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  1. Article ; Online: Monitoring patients with severe traumatic brain injury - Authors' reply.

    Payen, Jean-Francois / Gauss, Tobias / Vilotitch, Antoine / Bouzat, Pierre

    The Lancet. Neurology

    2024  Volume 23, Issue 3, Page(s) 232–233

    MeSH term(s) Humans ; Brain Injuries, Traumatic ; Brain Injuries ; Monitoring, Physiologic
    Language English
    Publishing date 2024-01-25
    Publishing country England
    Document type Letter
    ZDB-ID 2081241-3
    ISSN 1474-4465 ; 1474-4422
    ISSN (online) 1474-4465
    ISSN 1474-4422
    DOI 10.1016/S1474-4422(24)00030-9
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    Zs.A 5955: Show issues Location:
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  2. Article ; Online: Toward individualized sedation in patients with acute brain damage.

    Payen, Jean-François / Schilte, Clotilde / Bertrand, Barthelemy / Behouche, Alexandre

    Anaesthesia, critical care & pain medicine

    2023  Volume 42, Issue 4, Page(s) 101219

    Abstract: Sedation/analgesia in patients with acute brain damage, either traumatic or non-traumatic, is paramount to prevent alterations in brain perfusion secondary to the injury. Despite reviews on sedative and analgesic drugs, adequate sedation is an overlooked ...

    Abstract Sedation/analgesia in patients with acute brain damage, either traumatic or non-traumatic, is paramount to prevent alterations in brain perfusion secondary to the injury. Despite reviews on sedative and analgesic drugs, adequate sedation is an overlooked therapy in the prevention and treatment of intracranial hypertension. When to indicate continued sedation? How to guide the level of sedation? How to terminate sedation? This narrative review provides a practical approach to the individualized use of sedative/analgesic drugs in patients with acute brain damage.
    MeSH term(s) Humans ; Brain Injuries/therapy ; Brain Injuries/complications ; Hypnotics and Sedatives/therapeutic use ; Analgesics ; Pain ; Brain
    Chemical Substances Hypnotics and Sedatives ; Analgesics
    Language English
    Publishing date 2023-03-16
    Publishing country France
    Document type Journal Article ; Review
    ISSN 2352-5568
    ISSN (online) 2352-5568
    DOI 10.1016/j.accpm.2023.101219
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  3. Article ; Online: Central Sensitization and Small-fiber Neuropathy Are Associated in Patients With Fibromyalgia.

    Dumolard, Anne / Lefaucheur, Jean-Pascal / Hodaj, Enkelejda / Liateni, Zaki / Payen, Jean-François / Hodaj, Hasan

    The Clinical journal of pain

    2023  Volume 39, Issue 1, Page(s) 8–14

    Abstract: Objective: To study the prevalence of small-fiber neuropathy (SFN) in a large cohort of patients with fibromyalgia (FM) and to better characterize the subset of patients with both FM and SFN.: Methods: This 1-year, retrospective, observational cohort ...

    Abstract Objective: To study the prevalence of small-fiber neuropathy (SFN) in a large cohort of patients with fibromyalgia (FM) and to better characterize the subset of patients with both FM and SFN.
    Methods: This 1-year, retrospective, observational cohort study included 265 patients with FM. They all performed electrochemical skin conductance (ESC) using the Sudoscan device, 1 of the simplest and most reliable technique to assess the distal autonomic nerve fibers. They completed 4 self-assessment questionnaires: (1) the Central Sensitization Inventory (CSI), (2) the Neuropathic Pain Symptom Inventory (NPSI), and (3) the Hospital Anxiety and Depression Scale (HADS), the Fibromyalgia Impact Questionnaire (FIQ).
    Results: Fifty-three patients (20%) had reduced ESC values. These patients had higher CSI and HADS scores, and a larger intake of analgesic drugs compared with patients with no ESC abnormalities. Central sensitization, which was extreme in 69% of the patients (CSI score ≥60), was 1 of the main determinants of ESC abnormalities and was associated with a higher NPSI score, even though these 2 factors were not correlated.
    Conclusion: Over the past 10 years, studies have shown that a significant proportion of patients with FM have signs of small nerve fiber impairment. The possible involvement of SFN, in the occurrence and presentation of clinical symptoms in FM patients, remains however unclear. This is the first study that showed an association between central sensitization and both small nerve fiber impairment and neuropathic pain features in FM patients, rather than a direct association between SFN and neuropathic pain.
    MeSH term(s) Humans ; Fibromyalgia/complications ; Fibromyalgia/diagnosis ; Central Nervous System Sensitization ; Retrospective Studies ; Neuralgia/epidemiology ; Neuralgia/complications ; Surveys and Questionnaires
    Language English
    Publishing date 2023-01-01
    Publishing country United States
    Document type Observational Study ; Journal Article
    ZDB-ID 632582-8
    ISSN 1536-5409 ; 0749-8047
    ISSN (online) 1536-5409
    ISSN 0749-8047
    DOI 10.1097/AJP.0000000000001085
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    Zs.A 2078: Show issues Location:
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  4. Article ; Online: Therapeutic hypothermia after traumatic brain injury: Wrong hypotheses may lead to specious interpretations.

    Bouzat, Pierre / Payen, Jean-François

    Anaesthesia, critical care & pain medicine

    2019  Volume 38, Issue 2, Page(s) 95–96

    MeSH term(s) Brain Injuries, Traumatic/therapy ; Carbon Dioxide/blood ; Humans ; Hypothermia, Induced/adverse effects ; Neuroprotection
    Chemical Substances Carbon Dioxide (142M471B3J)
    Language English
    Publishing date 2019-02-05
    Publishing country France
    Document type Editorial
    ISSN 2352-5568
    ISSN (online) 2352-5568
    DOI 10.1016/j.accpm.2019.01.008
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  5. Article ; Online: Neural Correlates of Pain-Autonomic Coupling in Patients With Complex Regional Pain Syndrome Treated by Repetitive Transcranial Magnetic Stimulation of the Motor Cortex.

    Delon-Martin, Chantal / Lefaucheur, Jean-Pascal / Hodaj, Enkeledja / Sorel, Marc / Dumolard, Anne / Payen, Jean-François / Hodaj, Hasan

    Neuromodulation : journal of the International Neuromodulation Society

    2023  Volume 27, Issue 1, Page(s) 188–199

    Abstract: Objectives: Complex regional pain syndrome (CRPS) is a chronic pain condition involving autonomic dysregulation. In this study, we report the results of an ancillary study to a larger clinical trial investigating the treatment of CRPS by neuromodulation. ...

    Abstract Objectives: Complex regional pain syndrome (CRPS) is a chronic pain condition involving autonomic dysregulation. In this study, we report the results of an ancillary study to a larger clinical trial investigating the treatment of CRPS by neuromodulation. This ancillary study, based on functional magnetic resonance imaging (fMRI), evaluated the neural correlates of pain in patients with CRPS in relation to the sympathetic nervous system and for its potential relief after repetitive transcranial magnetic stimulation of the motor cortex.
    Materials and methods: Eleven patients with CRPS at one limb (six women, five men, aged 52.0 ± 9.6 years) were assessed before and one month after the end of a five-month repetitive transcranial magnetic stimulation (rTMS) therapy targeting the motor cortex contralateral to the painful limb, by means of electrochemical skin conductance (ESC) measurement, daily pain intensity scores on a visual numerical scale (VNS), and fMRI with motor tasks (alternation of finger movements and rest). The fMRI scans were analyzed voxelwise using ESC and VNS pain score as regressors to derive their neural correlates. The criterion of response to rTMS therapy was defined as ≥30% reduction in VNS pain score one month after treatment compared with baseline.
    Results: At baseline, ESC values were reduced in the affected limb vs the nonaffected limb. There was a covariance of VNS with brain activation in a small region of the primary somatosensory cortex (S1) contralateral to the painful side on fMRI investigation. After rTMS therapy on motor cortex related to the painful limb, the VNS pain scores significantly decreased by 22% on average. The criterion of response was met in six of 11 patients (55%). In these responders, at one month after treatment, ESC value increased and returned to normal in the CRPS-affected limb, and overall, the increase in ESC correlated with the decrease in VNS after motor cortex rTMS therapy. At one month after treatment, there also was a covariance of both variables (ESC and VNS) with fMRI activation of the S1 region previously mentioned. The fMRI activation of other brain regions (middle frontal gyrus and temporo-parietal junction) showed correlation with ESC values before and after treatment. Finally, we found a positive correlation at one month after treatment (not at baseline) between VNS pain score and fMRI activation in the temporo-parietal junction contralateral to painful side.
    Conclusions: This study first shows a functional pain-autonomic coupling in patients with CRPS, which could involve a specific S1 region. However, the modulation of sympathetic sudomotor activities expressed by ESC changes was rather correlated with functional changes in other brain regions. Finally, the pain relief observed at one month after rTMS treatment was associated with a reduced activation of the temporo-parietal junction on the side in which rTMS was performed. These findings open perspectives to define new targets or biomarkers for using rTMS to treat CRPS-associated pain.
    Clinical trial registration: The Clinicaltrials.gov registration number for the study is NCT02817880.
    MeSH term(s) Male ; Humans ; Female ; Transcranial Magnetic Stimulation/methods ; Motor Cortex/diagnostic imaging ; Treatment Outcome ; Pain ; Complex Regional Pain Syndromes/diagnostic imaging ; Complex Regional Pain Syndromes/therapy ; Magnetic Resonance Imaging
    Language English
    Publishing date 2023-08-16
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1500372-3
    ISSN 1525-1403 ; 1094-7159
    ISSN (online) 1525-1403
    ISSN 1094-7159
    DOI 10.1016/j.neurom.2023.05.005
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    Zs.A 5912: Show issues Location:
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  6. Article ; Online: Bilateral Sphenopalatine Ganglion Block for Postoperative Spinal Dural Tear.

    Ferjani, Malik / Baud, Mariette / Pelen, Félix / Schilte, Clotilde / Payen, Jean-Francois

    Pain medicine (Malden, Mass.)

    2022  Volume 24, Issue 4, Page(s) 466–467

    MeSH term(s) Humans ; Sphenopalatine Ganglion Block ; Post-Dural Puncture Headache/therapy ; Blood Patch, Epidural
    Language English
    Publishing date 2022-09-23
    Publishing country England
    Document type Journal Article
    ZDB-ID 2015903-1
    ISSN 1526-4637 ; 1526-2375
    ISSN (online) 1526-4637
    ISSN 1526-2375
    DOI 10.1093/pm/pnac146
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    Zs.A 6119: Show issues Location:
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  7. Article ; Online: Prediction of neurocritical care intensity through automated infrared pupillometry and transcranial doppler in blunt traumatic brain injury: the NOPE study.

    Banco, Pierluigi / Taccone, Fabio Silvio / Sourd, Dimitri / Privitera, Claudio / Bosson, Jean-Luc / Teixeira, Thomas Luz / Adolle, Anais / Payen, Jean-François / Bouzat, Pierre / Gauss, Tobias

    European journal of trauma and emergency surgery : official publication of the European Trauma Society

    2024  

    Abstract: Purpose: This pilot study aimed to determine the capacity of automated infrared pupillometry (AIP) alone and in combination with transcranial doppler (TCD) on admission to rule out need for intense neuroAQ2 critical care (INCC) in severe traumatic brain ...

    Abstract Purpose: This pilot study aimed to determine the capacity of automated infrared pupillometry (AIP) alone and in combination with transcranial doppler (TCD) on admission to rule out need for intense neuroAQ2 critical care (INCC) in severe traumatic brain injury (TBI).
    Methods: In this observational pilot study clinicians performed AIP and TCD measurements on admission in blunt TBI patients with a Glasgow Coma Score (GCS) < 9 and/or motor score < 6. A Neurological Pupil index (NPi) < 3, Pulsatility Index (PI) > 1,4 or diastolic blood flow velocity (dV) of < 20 cm/s were used to rule out the need for INCC (exceeding the tier 0 Seattle Consensus Conference). The primary outcome was the negative likelihood ratio (nLR) of NPi < 3 alone or in combination with TCD to detect need for INCC.
    Results: A total of 69 TBI patients were included from May 2019 to September 2020. Of those, 52/69 (75%) median age was 45 [28-67], median prehospital GCS of 7 [5-8], median Injury Severity Scale of 13.0 [6.5-25.5], median Marshall Score of 4 [3-5], the median Glasgow Outcome Scale at discharge was 3 [1-5]. NPi < 3 was an independent predictor of INCC. NPi demonstrated a nLR of 0,6 (95%CI 0.4-0.9; AUROC, 0.65, 95% CI 0.51-0.79), a combination of NPi and TCD showed a nLR of 0.6 (95% CI 0.4-1.0; AUROC 0.67 95% CI 0.52-0.83) to predict INCC.
    Conclusion: This pilot study suggests a possible useful contribution of NPi to determine the need for INCC in severe blunt TBI patients on admission.
    Language English
    Publishing date 2024-01-16
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 2275480-5
    ISSN 1863-9941 ; 1863-9933
    ISSN (online) 1863-9941
    ISSN 1863-9933
    DOI 10.1007/s00068-023-02435-1
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  8. Article ; Online: Long-term analgesic effect of trans-spinal direct current stimulation compared to non-invasive motor cortex stimulation in complex regional pain syndrome.

    Hodaj, Hasan / Payen, Jean-Francois / Hodaj, Enkelejda / Sorel, Marc / Dumolard, Anne / Vercueil, Laurent / Delon-Martin, Chantal / Lefaucheur, Jean-Pascal

    Brain communications

    2023  Volume 5, Issue 4, Page(s) fcad191

    Abstract: The aim of the present study was to compare the analgesic effect of motor cortex stimulation using high-frequency repetitive transcranial magnetic stimulation or transcranial direct current stimulation and transcutaneous spinal direct current stimulation ...

    Abstract The aim of the present study was to compare the analgesic effect of motor cortex stimulation using high-frequency repetitive transcranial magnetic stimulation or transcranial direct current stimulation and transcutaneous spinal direct current stimulation in patients with complex regional pain syndrome. Thirty-three patients with complex regional pain syndrome were randomized to one of the three treatment groups (repetitive transcranial magnetic stimulation,
    Language English
    Publishing date 2023-07-01
    Publishing country England
    Document type Journal Article
    ISSN 2632-1297
    ISSN (online) 2632-1297
    DOI 10.1093/braincomms/fcad191
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  9. Article ; Online: Functional hub disruption emphasizes consciousness recovery in severe traumatic brain injury.

    Oujamaa, Lydia / Delon-Martin, Chantal / Jaroszynski, Chloé / Termenon, Maite / Silva, Stein / Payen, Jean-François / Achard, Sophie

    Brain communications

    2023  Volume 5, Issue 6, Page(s) fcad319

    Abstract: Severe traumatic brain injury can lead to transient or even chronic disorder of consciousness. To increase diagnosis and prognosis accuracy of disorder of consciousness, functional neuroimaging is recommended 1 month post-injury. Here, we investigated ... ...

    Abstract Severe traumatic brain injury can lead to transient or even chronic disorder of consciousness. To increase diagnosis and prognosis accuracy of disorder of consciousness, functional neuroimaging is recommended 1 month post-injury. Here, we investigated brain networks remodelling on longitudinal data between 1 and 3 months post severe traumatic brain injury related to change of consciousness. Thirty-four severe traumatic brain-injured patients were included in a cross-sectional and longitudinal clinical study, and their MRI data were compared to those of 20 healthy subjects. Long duration resting-state functional MRI were acquired in minimally conscious and conscious patients at two time points after their brain injury. The first time corresponds to the exit from intensive care unit and the second one to the discharge from post-intensive care rehabilitation ward. Brain networks data were extracted using graph analysis and metrics at each node quantifying local (clustering) and global (degree) connectivity characteristics. Comparison with brain networks of healthy subjects revealed patterns of hyper- and hypo-connectivity that characterize brain networks reorganization through the hub disruption index, a value quantifying the functional disruption in each individual severe traumatic brain injury graph. At discharge from intensive care unit, 24 patients' graphs (9 minimally conscious and 15 conscious) were fully analysed and demonstrated significant network disruption. Clustering and degree nodal metrics, respectively, related to segregation and integration properties of the network, were relevant to distinguish minimally conscious and conscious groups. At discharge from post-intensive care rehabilitation unit, 15 patients' graphs (2 minimally conscious, 13 conscious) were fully analysed. The conscious group still presented a significant difference with healthy subjects. Using mixed effects models, we showed that consciousness state, rather than time, explained the hub disruption index differences between minimally conscious and conscious groups. While severe traumatic brain-injured patients recovered full consciousness, regional functional connectivity evolved towards a healthy pattern. More specifically, the restoration of a healthy brain functional segregation could be necessary for consciousness recovery after severe traumatic brain injury. For the first time, extracting the hub disruption index directly from each patient's graph, we were able to track the clinical alteration and subsequent recovery of consciousness during the first 3 months following a severe traumatic brain injury.
    Language English
    Publishing date 2023-11-22
    Publishing country England
    Document type Journal Article ; Comment
    ISSN 2632-1297
    ISSN (online) 2632-1297
    DOI 10.1093/braincomms/fcad319
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  10. Article ; Online: Influence of units to express end-tidal carbon dioxide on the awareness of intraoperative hypocapnia.

    Lalmi, Vanessa / Chenavas, Marie-Amelie / Evain, Jean-Noel / Payen, Jean-Francois

    Anaesthesia, critical care & pain medicine

    2020  Volume 39, Issue 6, Page(s) 893–894

    MeSH term(s) Carbon Dioxide ; Humans ; Hypocapnia
    Chemical Substances Carbon Dioxide (142M471B3J)
    Language English
    Publishing date 2020-09-29
    Publishing country France
    Document type Letter
    ISSN 2352-5568
    ISSN (online) 2352-5568
    DOI 10.1016/j.accpm.2020.08.007
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