FLAIR modalities could be further investigated in order to detect early natalizumab-associated PML, leading to benign outcomes. [less ▲]

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See detailMultimodal neuroimaging in patients with disorders of consciousness showing "functional hemispherectomy".
Bruno, Marie-Aurélie ULg; Fernandez-Espejo, D.; Lehembre, Remy ULg et al

in Progress in Brain Research (2011), 193

Beside behavioral assessment of patients with disorders of consciousness, neuroimaging modalities may offer objective paraclinical markers important for diagnosis and prognosis. They provide information ... [more ▼]

Beside behavioral assessment of patients with disorders of consciousness, neuroimaging modalities may offer objective paraclinical markers important for diagnosis and prognosis. They provide information on the structural location and extent of brain lesions (e.g., morphometric MRI and diffusion tensor imaging (DTI-MRI) assessing structural connectivity) but also their functional impact (e.g., metabolic FDG-PET, hemodynamic fMRI, and EEG measurements obtained in "resting state" conditions). We here illustrate the role of multimodal imaging in severe brain injury, presenting a patient in unresponsive wakefulness syndrome (UWS; i.e., vegetative state, VS) and in a "fluctuating" minimally conscious state (MCS). In both cases, resting state FDG-PET, fMRI, and EEG showed a functionally preserved right hemisphere, while DTI showed underlying differences in structural connectivity highlighting the complementarities of these neuroimaging methods in the study of disorders of consciousness. [less ▲]

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See detailLe cas clinique du mois. Une cause inhabituelle de sciatalgie nécessitant un traitement chirurgical : le kyste arthrosynovial lombaire
Lommers, Emilie ULg; Gillet, Philippe ULg

in Revue Médicale de Liège (2010), 65(12), 665-8

We describe the case of a 46-year-old woman suffering from an hyperalgic sciatica caused by a lumbar synovial cyst. These are uncommon lesions associated with degenerative spine disease. They may be ... [more ▼]

We describe the case of a 46-year-old woman suffering from an hyperalgic sciatica caused by a lumbar synovial cyst. These are uncommon lesions associated with degenerative spine disease. They may be asymptomatic or may produce symptoms resulting from nervous structures compression. They are commonly found at the L4-L5 level, the site of maximum mobility. Their etiopathogeny is still unclear but degenerative spinal instability is the strongest factor for their growth. MRI is the most effective for the diagnosis. Conservative management is usually unsuccessful. Resection with or without fusion remains the more appropriate therapeutic option. [less ▲]

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