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4. Screening Strategies for Sleep-Disordered Breathing in Patients With Spinal Cord Injury in a Tertiary Care Rehabilitation Center.

Author

Di Maria, Julie, Hartley, Sarah, Levy, Jonathan, Bossard, Isabelle, Messirejean, Laure, Lofaso, Frédéric, Bensmail, Djamel, Prigent, Hélène, and Léotard, Antoine

Subjects
BLOOD gases analysis, OXYGEN saturation, HYPOVENTILATION, T-test (Statistics), OXIMETRY, QUESTIONNAIRES, FISHER exact test, SPINAL cord injuries, TERTIARY care, TRANSCUTANEOUS blood gas monitoring, RETROSPECTIVE studies, DESCRIPTIVE statistics, REHABILITATION centers, SLEEP apnea syndromes, MEDICAL screening, POLYSOMNOGRAPHY, DATA analysis software, HOSPITAL wards, DISEASE complications
Abstract

BACKGROUND: Sleep-disordered breathing (SDB) is frequent in patients with spinal-cord injury (SCI). However, SDB is frequently underdiagnosed due to limited access to diagnostic testing and knowledge about the condition. Moreover, SDB heterogeneity (sleep apnea, obstructive sleep apnea or central sleep apnea and nocturnal alveolar hypoventilation) implies complex evaluation of both nocturnal respiratory effort and hypercapnia. The aim of this study was to compare different screening strategies for an SDB diagnosis in patients with SCI. METHODS: This was a retrospective analysis of data from subjects with SCI followed up in a tertiary-care rehabilitation center with a specialized sleep unit. Subjective (questionnaires) and objective data (polysomnography [PSG]), ... extracted from the PSG, morning blood gases, and nocturnal transcutaneous CO2 (...) were collected and analyzed. A retrospective comparison of different strategies for SDB screening was carried out. Each strategy was compared (alone and in combination) with the standard of care for sleep apnea (PSG) and nocturnal alveolar hypoventilation (...) diagnosis. The performance of the usual cutoff and visual analysis was studied. RESULTS: Among 190 subjects with SCI who underwent a full night's PSG, data were available for 104 questionnaires and 162 with oximetry. Nocturnal alveolar hypoventilation was screened by ... and blood gases in 52 subjects with SCI. Questionnaires (the modified Screening for Obstructive Sleep Apnea in Tetraplegia and the Epworth Sleepiness Scale) had poor performance for identifying sleep apnea and did not identify nocturnal alveolar hypoventilation. ... (oxygen desaturation index score ≥ 13) and visual analysis of were good at identifying sleep apnea but insufficient to identify nocturnal alveolar hypoventilation. Diurnal blood gases were poor predictors of nocturnal alveolar hypoventilation. CONCLUSIONS: Questionnaires were of limited use in subjects with SCI, but the oxygen desaturation index derived from oximetry performed well for sleep apnea screening. Both diurnal blood gases and oximetry visual analysis were insufficient for nocturnal alveolar hypoventilation screening. ... monitoring should be mandatory and ideally combined with PSG given the heterogeneity of SDB phenotypes and associated sleep comorbidities of patients with SCI. [ABSTRACT FROM AUTHOR]

Published
2024
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9. Concomitant Botulinum Toxin Injections for Neurogenic Detrusor Overactivity and Spasticity—A Retrospective Analysis of Practice and Safety.

Author

Leilaz, Arnaud, Joussain, Charles, Denys, Pierre, Bensmail, Djamel, and Levy, Jonathan

Subjects
BOTULINUM toxin, BOTULINUM A toxins, HEALTH facilities, INJECTIONS, SPASTICITY, FAMILIAL spastic paraplegia
Abstract

As multiple indications for botulinum toxin injections (BTIs) can coexist for neurological patients, there are to date no description of concomitant injections (CIs) to treat both spasticity and neurogenic detrusor overactivity incontinence (NDOI) in patients with spinal cord injuries (SCIs) and multiple sclerosis (MS). We therefore identified patients followed at our institution by health data hub digging, using a specific procedure coding system in use in France, who have been treated at least once with detrusor and skeletal muscle BTIs within the same 1-month period, over the past 5 years (2017–2021). We analyzed 72 patients representing 319 CIs. Fifty (69%) were male, and the patients were mostly SCI (76%) and MS (18%) patients and were treated by a mean number of CIs of 4.4 ± 3.6 [1–14]. The mean cumulative dose was 442.1 ± 98.8 U, and 95% of CIs were performed within a 72 h timeframe. Among all CIs, five patients had symptoms evocative of distant spread but only one had a confirmed pathological jitter in single-fiber EMG. Eleven discontinued CIs for surgical alternatives: enterocystoplasty (five), tenotomy (three), intrathecal baclofen (two) and neurotomy (one). Concomitant BTIs for treating both spasticity and NDOI at the same time appeared safe when performed within a short delay and in compliance with actual knowledge for maximum doses. [ABSTRACT FROM AUTHOR]

Published
2024
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14. Long-term effectiveness of a cognitive behavioural therapy (CBT) in the management of fatigue in patients with relapsing remitting multiple sclerosis (RRMS): a multicentre, randomised, open-label, controlled trial versus standard care.

Author

Gay, Marie Claire, Cassedanne, Fanny, Barbot, Frederic, Vaugier, Isabelle, Thomas, Sarah, Manchon, Eric, Bensmail, Djamel, Blanchere, Marie, and Heinzlef, Olivier

Subjects
BEHAVIOR therapy, FATIGUE (Physiology), COGNITIVE therapy, MULTIPLE sclerosis, CANCER fatigue, DISEASE relapse, ANXIETY disorders, GROUP psychotherapy
Published
2024
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15. Long-term effectiveness of a cognitive behavioural therapy (CBT) in the management of fatigue in patients with relapsing remitting multiple sclerosis (RRMS): a multicentre, randomised, open-label, controlled trial versus standard care

Author

Gay, Marie Claire, primary, Cassedanne, Fanny, additional, Barbot, Frederic, additional, Vaugier, Isabelle, additional, Thomas, Sarah, additional, Manchon, Eric, additional, Bensmail, Djamel, additional, Blanchere, Marie, additional, and Heinzlef, Olivier, additional

Published
2023
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17. Central Nervous System Reorganization and Pain After Spina Cord Injury: Possible Targets for Physical Therapy--A Systematic Review of Neuroimaging Studies

Author

Osinski, Thomas, Acapo, Sessi, Bensmail, Djamel, Bouhassira, Didier, and Martinez, Valeria

Subjects
Diagnostic imaging -- Physiological aspects, Neurophysiology -- Physiological aspects, Physical therapy -- Physiological aspects, Spinal cord injuries -- Physiological aspects, Central nervous system -- Physiological aspects, Health
Abstract

Background. Pain is one of the main symptoms associated with spinal cord injury (SCI) and can be associated with changes to the central nervous system (CNS). Purpose. This article provides an overview of the evidence relating to CNS changes (structural and functional) associated with pain in SCIs. Data Sources. A systematic review was performed, according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations, on PubMed, Embase, and Web of Science in March 2018. Study Selection. Studies were selected if they concerned changes in the CNS of patients with SCI, regardless of the type of imagery. Data Extraction. Data were extracted by 2 blinded reviewers. Data Synthesis. There is moderate evidence for impaired electroencephalographic function and metabolic abnormalities in the anterior cingulate in patients experiencing pain. There is preliminary evidence that patients with pain have morphological and functional changes to the somatosensory cortex and alterations to thalamic metabolism. There are conflicting data regarding the relationships between lesion characteristics and pain. In contrast, patients without pain can display protective neuroplasticity. Limitations and Conclusion. Further studies are required to elucidate fully the relationships between pain and neuroplasticity in patients with SCIs. However, current evidence might support the use of physical therapist treatments targeting CNS plasticity in patients with SCI pain., The prevalence of chronic pain ranges from 11% to 94% in patients with spinal cord injury (SCI). (1,2) Half the patients have chronic neuropathic pain, with a severe impact on [...]

Published
2020
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20. Feasibility of a serious game system including a tangible object for post stroke upper limb rehabilitation: a pilot randomized clinical study

Author

Pouplin, Samuel, primary, Bonnyaud, Céline, additional, Bouchigny, Sylvain, additional, Mégard, Christine, additional, Bertholier, Lucie, additional, Goulamhoussen, Rafik, additional, Foulon, Pierre, additional, Bensmail, Djamel, additional, Barbot, Frédéric, additional, and Roche, Nicolas, additional

Published
2023
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29. Module 2

Author

Reebye, Rajiv, primary, Balbert, Alexander, additional, Bensmail, Djamel, additional, Walker, Heather, additional, Wissel, Jörg, additional, Deltombe, Thierry, additional, and Francisco, Gerard E., additional

Published
2022
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30. A Restructured Hospital Into a One-Building Organization for COVID-19 Patients: A Resilient and Effective Response to the Pandemic

Author

Bessis, Simon, primary, Dinh, Aurélien, additional, Gautier, Sylvain, additional, Davido, Benjamin, additional, Levy, Jonathan, additional, Lawrence, Christine, additional, Lot, Anne-Sophie, additional, Bensmail, Djamel, additional, Rech, Célia, additional, Farcy-Afif, Muriel, additional, Bouchand, Frédérique, additional, de Truchis, Pierre, additional, Herrmann, Jean-Louis, additional, Barbot, Frédéric, additional, Orlikowski, David, additional, Moine, Pierre, additional, Perronne, Christian, additional, Josseran, Loïc, additional, Prigent, Hélène, additional, and Annane, Djillali, additional

Published
2022
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31. Long-term efficacy of cognitive-behavioral approaches (CBT) in the management of fatigue in patients with relapsing remitting multiple sclerosis (RRMS): a randomized, parallel-group, multicenter, open-label, controlled trial versus standard care (S19.009)

Author

Heinzlef, Olivier, primary, Cassedanne, Fanny, additional, Barbot, Frederic, additional, Vaugier, Isabelle, additional, Blanchere, Marie, additional, Manchon, Eric, additional, Bensmail, Djamel, additional, and Gay, Marie Claire, additional

Published
2022
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32. Efficacité à long terme des approches cognitives et comportementales (TCC) dans la gestion de la fatigue chez les patients atteints de sclérose en plaques récurrente-rémittente (SEP-RR) : un essai clinique randomisé (ECR), en groupes parallèles, multicentrique, ouvert et contrôlé par rapport aux soins standards

Author

Hamelin, Fanny, primary, Blanchere, Marie, additional, Barbot, Frédéric, additional, Vaugier, Isabelle, additional, Thomas, Sarah, additional, Manchon, Eric, additional, Bensmail, Djamel, additional, Heinzlef, Olivier, additional, and Gay, Marie-Claire, additional

Published
2022
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37. Long-Term Effectiveness of a Cognitive Behavioral Therapy (CBT) in the Management of Fatigue in Patients with Relapsing Remitting Multiple Sclerosis (RRMS): A Multi-Centre, Randomised, Open-Label, Controlled Trial Versus Standard Care

Author

Gay, Marie-Claire, primary, Cassedanne, Fanny, additional, Barbot, Frédéric, additional, Vaugier, Isabelle, additional, Thomas, Sarah, additional, Manchon, Eric, additional, Bensmail, Djamel, additional, Blanchère, Marie, additional, and Heinzlef, Olivier, additional

Published
2022
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