Comparison of Sodium Selenite and Selenium-Enriched Spirulina Supplementation Effects After Selenium Deficiency on Growth, Tissue Selenium Concentrations, Antioxidant Activities, and Selenoprotein Expression in Rats.

Selenium contributes to physiological functions through its incorporation into selenoproteins. It is involved in oxidative stress defense. A selenium deficiency results in the onset or aggravation of pathologies. Following a deficiency, the repletion of selenium leads to a selenoprotein expression hierarchy misunderstood. Moreover, spirulina, a microalga, exhibits antioxidant properties and can be enriched in selenium.. Our objective was to determine the effects of a sodium selenite or selenium-enriched spirulina supplementation. Thirty-two female Wistar rats were fed for 12 weeks with a selenium-deficient diet. After 8 weeks, rats were divided into 4 groups and were fed with water, sodium selenite (20 µg Se/kg body weight), spirulina (3 g/kg bw), or selenium-enriched spirulina (20 µg Se/kg bw + 3 g spirulina/kg bw). Another group of 8 rats was fed with normal diet during 12 weeks. Selenium concentration and antioxidant enzyme activities were measured in plasma, urine, liver, brain, kidney, heart, and soleus. Expression of GPx (1, 3), Sel (P, S, T, W), SEPHS2, TrxR1, ApoER2, and megalin were quantified in liver, kidney, brain, and heart. We showed that a selenium deficiency leads to a growth delay, reversed by selenium supplementation despite a minor loss of weight in week 12 for SS rats. All tissues displayed a decrease in selenium concentration following deficiency. The brain seemed protected. We demonstrated a hierarchy in selenium distribution and selenoprotein expression. A supplementation of sodium selenite improved GPx activities and selenoprotein expression while a selenium-enriched spirulina was more effective to restore selenium concentration especially in the liver, kidney, and soleus.

[Social rehabilitation after epilepsy surgery]. / Réinsertion sociale après chirurgie de l'épilepsie.

No strict relationship has been observed between seizure outcome after surgery and the psychosocial status of patients with refractory epilepsy. The main reason is that seizures are not the sole criteria in evaluating social outcome. The presurgical status in terms of education, the mainly neuropsychological associated handicap, socio-occupational life, and the expectations of the patient must be taken into account. Psychosocial adjustment after surgery needs to be prepared long before surgery, in full cooperation with the patient and his or her family. Standardized tools must be developed to allow for a multidisciplinary approach and an objective evaluation of the psychosocial status of epileptic patients after surgery.

Motor threshold in transcranial magnetic stimulation: comparison of three estimation methods.

AIMS: Motor threshold (MT) is an important parameter for the practice of transcranial magnetic stimulation. Our goal was to compare three methods to estimate MT in a clinical setting. METHODS: Comparison of three MT estimation algorithms: 1) the Rossini-Rothwell method consists in lowering stimulus intensity until only five positive responses out of 10 trials are recorded, defining MT; 2) the Mills-Nithi method considers the MT as the mean of an upper threshold (10 positive out of 10 trials) and a lower threshold (0 out of 10 trials); 3) the supervised parametric method estimates the MT by fitting (mathematically and graphically) a sigmoid function on raw data obtained by stimulation at variable intensities. Six MT estimations (two per method) were recorded in a single session in 10 healthy subjects. RESULTS: The within-subject variation of MT (expressed as % of the mean MT+/-standard deviation) during a single session was of 8.5+/-7.2% for the Rossini-Rothwell method, 8.7+/-5.7% for the Mills-Nithi method and 9.5+/-4.0% for the supervised parametric method. No significant differences in variability of MT estimation were found between the methods, but the Rossini-Rothwell method was significantly shorter (half the number of stimuli compared to the two other methods). CONCLUSION: In our setting, Rossini-Rothwell method was superior to the two other methods. The variability of MT estimation measured in our study is important, yet acceptable for clinical applications. However, this variability can be a source of considerable errors in excitability studies and should be a focus of future research.

Chess-playing epilepsy: a case report with video-EEG and back averaging.

A patient suffering from juvenile myoclonic epilepsy experienced myoclonic jerks, fairly regularly, while playing chess. The myoclonus appeared particularly when he had to plan his strategy, to choose between two solutions or while raising the arm to move a chess figure. Video-EEG-polygraphy was performed, with back averaging of the myoclonus registered during a chess match and during neuropsychological testing with Kohs cubes. The EEG spike wave complexes were localised in the fronto-central region. [Published with video sequences].

[Indications for EEG in mental confusion and behavior problems]. / Indications de l'EEG dan les confusions mentales et les troubles du comportement.

Even in 1998 at the time of brain imaging, EEG recording is undoubtedly useful in clinical psychiatry when a true cerebral disease takes the form of an acute psychiatric disorder. Though the real place of EEG recording cannot be yet accurately quantified, it may help guide the diagnosis, as it is of either positive (ie, confirming the diagnosis via additional information) or negative (ie, rejecting various etiologies) value. Most of the time, only the former is considered in published studies. The clinical value of EEG recording in psychiatry emergency unit is therefore still not clearly established. The study of patients admitted during two years in the emergency unit at Sainte-Anne hospital (Paris, France) does not bring new conclusions, mainly because of bias in the modalities of admission and follow-up. As well, the role of EEG recording for the diagnosis of non-psychiatric diseases in psychiatry emergency units cannot be defined today. The authors review clinical situations where EEG recording is still highly advisable.

[Refractory epilepsy]. / Epilepsies réfractaires.

DRUG-RESISTANCE: Partial epilepsies are more often drug-resistant than generalized epilepsies, excepting severe syndromes which often begin in childhood. There is no need to try all anti-epileptic drugs before concluding as to the drug-resistant nature of the seizures. Refractory epilepsy can be diagnosed if well-conducted therapy (two alternative single-drug regimens with classical anti-seizure drugs and 1 or 2 trials with a two-drug regimen using new-generation compounds) is unsuccessful. MECHANISMS OF DRUG-RESISTANCE: The clinician should revisit the entire clinical history in patients with apparently refractory epilepsy, evaluating the treatments and the specific manifestations of the seizures. Conducted in a specialized center, this reassessment can recognize false cases of drug resistance such as non-epilepsy-related malaise or syncopes, inadequate regimens, or psychogenic "pseudo-seizures" which can be observed in patients with authentic epilepsy. Video-coupled EEG and ambulatory EEG may offer very useful information. SEVERAL EFFECTIVE THERAPEUTIC OPTIONS: Prognosis depends on effective and early control of seizures. This implies entertaining surgical excision of the epileptogenic focus early in the disease course. With several promising anti-epilepsy drugs, either recently marketed or under development, therapeutic indications in epilepsy should progress to more evidence-based prescriptions adapted to the type of epilepsy and the underlying cause.

[Memory disorders in the elderly: complementary examinations--for whom?]. / Troubles de la mémoire chez le sujet agé: examens complémentaires--pour qui?

Recognizing the existence of memory disorders in elderly subjects necessarily involves developing a diagnostic strategy to identify the causes. Three types of complementary investigation are available: neurophysiological and neurobiological tests, and anatomical and functional brain imaging studies. Major efforts have been made to identify diagnostic markers on the electroencephalogram. Quantified EEG may have a certain value. However, it provides a plethora of data and there is no consensus on which items are most relevant on the EEG, whether the patient is awake or asleep. Evoked 'cognitive' potentials may also provide useful data, particularly to distinguish between the different types of degenerative dementia. Exaggerated pupil dilation in response to a mydriatric drug has also been put forward as a diagnostic test. The results, however, are controversial. For the time being there is no diagnostic laboratory parameter that can be used routinely, even if studies of the proteins tau and P97 are promising. Molecular genetics-based studies have identified a number of chromosomal abnormalities in certain families. Apart from studies of chromosome 19 and apolipoprotein 3, these markers have no practical utility. Allele sigma 4 is associated with a higher risk of Alzheimer's disease. Apolipoprotein E phenotyping can of course be of diagnostic value, but no more so than neuropsychological or neuroimaging methods. On the other hand, it is difficult to derive a predictive test. It also seems difficult to develop a diagnostic strategy without including brain imaging studies. The value of morphological imaging (CT, MRI) in the diagnosis of dementias is clear. Volumetric measurements of certain brain structures might be a useful diagnostic approach for early detection. Functional brain imaging methods (PET and SPECT) appear particularly suited to the diagnosis of degenerative dementias. The presence of functional abnormalities at onset, and, even before the first clinical signs appear, is clearly valuable.

[Quantified EEG in the diagnosis of Alzheimer's type dementia]. / Apport de l'EEG quantifié au diagnostic de démence de type Alzheimer.

79 subjects (mean age 70.2 ans, 31 males, 48 females) selected as probable dementia of the Alzheimer type, at the early stage of the disease and 17 normal aged people (mean age: 72.2, 5 males, 12 females) were recorded with a 16 channel computerized-EEG (C-EEG) with topographical analysis of the observed changes and with classical visual analysis of the EEG. Quite simple C-EEG parameters as mean dominant frequency (MF) and alpha to theta ratio are able to discriminate patients from normal with a greater accuracy than visual analysis. The values of 8.6 for the MF and 1.3 for the alpha/theta ratio are proposed as cut off values between normal and DAT patients. The topographical analysis appear to be of no additional usefulness in the discrimination of the two groups.

[Comparison of SPECT and quantified EEG features in Alzheimer's type dementia]. / Comparaison des aspects SPECT et EEG quantifié dans les démences de type Alzheimer.

Forty-one patients with probable dementia of the Alzheimer type (DAT) have been studied by computerized EEg (C-EEG) and single photon emission tomography (SPECT) using 123-IMP. Four groups have been distinguished according to SPECT hypoperfusion topography: frontal, temporo-parietal, fronto-parietal and fronto-temporo-parietal. C-EEG parameters were much more disturbed in the 2 latter than in the 2 former groups. Thus a normal C-EEG could indicate a dominant frontal or temporo-parietal form of DAT. Therefore some bias due to duration or rate of disease progression cannot be excluded. So far the important finding is that EEG changes are diffuse and do not reflect the topography of SPECT hypoperfusion questioning the value of EEG topographical analysis in DTA.

[EEG value for the prediction of the evolution of Alzheimer's type dementia]. / Intérêt de l'EEG pour la prédiction de l'évolution des démences de type Alzheimer.

Twenty patients selected as probable dementia of the Alzheimer type (DAT) have been examined two times during a mean follow-up period of 14.5 months. Two groups have been distinguished at the end of this period: a cognitively impaired one and a stable one. EEG features at T1, at T2 or the difference T1-T2 does not allow an accurate and predictive discrimination between the two groups. But we cannot conclude that EEG is useless for prediction of the rate of progression of the disease in DAT because most of the cognitively stable patients are also stable for mean frequency. So mean frequency could be an interesting marker of evolutivity but this to be tested with more patients including more subjects reaching the severe stage of dementia.

[Topographical analysis of endogenous evoked potentials in depressed old people and in patients with Alzheimer's type dementia]. / Analyse topographique des potentiels évoqués endogènes chez des sujets âgés déprimés et chez des sujets atteints de démence de type Alzheimer.

Latencies, amplitudes and localization of the maximum of the peaks of late onset evoked responses have been studied in 3 groups of elderly people: normal, depressed and demented (probable dementia of Alzheimer type DAT) at the early stage of the disease. Evoked responses with an auditory oddball paradigm have been recorded with 16 electrodes in 2 situations: counting the target sounds, and motor response with measurement of the reaction time. No difference in amplitude was observed between the 3 groups. Only a significant difference for P3 latency was observed between the DAT and the depressed groups and only in the counting situation. The maximum P3 response was most often found on the anterior areas in the DAT group and in the posterior areas in the normal and depressed groups. The topographic localization of the P3 peak could therefore be of some help in the characterize of subjects with probable DAT at the early stage of the disease.

[Arguments for cerebral dysfunction in obsessive-compulsive disorder. A review and synthesis of the literature]. / Arguments en faveur d'un dysfonctionnement cérébral dans le trouble obsessionnel-compulsif. Revue et synthèse de la littérature.

Until recently, particular interest was focalized on the association between Obsessive Compulsive Disorder (OCD) and biochemical markers, for testing the biological hypothesis. The neurotransmitter, most involved in OCD, seems actually to be serotonin. In contrast, few studies were concentrated on searching for the site of dysfunction in specific areas of the brain. Expanding exploration methods of the central nervous system (computerized EEG, evoked potentials, positions emission tomography...) and their recent application in OCD have given more evidence for the validity of the "neurodysfunctional" hypothesis and the localization of the dysfunction in OCD.

[Caffeine and EEG mapping: effects of visuo-spatial task in healthy volunteers]. / Caféine et cartographie EEG: effets d'une tache visuospatiale chez des volontaires sains. Stratégie d'analyse des données électropharmacologiques.

A group of 10 subjects, normal volunteers (6 men, 4 women), mean age 27.2 years, right-handers, has been selected for a double-blind study of caffeine effects (400 mg per os) versus placebo. One week delay separated the two EEG sessions quantified by spectral analysis. During each session (16 EEG channels, common reference), each subject was recorded four times: 2.5 min, in eyes-closed condition, under diffuse attention, followed by 2.5 min, during a visuo-spatial task ("eyes open" condition: presentation of a picture). These two EEG recordings were obtained before the oral administration and repeated 1 hr after the administration of caffeine or placebo. Individual and group results presented globally: 1) an increase in mean frequencies of alpha activity in "eyes closed" condition, and of delta activity in "eyes open" condition; 2) a decrease of alpha activity amplitudes (both RMS and % values) in both conditions; 3) a decrease of total RMS amplitudes in "eyes closed" condition; 4) an increase of relative % amplitudes for beta 2% fast activity in the "eyes open condition". These results characterize the psycho-stimulant effects of caffeine, especially over the left temporal area which was confirming an initial statistical hypothesis of specific cerebral local activation. The non-parametric permutation tests of Fisher, were not always reaching statistical significance for the same EEG channel quantified by one of the 17 analyzed spectral parameters, except on the left temporal area. During the visuo-spatial task, the decrease in alpha amplitudes (RMS and %) was also statistically significant, but over larger areas: over left and right temporal, central and parietal regions. In both conditions, eyes closed and eyes open, the alpha RMS amplitude was also decreased over the right anterior frontal area.

[Clinical, electrophysiologic and endocrine effects of the perfusion of high doses of TRH in amyotrophic lateral sclerosis]. / Effets cliniques, électrophysiologiques et endocriniens de la TRH en perfusion à doses élevées dans la sclérose latérale amyotrophique.

Eight patients with amyotrophic lateral sclerosis received 500 mg TRH by IV infusion, at a progressive rate during 3 hours. Only 3 patients noted subjective improvement of strength. Clinical muscular testing and H response study failed to show any change. Moreover modifications of the prolactin, growth hormone, TSH and T3 serum levels raise a question concerning the tolerance with long term utilization of TRH.

[Role of electroencephalography in the diagnosis of acute cerebral diseases]. / Place de l'électroencéphalogramme dans le diagnostic des affections cérébrales aiguës.

It appears from a study of 100 cases of acute cerebral disease that electroencephalography is valuable as part of the diagnosis strategy and not only to establish the correct final diagnosis. This examination therefore plays a non-negligible role in neurological practice. In a number of diseases it provides information that no other examination can provide, being a dynamic, functional method of brain tissue analysis.

Vascular malformations of the spinal cord: intrathecal perimedullary arteriovenous fistulas fed by medullary arteries.

We studied eleven patients with intrathecal extramedullary arteriovenous fistulas identified by selective angiography and myelography. The fistulas were located on the surface of the cord, fed by medullary arteries. Angiography distinguished three separate types that gave identical clinical disorders. Therapeutic results of surgery and embolization allowed specific indications to be defined for treatment of each type of fistula.

[Value of quantitative EEG and EEG mapping in medicine]. / Intérêt de l'EEG quantitatif et de la cartographie EEG en médecine.

Quantitative EEG consists in digitising the EEG from one or several leads and then mathematically processing the signal usually by Fourier spectral analysis. A reduction of the digital information gives characteristic parameters (frequency, amplitude or power, asymmetry, etc.), which can themselves be averaged and submitted to different statistical analysis. Quantitative EEG is particularly suitable for clinical electropharmacology for the assessment of the profiles of psychotropic drugs, for pharmacokinetic correlations of dose-effect relationships and studies of drug bioavailability. The signals obtained from schizophrenic and depressed patients have well defined quantitative EEG characteristics: dissymmetry of the amplitude and hypovariability of the EEG signals. EEg mapping is performed by computer processing of 16 simultaneous EEG lead recordings. This new form of medical imaging is fast, relatively economical and non-invasive, and it is used in psychophysiology to study cognitive tasks and the states of vigilance and sleep. It is also used to study the EEG topography of cerebrovascular accidents, brain tumours, cranial trauma, cerebral degeneration and dementia, and the EEGs of psychiatric patients on psychotropic drugs. EEG mapping represents not only a static and statistical approach by drawing the averaged maps of groups of patients but also a dynamic approach by the recording of sequential individual maps presented as an animated film. The results of this method can be correlated with other medical imaging techniques used to investigate the central nervous system.

[EEG mapping in partial epilepsy]. / La cartographie EEG dans les épilepsies à crises partielles.

Even if mathematic treatment of EEG signals by Fast Fourier Transformation (FFT) in cases of transient epileptic discharges is still controversial, this method has been applied to 21 cases of epileptic partial seizures. Examples are shown, and compared to CT-Scan data. In 17 cases, EEG mapping identified alterations of basic activities upon a definite area. In addition, a focal peak of maximal alterations displacing itself into the limits of the whole epileptogenic area is demonstrated; it is furthermore suggested that the power spectrum keeps, especially during seizures, a peculiar ("combing") morphology, possibly specific of epileptic diseases.