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Article ; Online: Risk and benefit of statins in stroke secondary prevention.

Laloux, Patrice

2014 Volume 11, Issue 6, Page(s) 812–816

Abstract: Statin is now recommended in secondary prevention after stroke or transient ischemic attacks to reduce the risk of a new stroke or major cardiovascular events. However, some issues about the extent of the benefit in some stroke patients and the risk of ... ...

Abstract	Statin is now recommended in secondary prevention after stroke or transient ischemic attacks to reduce the risk of a new stroke or major cardiovascular events. However, some issues about the extent of the benefit in some stroke patients and the risk of cerebral hemorrhage remain debated. This review shows that statins are significantly effective in decreasing the risk of further strokes despite an increase in the risk of brain hemorrhage. A significant benefit was observed in men and women, in aged patients and possibly to a greater extent in patients with carotid artery stenosis. Intensive statin therapy lowering the LDL-cholesterol beyond the cut-off value of 1.8 mmol/L (70 mg/dl) seems to be more effective than less intensive treatment and without an increased risk of side effects. Overall, statins are well tolerated. Further prospective studies should clarify whether the effect is of the same magnitude in small vessel disease and how to select the patients to reduce the risk of cerebral hemorrhage.
MeSH term(s)	Animals ; Cerebral Hemorrhage/blood ; Cerebral Hemorrhage/chemically induced ; Cholesterol, LDL/blood ; Clinical Trials as Topic/methods ; Clinical Trials as Topic/trends ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors/administration & dosage ; Hydroxymethylglutaryl-CoA Reductase Inhibitors/adverse effects ; Risk Factors ; Secondary Prevention/methods ; Secondary Prevention/trends ; Stroke/blood ; Stroke/prevention & control ; Treatment Outcome
Chemical Substances	Cholesterol, LDL ; Hydroxymethylglutaryl-CoA Reductase Inhibitors
Language	English
Publishing date	2014-01-16
Publishing country	United Arab Emirates
Document type	Journal Article ; Review
ZDB-ID	2192362-0
ISSN	1875-6212 ; 1570-1611
ISSN (online)	1875-6212
ISSN	1570-1611
DOI	10.2174/157016111106140128113121
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Article ; Online: Steroid-responsive leucoencephalopathy due to cholesterol embolism.

Laloux, Patrice

Journal of neurology, neurosurgery, and psychiatry

2007 Volume 78, Issue 2, Page(s) 112

MeSH term(s)	Adrenal Cortex Hormones/therapeutic use ; Brain Diseases/drug therapy ; Brain Diseases/etiology ; Embolism, Cholesterol/complications ; Humans
Chemical Substances	Adrenal Cortex Hormones
Language	English
Publishing date	2007-02
Publishing country	England
Document type	Comment ; Editorial
ZDB-ID	3087-9
ISSN	1468-330X ; 0022-3050
ISSN (online)	1468-330X
ISSN	0022-3050
DOI	10.1136/jnnp.2006.105981
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Article ; Online: Preserved motor skill learning in acute stroke patients.

Baguma, Marius / Yeganeh Doost, Maral / Riga, Audrey / Laloux, Patrice / Bihin, Benoît / Vandermeeren, Yves

Acta neurologica Belgica

2020 Volume 120, Issue 2, Page(s) 365–374

Abstract: Recovery is dynamic during acute stroke, but whether new motor skills can be acquired with the paretic upper limb (UL) during this recovery period is unknown. Clarifying this unknown is important, because neurorehabilitation largely relies on motor ... ...

Abstract	Recovery is dynamic during acute stroke, but whether new motor skills can be acquired with the paretic upper limb (UL) during this recovery period is unknown. Clarifying this unknown is important, because neurorehabilitation largely relies on motor learning. The aim was to investigate whether, during acute stroke, patients achieved motor skill learning and retention with the paretic UL. Over 3 consecutive days (D1-D3), 14 patients practiced with their paretic UL the CIRCUIT, a motor skill learning task with a speed/accuracy trade-off (SAT). A Learning Index (LI) was used to quantify normalised SAT changes in comparison with baseline. Spontaneous motor recovery was quantified by another task without SAT constraint (EASY), by grip force (GF), and the Box and Blocks test (BBT). In patients, CIRCUIT LI improved 98% ± 66.2 (mean ± SD). This improvement was similar to that of young healthy individuals (n = 30) who trained with a slightly different protocol for 3 consecutive days (83.8% ± 58.8%). Generalisation of SAT gains to an untrained circuit was observed in both groups. From D1 to D3, stroke patients improved their performance on EASY, while changes in GF and BBT were heterogeneous. During acute stroke, patients retained SAT gains for a motor skill learned with the paretic UL in a manner similar to that of healthy individuals. These results demonstrate acute stroke patients achieved motor skill learning and retention that exceeded paretic UL improvements explained by spontaneous recovery.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Learning/physiology ; Male ; Middle Aged ; Motor Skills/physiology ; Stroke ; Stroke Rehabilitation/methods
Language	English
Publishing date	2020-03-09
Publishing country	Italy
Document type	Clinical Trial ; Journal Article
ZDB-ID	127315-2
ISSN	2240-2993 ; 0300-9009
ISSN (online)	2240-2993
ISSN	0300-9009
DOI	10.1007/s13760-020-01304-7
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Article: Bimanual motor skill learning and robotic assistance for chronic hemiparetic stroke: a randomized controlled trial.

Yeganeh Doost, Maral / Herman, Benoît / Denis, Adrien / Sapin, Julien / Galinski, Daniel / Riga, Audrey / Laloux, Patrice / Bihin, Benoît / Vandermeeren, Yves

Neural regeneration research

2021 Volume 16, Issue 8, Page(s) 1566–1573

Abstract: Using robotic devices might improve recovery post-stroke, but the optimal way to apply robotic assistance has yet to be determined. The current study aimed to investigate whether training under the robotic active-assisted mode improves bimanual motor ... ...

Abstract	Using robotic devices might improve recovery post-stroke, but the optimal way to apply robotic assistance has yet to be determined. The current study aimed to investigate whether training under the robotic active-assisted mode improves bimanual motor skill learning (biMSkL) more than training under the active mode in stroke patients. Twenty-six healthy individuals (HI) and 23 chronic hemiparetic stroke patients with a detectable lesion on MRI or CT scan, who demonstrated motor deficits in the upper limb, were randomly allocated to two parallel groups. The protocol included a two-day training on a new bimanual cooperative task, LIFT-THE-TRAY, under either the active or active-assisted modes (where assistance decreased in a pre-determined stepwise fashion) with the bimanual version of the REAplan® robotic device. The hypothesis was that the active-assisted mode would result in greater biMSkL than the active mode. The biMSkL was quantified by a speed-accuracy trade-off (SAT) before (T1) and immediately after (T2) training on days 1 and 2 (T3 and T4). The change in SAT after 2 days of training (T4/T1) indicated that both HI and stroke patients learned and retained the bimanual cooperative task. After 2 days of training, the active-assisted mode did not improve biMSkL more than the active mode (T4/T1) in HI nor stroke patients. Whereas HI generalized the learned bimanual skill to different execution speeds in both the active and active-assisted subgroups, the stroke patients generalized the learned skill only in the active subgroup. Taken together, the active-assisted mode, applied in a pre-determined stepwise decreasing fashion, did not improve biMSkL more than the active mode in HI and stroke subjects. Stroke subjects might benefit more from robotic assistance when applied "as-needed." This study was approved by the local ethical committee (Comité d'éthique médicale, CHU UCL Namur, Mont-Godinne, Yvoir, Belgium; Internal number: 54/2010, EudraCT number: NUB B039201317382) on July 14, 2016 and was registered with ClinicalTrials.gov (Identifier: NCT03974750) on June 5, 2019.
Language	English
Publishing date	2021-01-11
Publishing country	India
Document type	Journal Article
ZDB-ID	2388460-5
ISSN	1876-7958 ; 1673-5374
ISSN (online)	1876-7958
ISSN	1673-5374
DOI	10.4103/1673-5374.301030
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Article: Cost of acute stroke. A review.

Laloux, Patrice

Acta neurologica Belgica

2003 Volume 103, Issue 2, Page(s) 71–77

Abstract: The annual incidence of cerebrovascular diseases in Belgium is between 200 and 230/100,000 inhabitants. Mortality after stroke is about 21% and approximately 30% of stroke patients will be dependent on others. Cost is mainly related to the length of ... ...

Abstract	The annual incidence of cerebrovascular diseases in Belgium is between 200 and 230/100,000 inhabitants. Mortality after stroke is about 21% and approximately 30% of stroke patients will be dependent on others. Cost is mainly related to the length of hospital stay but also to outpatient care. Length of stay is dependent on stroke severity at entry, stroke location (total infarct in the anterior circulation costs twice as much as small lacunar infarcts), and the social status (patients living alone or in a nursing home have a longer length of stay gene-rating a higher cost). Stroke units by using rationalized acute stroke therapy (including thrombolysis) reduce death and disability and decrease the length of stay by acting on stroke severity and co-morbidities. Stroke units also facilitate early discharge by coordinating outpatient care with the general practitioners, rehab centers, and nursing home. A global stroke-based prospective payment should be implemented in Belgium.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Belgium/epidemiology ; Female ; Health Care Costs ; Hospital Units/economics ; Hospitalization/economics ; Humans ; Length of Stay/economics ; Male ; Middle Aged ; Stroke/economics ; Stroke/epidemiology ; Stroke/mortality
Language	English
Publishing date	2003-06
Publishing country	Italy
Document type	Journal Article ; Review
ZDB-ID	127315-2
ISSN	2240-2993 ; 0300-9009
ISSN (online)	2240-2993
ISSN	0300-9009
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Article ; Online: Could dual-hemisphere transcranial direct current stimulation (tDCS) reduce spasticity after stroke?

Vandermeeren, Yves / Lefebvre, Stéphanie / Desfontaines, Philippe / Laloux, Patrice

Acta neurologica Belgica

2013 Volume 113, Issue 1, Page(s) 87–89

MeSH term(s)	Double-Blind Method ; Electric Stimulation Therapy ; Female ; Humans ; Middle Aged ; Muscle Spasticity/etiology ; Muscle Spasticity/rehabilitation ; Paresis/etiology ; Paresis/rehabilitation ; Stroke/complications ; Stroke Rehabilitation ; Treatment Outcome
Language	English
Publishing date	2013-03
Publishing country	Italy
Document type	Letter ; Research Support, Non-U.S. Gov't
ZDB-ID	127315-2
ISSN	2240-2993 ; 0300-9009
ISSN (online)	2240-2993
ISSN	0300-9009
DOI	10.1007/s13760-012-0163-5
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Article ; Online: Learning a Bimanual Cooperative Skill in Chronic Stroke Under Noninvasive Brain Stimulation: A Randomized Controlled Trial.

Doost, Maral Yeganeh / Orban de Xivry, Jean-Jacques / Herman, Benoît / Vanthournhout, Léna / Riga, Audrey / Bihin, Benoît / Jamart, Jacques / Laloux, Patrice / Raymackers, Jean-Marc / Vandermeeren, Yves

Neurorehabilitation and neural repair

2019 Volume 33, Issue 6, Page(s) 486–498

Abstract: ... ...

Abstract	Background
MeSH term(s)	Adult ; Aged ; Cross-Over Studies ; Double-Blind Method ; Female ; Humans ; Male ; Middle Aged ; Motor Cortex/physiopathology ; Motor Skills/physiology ; Paresis/etiology ; Paresis/physiopathology ; Paresis/rehabilitation ; Placebos ; Retention, Psychology/physiology ; Stroke/complications ; Stroke/physiopathology ; Stroke/therapy ; Stroke Rehabilitation ; Transcranial Direct Current Stimulation/methods ; Treatment Outcome
Chemical Substances	Placebos
Language	English
Publishing date	2019-05-15
Publishing country	United States
Document type	Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
ZDB-ID	1491637-x
ISSN	1552-6844 ; 1545-9683 ; 0888-4390
ISSN (online)	1552-6844
ISSN	1545-9683 ; 0888-4390
DOI	10.1177/1545968319847963
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Article ; Online: Increased functional connectivity one week after motor learning and tDCS in stroke patients.

Lefebvre, Stéphanie / Dricot, Laurence / Laloux, Patrice / Desfontaines, Philippe / Evrard, Frédéric / Peeters, André / Jamart, Jacques / Vandermeeren, Yves

Neuroscience

2017 Volume 340, Page(s) 424–435

Abstract: Recent studies using resting-state functional magnetic resonance imaging (rs-fMRI) demonstrated that changes in functional connectivity (FC) after stroke correlate with recovery. The aim of this study was to explore whether combining motor learning to ... ...

Abstract	Recent studies using resting-state functional magnetic resonance imaging (rs-fMRI) demonstrated that changes in functional connectivity (FC) after stroke correlate with recovery. The aim of this study was to explore whether combining motor learning to dual transcranial direct current stimulation (dual-tDCS, applied over both primary motor cortices (M1)) modulated FC in stroke patients. Twenty-two chronic hemiparetic stroke patients participated in a baseline rs-fMRI session. One week later, dual-tDCS/sham was applied during motor skill learning (intervention session); one week later, the retention session started with the acquisition of a run of rs-fMRI imaging. The intervention+retention sessions were performed once with dual-tDCS and once with sham in a randomized, cross-over, placebo-controlled, double-blind design. A whole-brain independent component analysis based analysis of variance (ANOVA) demonstrated no changes between baseline and sham sessions in the somatomotor network, whereas a FC increase was observed one week after dual-tDCS compared to baseline (qFDR <0.05, t
MeSH term(s)	Aged ; Aged, 80 and over ; Chronic Disease ; Cross-Over Studies ; Double-Blind Method ; Female ; Humans ; Learning/physiology ; Magnetic Resonance Imaging ; Male ; Memory/physiology ; Middle Aged ; Motor Cortex/diagnostic imaging ; Motor Cortex/physiopathology ; Motor Skills/physiology ; Neural Pathways/diagnostic imaging ; Neural Pathways/physiopathology ; Neuronal Plasticity/physiology ; Paresis/diagnostic imaging ; Paresis/etiology ; Paresis/physiopathology ; Paresis/rehabilitation ; Stroke/complications ; Stroke/diagnostic imaging ; Stroke/physiopathology ; Stroke Rehabilitation ; Transcranial Direct Current Stimulation ; Transcranial Magnetic Stimulation ; Treatment Outcome
Language	English
Publishing date	2017--06
Publishing country	United States
Document type	Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
ZDB-ID	196739-3
ISSN	1873-7544 ; 0306-4522
ISSN (online)	1873-7544
ISSN	0306-4522
DOI	10.1016/j.neuroscience.2016.10.066
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Article ; Online: Brain activations underlying different patterns of performance improvement during early motor skill learning.

Lefebvre, Stéphanie / Dricot, Laurence / Gradkowski, Wojciech / Laloux, Patrice / Vandermeeren, Yves

NeuroImage

2012 Volume 62, Issue 1, Page(s) 290–299

Abstract: Background/introduction: Motor learning plays a central role in daily life and in neurorehabilitation. Several forms of motor learning have been described, among which motor skill learning, i.e. reaching a superior level of performance (a skill) through ...

Abstract	Background/introduction: Motor learning plays a central role in daily life and in neurorehabilitation. Several forms of motor learning have been described, among which motor skill learning, i.e. reaching a superior level of performance (a skill) through a shift of the speed/accuracy trade-off. During the first stage of learning a visuomotor skill, we observed differential patterns of evolution of the speed/accuracy trade-off in normal subjects. Half of the subjects rapidly achieved successful motor skill learning with an early shift of the speed/accuracy trade-off leading to a superior level of performance (shift pattern). The other subjects attained only minimal global improvement due to a converse evolution of speed and accuracy (i.e. a respect of the speed/accuracy trade-off: fit pattern). Functional magnetic resonance imaging (fMRI) was used to explore the neural substrates underlying these differential patterns during the first stage of motor skill learning in normal subjects. Methods: Twenty right-handed normal subjects performed an implicit visuomotor learning task with their non-dominant hand. The task ("circuit game") consisted in learning to navigate a pointer along a circuit as quickly and accurately as possible using a fMRI-compatible mouse. Velocity, accuracy, and performance indexes were used to characterise the motor learning pattern (shift/fit) and to perform fMRI correlation analysis in order to find the neural substrate associated with the shift and fit patterns during early motor skill learning. Results: Nine subjects showed a fit pattern (fitters), and eleven, a shift pattern ("shifters"). fMRI analyses at whole group level (ANOVA) and at sub-group level demonstrated that the supplementary motor area (SMA) was more activated in "shifters" than in the "fitters" groups and that the BOLD activation within the SMA correlated significantly with the on-line shift of the speed/accuracy trade-off in the "shifters" group. Conclusion: Despite identical instructions and experimental conditions, during the first stage of motor skill learning normal subjects spontaneously adopted different patterns that can be differentiated based on distinct fMRI activation patterns. In this implicit visuomotor task, the SMA proper was the key area underlying the achievement of early successful motor skill learning, i.e. on-line shift of the speed/accuracy trade-off.
MeSH term(s)	Adolescent ; Adult ; Aged ; Aged, 80 and over ; Aging/physiology ; Brain Mapping ; Female ; Humans ; Learning/physiology ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Motor Skills/physiology ; Movement/physiology ; Reference Values ; Task Performance and Analysis ; User-Computer Interface ; Young Adult
Language	English
Publishing date	2012-08-01
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1147767-2
ISSN	1095-9572 ; 1053-8119
ISSN (online)	1095-9572
ISSN	1053-8119
DOI	10.1016/j.neuroimage.2012.04.052
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Zs.A 3664: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Single session of dual-tDCS transiently improves precision grip and dexterity of the paretic hand after stroke.

Lefebvre, Stéphanie / Thonnard, Jean-Louis / Laloux, Patrice / Peeters, André / Jamart, Jacques / Vandermeeren, Yves

Neurorehabilitation and neural repair

2014 Volume 28, Issue 2, Page(s) 100–110

Abstract: Background: After stroke, deregulated interhemispheric interactions influence residual paretic hand function. Anodal or cathodal transcranial direct current stimulation (tDCS) can rebalance these abnormal interhemispheric interactions and improve motor ... ...

Abstract	Background: After stroke, deregulated interhemispheric interactions influence residual paretic hand function. Anodal or cathodal transcranial direct current stimulation (tDCS) can rebalance these abnormal interhemispheric interactions and improve motor function. Objective: We explored whether dual-hemisphere tDCS (dual-tDCS) in participants with chronic stroke can improve fine hand motor function in 2 important aspects: precision grip and dexterity. Methods: In all, 19 chronic hemiparetic individuals with mild to moderate impairment participated in a double-blind, randomized trial. During 2 separate cross-over sessions (real/sham), they performed 10 precision grip movements with a manipulandum and the Purdue Pegboard Test (PPT) before, during, immediately after, and 20 minutes after dual-tDCS applied simultaneously over the ipsilesional (anodal) and contralateral (cathodal) primary motor cortices. Results: The precision grip performed with the paretic hand improved significantly 20 minutes after dual-tDCS, with reduction of the grip force/load force ratio by 7% and in the preloading phase duration by 18% when compared with sham. The dexterity of the paretic hand started improving during dual-tDCS and culminated 20 minutes after the end of dual-tDCS (PPT score +38% vs +5% after sham). The maximal improvements in precision grip and dexterity were observed 20 minutes after dual-tDCS. These improvements correlated negatively with residual hand function quantified with ABILHAND. Conclusions: One bout of dual-tDCS improved the motor control of precision grip and digital dexterity beyond the time of stimulation. These results suggest that dual-tDCS should be tested in longer protocols for neurorehabilitation and with moderate to severely impaired patients. The precise timing of stimulation after stroke onset and associated training should be defined.
MeSH term(s)	Adult ; Aged ; Double-Blind Method ; Electric Stimulation ; Female ; Hand/physiopathology ; Hand Strength/physiology ; Humans ; Male ; Middle Aged ; Paralysis/physiopathology ; Paralysis/therapy ; Stroke/physiopathology
Language	English
Publishing date	2014-02
Publishing country	United States
Document type	Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
ZDB-ID	1491637-x
ISSN	1552-6844 ; 1545-9683 ; 0888-4390
ISSN (online)	1552-6844
ISSN	1545-9683 ; 0888-4390
DOI	10.1177/1545968313478485
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