Publications by authors named "Jean-Marc Michel"

4 Publications

  • Page 1 of 1

Long-lasting diagonistic dyspraxia suppressed by rTMS applied to the right motor cortex.

J Neurol 2019 Mar 10;266(3):631-635. Epub 2019 Jan 10.

Gerontology Pole, Hôpitaux Civils, Colmar, France.

We describe the case of a 58-year-old patient with complete callosal agenesis, who developed after a stroke a long lasting and distressing diagonistic dyspraxia. We found two original treatments to relieve the patient from his left limb conflicting movements. Reinforcing left arm sensory input minimized dyspraxic movements but was difficult to apply daily and was found unsatisfactory by the patient. As left anarchic, unwished movements of diagonistic dyspraxia have been attributed to the lack of inhibition exerted by supplementary motor area on right motor cortex, we applied sham-controlled rTMS to the right motor cortex. This procedure provided a dramatic suppression of left-hand involuntary movements. To our knowledge, this is the first description of the successful treatment of diagonistic dyspraxia.
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March 2019

Prevention of pressure ulcers with a motorized air support in at-risk patients hospitalized in rehabilitation departments APAM + an observational prevalence study with historical control and incidence study.

Panminerva Med 2018 Dec 28;60(4):161-169. Epub 2018 Jun 28.

Department of Rehabilitation, University Hospital, Saint-Etienne, France.

Background: The main study was a cross-sectional multicenter study of the prevalence of pressure ulcers in rehabilitation services (RS) where Axtair Automorpho® Plus mattresses were made available ad libitum. The primary objective was to enable comparison with prevalence as observed in the national PERSE study (historical control) in similar departments using a variety of prevention aids.

Methods: This cross-sectional prevalence study was combined with a prospective study of the incidence of pressure ulcer occurrence in the high-risk target population whose beds were systematically equipped with the studied support.

Results: On the day of the prevalence study, 18 of the 456 patients presented pressure ulcers which occurred during the period when Axtair Automorpho® Plus supports were made available to the departments. This corresponds to a prevalence of 3.9% [2.4, 6.2] which is significantly lower than those recorded in the PERSE study: 11.8% [10.8; 12.8] p <0.0001. The ulcer incidence study covers 57 patients who were hospitalized on a bed with an Axtair Automorpho® Plus support because of their risk of contracting pressure ulcers. One pressure ulcer occurred in 3 patients and 3 pressure ulcers occurred in another patient, i.e. 4 out of 57 corresponding to an incidence of 7.0% [2.0; 17.0].

Conclusions: The results of the pressure ulcer prevalence study in rehabilitation departments where Axtair Automorpho® Plus supports were available as well as results of the study of pressure ulcer incidence in patients bedridden on Axtair Automorpho® Plus, confirm the expected benefit provided to patients in terms of prevention.
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December 2018

Long-term cognitive outcome of Alzheimer's disease and dementia with Lewy bodies: dual disease is worse.

Alzheimers Res Ther 2017 Jun 27;9(1):47. Epub 2017 Jun 27.

University of Strasbourg, Laboratory of Biostatistics and French National Centre for Scientific Research (CNRS), ICube Laboratory, Team Modèles, Images et Vision (MIV), Strasbourg, France.

Background: Longitudinal studies of dementia with Lewy bodies (DLB) are rare. Clinically, DLB is usually considered to worsen into Alzheimer's disease (AD). The aim of our study was to compare the rate of the cognitive decline in DLB, AD, and the association of the two diseases (AD + DLB).

Methods: Using the Regional Network for Diagnostic Aid and Management of Patients with Cognitive Impairment database, which includes all the patients seen at all memory clinics (medical consultation and day hospitals) in four French regions, and beta regression, we compared the longitudinal the Mini-Mental State Examination scores of 1159 patients with AD (n = 1000), DLB (n = 131) and AD + DLB (association of the two) (n = 28) during follow-up of at least 4 years.

Results: The mean follow-up of the patients was 5.88 years. Using beta regression without propensity scores, the comparison of the decline of patients with AD and patients with DLB did not show a significant difference, but the decline of patients with AD + DLB was worse than that of either patients with DLB (P = 0.006) or patients with AD (P < 0.001). Using beta regression weighted by a propensity score, comparison of patients with AD and patients with DLB showed a faster decline for patients with DLB (P < 0.001). The comparison of the decline of patients with AD + DLB with that of patients with DLB (P < 0.001) and patients with AD (P < 0.001) showed that the decline was clearly worse in the patients with dual disease.

Conclusions: Whatever the analysis, the rate of decline is faster in patients with AD + DLB dual disease. The identification of such patients is important to enable clinicians to optimise treatment and care and to better inform and help patients and caregivers.
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June 2017

["Reversible" dementia in 2011].

Geriatr Psychol Neuropsychiatr Vieil 2011 Jun;9(2):211-25

CMRR de Strasbourg-ColmarCMRR de Strasbourg-ColmarCMRR de Strasbourg-Colmar.

Reversible dementias are rare and account for approximately 1.5% of all dementias. The most frequent etiology is represented by neurosurgical causes such as benign tumours, adult chronic hydrocephalus (so-called « normal pressure » hydrocephalus) or subdural hematoma, which are easily revealed by neuroimaging. Systematic ancillary investigations aimed at detecting an infectious disease (syphilis, HIV infection, Lyme neuroborreliosis or, more rarely, Whipple disease), an endocrine aetiology or a vitamin deficiency are rarely contributory, but remain relevant since these dementias could be reversible. Discovering a reversible cause of dementia does not always allow full recovery after treatment. However, systematic ancillary investigations can identify and treat concomitant reversible conditions, which contribute to worsening the main clinical condition in nearly 25% of dementia cases.
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June 2011