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

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

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

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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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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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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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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

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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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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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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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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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Article ; Online: Four-factor prothrombin complex concentrate to reduce allogenic blood product transfusion in patients with major trauma, the PROCOAG trial: study protocol for a randomized multicenter double-blind superiority study.

Bouzat, Pierre / Bosson, Jean-Luc / David, Jean-Stéphane / Riou, Bruno / Duranteau, Jacques / Payen, Jean-François

Trials

2021 Volume 22, Issue 1, Page(s) 634

Abstract: Background: Optimal management of severe trauma patients with active hemorrhage relies on adequate initial resuscitation. Early administration of coagulation factors improves post-traumatic coagulation disorders, and four-factor prothrombin complex ... ...

Abstract	Background: Optimal management of severe trauma patients with active hemorrhage relies on adequate initial resuscitation. Early administration of coagulation factors improves post-traumatic coagulation disorders, and four-factor prothrombin complex concentrate (PCC) might be useful in this context. Our main hypothesis is that four-factor PCC in addition to a massive transfusion protocol decreases blood product consumption at day 1 in severe trauma patients with major bleeding. Methods: This is a prospective, randomized, multicenter, double-blind, parallel, controlled superiority trial. Eligible patients are trauma patients with major bleeding admitted to a French level-I trauma center. Patients randomized in the treatment arm receive 1 mL/kg (25 IU/ml of Factor IX/Kg) four-factor PCC within 1-h post-admission while patients randomized in the controlled group receive 1 mL/kg of saline solution 0.9% as a placebo. Treatments are given as soon as possible using syringe pumps (120 mL/h). The primary endpoint is the amount of blood products transfused in the first 24 h post-admission (including red blood cells, frozen fresh plasma, and platelets). The secondary endpoints are the amount of each blood product transfused in the first 24 h, time to achieve prothrombin time ratio < 1.5, time to hemostasis, number of thrombo-embolic events at 28 days, mortality at 24 h and 28 days, number of intensive care unit-free days, number of ventilator-free days, number of hospital-free days within the first 28 days, hospitalization status at day 28, Glasgow outcome scale extended for patients with brain lesions on initial cerebral imaging, and cost of each strategy at days 8 and 28. Inclusions have started in December 2017 and are expected to be complete by June 2021. Discussion: If PCC reduces total blood consumption at day 1 after severe trauma, this therapy, in adjunction to a classic massive transfusion protocol, may be used empirically on admission in patients at risk of massive transfusion to enhance coagulation. Moreover, this treatment may decrease blood product-related complications and may improve clinical outcomes after post-traumatic hemorrhage. Trial registration: ClinicalTrials.gov NCT03218722 . Registered on July 14, 2017.
MeSH term(s)	Blood Coagulation Factors ; Blood Transfusion ; Factor IX ; Humans ; Multicenter Studies as Topic ; Prospective Studies ; Randomized Controlled Trials as Topic
Chemical Substances	Blood Coagulation Factors ; prothrombin complex concentrates (37224-63-8) ; Factor IX (9001-28-9)
Language	English
Publishing date	2021-09-16
Publishing country	England
Document type	Clinical Trial Protocol ; Journal Article
ZDB-ID	2040523-6
ISSN	1745-6215 ; 1468-6694 ; 1745-6215
ISSN (online)	1745-6215
ISSN	1468-6694 ; 1745-6215
DOI	10.1186/s13063-021-05524-x
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