H Loiseau

University of Bordeaux, Burdeos, Aquitaine, France

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Publications (124)347.78 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: This work describes the clinical epidemiology and pathology for patients undergoing surgery for newly diagnosed meningiomas in France between 2006 and 2010. The methodology is based on a multidisciplinary national network previously established by the French Brain Tumor DataBase (FBTDB) (in French: Recensement national histologique des tumeurs primitives du système nerveux central [RnhTPSNC]), and the active participation of the scientific societies involved in neuro-oncology in France. From 2006 to 2010, 13,038 incident cases of meningioma with histological validation were identified and analyzed (9769 women, 3269 men, resection 98.2%, cryopreservation 20.5%). For each histological subtype of meningioma (meningothelial, fibrous, transitional, psammomatous, angiomatous, rare variety, microcystic, secretory, lymphoplasmacyte-rich, clear-cell, chordoid, rhabdoid, metaplastic, atypical, papillary, anaplastic and not otherwise specified), number of cases, sex, median age, cryopreservation and surgery were reported. Among the various histological subtypes, atypical meningioma (grade II) slightly, but significantly, increased after 2007. Headache, sensory-motor impairments and seizures were the most frequent clinical symptoms. Time between the first clinical symptom and surgery ranged from 0 to 314 months, and was <3 months in 37% of cases. At the time of surgery, 9% of patients were asymptomatic. Given the number of meningiomas not histologically-validated, we can estimate that the gross incidence rate for meningiomas operated in France is about 4.2 per 100,000 person/year. To our knowledge, this work is the most important study evaluating the different subtypes of meningiomas and it validates the relevance of histological databases for central nervous system tumors. Copyright © 2015 Elsevier Masson SAS. All rights reserved.
    Neurochirurgie 06/2015; DOI:10.1016/j.neuchi.2014.11.013 · 0.47 Impact Factor
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    ABSTRACT: Surgical excision of brain metastases has been well evaluated in unique metastases. Two randomized phase III trial have shown that combined with adjuvant whole brain radiotherapy, it significantly improves overall survival. However, even in the presence of multiple brain metastases, surgery may be useful. Also, even in lesions amenable to radiosurgery, surgical resection is preferred when tumors displayed cystic or necrotic aspect with important edema or when located in highly eloquent areas or cortico-subcortically. Furthermore, surgery may have a diagnostic role, in the absence of histological documentation of the primary disease, to rule out a differential diagnosis (brain abscess, lymphoma, primary tumor of the central nervous system or radionecrosis). Finally, the biological documentation of brain metastatic disease might be useful in situations where a specific targeted therapy can be proposed. Selection of patients who will really benefit from surgery should take into account three factors, clinical and functional status of the patient, systemic disease status and characteristics of intracranial metastases. Given the improved overall survival of cancer patients partially due to the advent of effective targeted therapies on systemic disease, a renewed interest has been given to the local treatment of brain metastases. Surgical resection currently represents a valuable tool in the armamentarium of brain metastases but has also become a diagnostic and decision tool that can affect therapeutic strategies in these patients.
    Cancer/Radiothérapie 01/2015; 19(1). DOI:10.1016/j.canrad.2014.11.007 · 1.11 Impact Factor
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    ABSTRACT: Bien que représentant plus d’un tiers des tumeurs primitives du système nerveux central (SNC), les données épidémiologiques concernant les méningiomes (chiffres d’incidence et facteurs de causalité) demeurent réduites comparativement à celles disponibles dans les gliomes. Un nombre limité de registres de cancers, à travers le monde, enregistrent non seulement les tumeurs malignes mais aussi les méningiomes. Leur pertinence et la qualité du recueil ont été l’objet de discussions importantes. Même si les comparaisons sont difficiles à cause des différences méthodologiques, les données disponibles, d’incidence annuelles des méningiomes (standardisée selon le sexe et l’âge en utilisant soit la population Nord-Américaine, soit la population mondiale) sont compris entre 1,3/100 000 et 7,8/100 000. Une augmentation de l’incidence des tumeurs primitives du SNC, en général, et des méningiomes, en particulier, a été observée au cours des dernières décennies dans plusieurs pays. Il a été suggéré que ces tendances pouvaient être artéfactuelles et seraient la ou les résultantes de tout ou partie du vieillissement de la population, de l’amélioration non seulement de son accès mais aussi de la qualité de l’imagerie diagnostique, et des modifications des prises en charge chirurgicale y compris chez les sujets les plus âgés induisant une augmentation des confirmations histologiques et, enfin, des modifications des classifications histologiques. Tous ces facteurs ont un rôle indéniable, mais ne permettent pas d’expliquer l’augmentation de l’incidence qui a été observée, pour les méningiomes, dans toutes les tranches d’âge. Au-delà des facteurs intrinsèques (groupes ethniques, sexe, terrain allergique, antécédents personnels et familiaux, polymorphismes et syndromes de prédisposition génétiques), un certain nombre de facteurs extrinsèques sont suspectés de jouer un rôle dans la survenue des méningiomes, et leurs changements au cours du temps est à même d’impacter les tendances en termes d’incidence. Une relation de causalité a été définie seulement pour les radiations ionisantes mais l’impact de nombreux autres est suspecté: champs électromagnétiques, facteurs nutritionnels, pesticides, traitements facteurs hormonaux. Dans la mesure où, d’une part, les méningiomes représentent une menace fonctionnelle et/ou vitale, et que, d’autre part, ils voient leur incidence augmenter, les différents acteurs de la communauté neuro-oncologique doivent se sentir concernés par ces affections, non seulement au niveau de leurs prises en charge mais aussi par les données épidémiologiques afférentes.
    Neurochirurgie 09/2014; DOI:10.1016/j.neuchi.2014.05.006 · 0.47 Impact Factor
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    ABSTRACT: The carcinogenic effect of radiofrequency electromagnetic fields in humans remains controversial. However, it has been suggested that they could be involved in the aetiology of some types of brain tumours. The objective was to analyse the association between mobile phone exposure and primary central nervous system tumours (gliomas and meningiomas) in adults. CERENAT is a multicenter case-control study carried out in four areas in France in 2004-2006. Data about mobile phone use were collected through a detailed questionnaire delivered in a face-to-face manner. Conditional logistic regression for matched sets was used to estimate adjusted ORs and 95% CIs. A total of 253 gliomas, 194 meningiomas and 892 matched controls selected from the local electoral rolls were analysed. No association with brain tumours was observed when comparing regular mobile phone users with non-users (OR=1.24; 95% CI 0.86 to 1.77 for gliomas, OR=0.90; 95% CI 0.61 to 1.34 for meningiomas). However, the positive association was statistically significant in the heaviest users when considering life-long cumulative duration (≥896 h, OR=2.89; 95% CI 1.41 to 5.93 for gliomas; OR=2.57; 95% CI 1.02 to 6.44 for meningiomas) and number of calls for gliomas (≥18 360 calls, OR=2.10, 95% CI 1.03 to 4.31). Risks were higher for gliomas, temporal tumours, occupational and urban mobile phone use. These additional data support previous findings concerning a possible association between heavy mobile phone use and brain tumours.
    Occupational and environmental medicine 05/2014; 71(7). DOI:10.1136/oemed-2013-101754 · 3.23 Impact Factor
  • Neurosurgery 04/2014; 75(2). DOI:10.1227/NEU.0000000000000364 · 3.03 Impact Factor
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    ABSTRACT: The incidence of glioblastoma (GBM) has increased in patients aged 70 years or older, and will continue to grow. Elderly GBM patients have been excluded from most clinical trials; furthermore, optimal care management as well as benefit/risk ratio of GBM treatments are still being debated. This study describes oncological patterns of care, prognostic factors, and survival for patients ≥70 years in France. We identified patients over 70 with newly diagnosed and histologically confirmed GBM on data previously published by the French Brain Tumor DataBase. We included 265 patients. Neurological deficits and mental status disorders were the most frequent symptoms. The surgery consisted of resection (RS n = 95) or biopsy (B n = 170); 98 patients did not have subsequent oncological treatment. After surgery, first-line treatment consisted of radiotherapy (RT n = 76), chemotherapy (CT n = 52), and concomitant radiochemotherapy (CRC n = 39). The median age at diagnosis was 76, 74, and 73 years, respectively, for the untreated, B + RT and/or CT, RS ± RT and/or CT groups. Median survival (in days, 95 % CI) with these main strategies, when analyzed according to surgical groups, was: B-CT n = 41, 199[155-280]; B-CRC n = 21, 318[166-480]; B-RT n = 37, 149[130-214]; RS-CT n = 11, 245[211-na]; RS-CRC n = 18, 372[349-593]; RS-RT n = 39, 269[218-343]. This population study for elderly GBM patients is one of the most important in Europe, and could be considered as a historical cohort to compare future treatments. Moreover, we can hypothesize that elderly patients (versus patients <70 years) are undertreated. Karnofsky performance status seems to be the most relevant clinical predictive factor, and RS and CRC have a positive impact on survival for elderly GBM patients in the general population, at least when feasible.
    Neurosurgical Review 02/2014; 37(3). DOI:10.1007/s10143-014-0528-8 · 1.86 Impact Factor
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    ABSTRACT: Background The aim of this study was to correlate MRI features and molecular characteristics in anaplastic oligodendrogliomas (AOs).Methods The MRI characteristics of 50 AO patients enrolled in the French national network for high-grade oligodendroglial tumors were analyzed. The genomic profiles and IDH mutational statuses were assessed using high-resolution single-nucleotide polymorphism arrays and direct sequencing, respectively. The gene expression profiles of 25 1p/19q-codeleted AOs were studied on Affymetrix expression arrays.ResultsMost of the cases were frontal lobe contrast-enhanced tumors (52%), but the radiological presentations of these cases were heterogeneous, ranging from low-grade glioma-like aspects (26%) to glioblastoma-like aspects (22%). The 1p/19q codeletion (n = 39) was associated with locations in the frontal lobe (P = .001), with heterogeneous intratumoral signal intensities (P = .003) and with no or nonmeasurable contrast enhancements (P = .01). The IDH wild-type AOs (n = 7) more frequently displayed ringlike contrast enhancements (P = .03) and were more frequently located outside of the frontal lobe (P = .01). However, no specific imaging pattern could be identified for the 1p/19q-codeleted AO or the IDH-mutated AO. Within the 1p/19q-codeleted AO, the contrast enhancement was associated with larger tumor volumes (P = .001), chromosome 9p loss and CDKN2A loss (P = .006), genomic instability (P = .03), and angiogenesis-related gene expression (P < .001), particularly for vascular endothelial growth factor A and angiopoietin 2.Conclusion In AOs, the 1p/19q codeletion and the IDH mutation are associated with preferential (but not with specific) imaging characteristics. Within 1p/19q-codeleted AO, imaging heterogeneity is related to additional molecular alterations, especially chromosome 9p loss, which is associated with contrast enhancement and larger tumor volume.
    Neuro-Oncology 12/2013; 16(5). DOI:10.1093/neuonc/not235 · 5.29 Impact Factor
  • Revue d Épidémiologie et de Santé Publique 10/2013; 61:S243-S244. DOI:10.1016/j.respe.2013.07.135 · 0.66 Impact Factor
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    ABSTRACT: Growing evidence supports a role for the Unfolded Protein Response (UPR) in carcinogenesis, however the precise molecular mechanisms underlying this phenomenon remain elusive. Herein, we identified the circadian clock PER1 mRNA as a novel substrate of the endoribonuclease activity of the UPR sensor IRE1α. Analysis of the mechanism demonstrates that IRE1α endoribonuclease activity decreased PER1 mRNA in tumor cells without affecting PER1 gene transcription. Inhibition of IRE1α signaling using either siRNA-mediated silencing or a dominant-negative strategy prevented PER1 mRNA decay, reduced tumorigenesis, and increased survival, features that were reversed upon PER1 silencing. Further analysis also identifies the chemokine CXCL3 as an IRE1α/PER1 target mediating these cellular effects. Clinically, patients showing reduced survival have lower levels of PER1 mRNA expression and increase splicing of XBP1, a known IRE1α substrate, thereby pointing towards an increase IRE1α activity in these patients. Hence, we describe a novel mechanism connecting the UPR and circadian clock components in tumor cells, thereby highlighting the importance of this interplay in tumor development.
    Cancer Research 06/2013; 73(15). DOI:10.1158/0008-5472.CAN-12-3989 · 9.28 Impact Factor
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    ABSTRACT: Background: Brain metastases (BM) from differentiated thyroid carcinoma (DTC) are uncommon and many questions about their management remain unsolved. The objective of this retrospective study is to analyze the characteristics, treatments and outcomes of patients with BM from DTC. Methods: Among the 1523 patients with a DTC prospectively recorded in institutional databases between 1989-2012, 21 patients (1.4%) with BM were retrospectively retrieved. Patient characteristics, histological findings on initial thyroidectomy specimen, treatments, and time to death were reviewed. Overall survival (OS) was calculated using the Kaplan-Meier method. Survival curves for various subgroups of patients according to baseline characteristics and treatment received were compared. Results: Mean age at initial and BM diagnosis were respectively 52.7 and 63.2 years. World Health Organization performance status (WHO PS) at BM diagnosis was good (< 2) for 12 patients and poor (≥ 2) for nine. The initial carcinoma was papillary for twelve patients, follicular for five, and poorly differentiated for four. Eighteen patients had other previous and/or synchronous distant metastases: lung (11), bone (10) and others (2 peritoneum, 1 liver, 1 adrenal gland and 1 uterine cervix). The average interval between the first metastasis and the BM was three years (range, 0-35.6y). The mean number and the mean size of BM were respectively 2.8 (range, 1-10) and 22.5 mm (range, 3-44 mm). Surgery was performed for ten patients and radiotherapy (RT) for 18 with two stereotactic radiosurgeries (SRS), two conformal RT limited to the metastasis and 15 whole brain radiotherapies (WBRT). The median OS after BM was 7.1 months. OS at 1 and 2 years were 41.6% and 35.6%. PS and realization of surgery or SRS had an impact on survival, with OS of 27 months when PS < 2 vs. 3 months when PS ≥ 2 (p=0.0009); and OS of 11.9 months after surgery or SRS vs. 3.6 months in their absence (p=0.04). Conclusions: BM from TC may have an indolent evolution with survival of one to two years or longer for specific groups of patients. Therefore, aggressive treatment options like neurosurgery and radiotherapy should be strongly considered in patients with good PS.
    Thyroid: official journal of the American Thyroid Association 06/2013; 24(2). DOI:10.1089/thy.2013.0061 · 3.84 Impact Factor
  • Neurochirurgie 12/2012; 58(6):436. DOI:10.1016/j.neuchi.2012.10.090 · 0.47 Impact Factor
  • International Journal of Radiation OncologyBiologyPhysics 11/2012; 84(3):S750. DOI:10.1016/j.ijrobp.2012.07.2007 · 4.18 Impact Factor
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    ABSTRACT: The human matrix metalloprotease 9 (hMMP-9) is involved in many physiological processes such as tissue remodeling. Its overexpression in tumors promotes the release of cancer cells thus contributing to tumor metastasis. It is a relevant marker of malignant tumors. We selected an RNA aptamer containing 2'fluoro, pyrimidine ribonucleosides, that exhibits a strong affinity for hMMP-9 (Kd = 20 nM) and that discriminates other human MMPs: no binding was detected to either hMMP-2 or -7. Investigating the binding properties of different MMP-9 aptamer variants by surface plasmon resonance allowed the determination of recognition elements. As a result, a truncated aptamer, 36 nucleotide long was made fully resistant to nuclease following the substitution of every purine ribonucleoside residue by 2'-O-methyl analogues and was conjugated to S-acetylmercaptoacetyltriglycine for imaging purposes. The resulting modified aptamer retained the binding properties of the originally selected sequence. Following 99mTc labelling this aptamer was used for ex vivo imaging slices of human brain tumors. We were able to specifically detect the presence of hMMP-9 in such tissues.
    Bioconjugate Chemistry 10/2012; 23(11). DOI:10.1021/bc300146c · 4.82 Impact Factor
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    ABSTRACT: Cancer registries cover 18% of the French population. A national surveillance might be warranted for some potentially environment-related cancers such as tumors of the central nervous system (CNS) to detect abnormal incidence variations. The PMSI database provides an interesting source of comprehensive, standardized and mandatory data collected from all health facilities. The aim of this work was to develop methods to identify incident CNS tumors using the PMSI database. A selection of patients living in Gironde was made in the 2004 PMSI database of the hospital of Bordeaux, using the CNS tumors codification. Cases were validated via the CNS primary tumor registry of Gironde taken as the reference, or medical records. Various combinations of criteria were defined and tested. The first selection based on diagnoses identified patients with a sensitivity of 84% and a positive predictive value (PPV) of 34%. Patients wrongly identified by the PMSI were non-incident cases (49%) or patients without a CNS tumor (45%). Patients with a tumor not identified by the PMSI had been hospitalized in 2005 (44%) or had no code for CNS tumor (42%). According to the algorithms, the sensitivity ranged from 64% to 84%, and the PPV from 34% to 69%. The best combination had a sensitivity of 67% and a PPV of 69% and was obtained with codes for CNS tumor in 2004 associated with a diagnostic or therapeutic code for persons under 70 years without code for CNS tumor in previous years or code for metastasis in 2004. According to these results, the PMSI database cannot be used alone to calculate the incidence of these complex tumors. However the PMSI database plays an important role in cancer surveillance, in combination with other information sources and the expertise of cancer registries. This role could increase with further reflection and improvement of data quality.
    Revue d Épidémiologie et de Santé Publique 06/2012; 60(4):295-304. DOI:10.1016/j.respe.2012.02.003 · 0.66 Impact Factor
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    International Journal of Cancer 02/2012; 130(3). DOI:10.1002/ijc.26051 · 5.01 Impact Factor
  • Isabelle Baldi · Hugues Loiseau
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    ABSTRACT: Epidemiology of primary brain tumors includes a descriptive approach (determination of prevalence and incidence) and an analytical approach (identification of risk factors). Among risk factors, some are intrinsic to the person and others are external causes that are more easily preventable. Descriptive epidemiological data have concluded an increase of annual incidence of primary brain tumor in most industrialized countries. Main explanations for this increase are the ageing of the population and a better access to the diagnostic imaging, albeit it is not possible to exclude changes in risks factors. Comparing incidences between registries is difficult. Spatial and temporal variations constitute one explanation for the discrepancies and evolutions of coding methods another one. Intrinsic factors likely to modify the risk are age, genetic predisposition and susceptibility, gender, race, birth weight, and allergy. Extrinsic factors likely to modify the risk are mainly radiation exposures. Many studies concerning, among others, electro magnetic fields, and especially cellular phones, pesticides, substitutive hormonal therapy, and diet have been published. Until now, results remain globally inconclusive. Weak incidence of primary brain tumors constitutes a huge limiting factor in the progress of knowledge, both on incidence and risk factors. Important mobilization of the neuro-oncological community is mandatory to obtain consistent and valuable data that will lead to a significant improvement in our knowledge of brain tumor epidemiology.
    Tumors of the Central Nervous System, Volume 4, 01/2012: pages 3-13; , ISBN: 978-94-007-1705-3
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    ABSTRACT: An increase in the incidence of CNS tumors has been observed in many countries in the last decades. The reality of this trend has been much debated, as it has happened during a period when computer-assisted tomography and MRI have dramatically improved the detection of these tumors. The Gironde CNS Tumor Registry provides here the first data on CNS tumor incidence and trends in France for all histological types, including benign and malignant tumors, for the period 2000-2007. Incidence rates were calculated globally and for each histological subtype. For trends, a piecewise log-linear model was used. The overall annual incidence rate was found to be 17.6/100 000. Of this rate, 7.9/100 000 were neuroepithelial tumors and 6.0/100 000 were meningiomas. An overall increase in CNS tumor incidence was observed from 2000 to 2007, with an annual percent change (APC) of +2.33%, which was explained mainly by an increase in the incidence of meningiomas over the 8-year period (APC = +5.4%), and also more recently by an increase in neuroepithelial tumors (APC = +7.45% from 2003). The overall increase was more pronounced in women and in the elderly, with an APC peaking at +24.65% in subjects 85 and over. The increase in the incidence rates we observed may have several explanations: not only improvements in registration, diagnosis, and clinical practice, but also changes in potential risk factors.
    Neuro-Oncology 12/2011; 13(12):1370-8. DOI:10.1093/neuonc/nor120 · 5.29 Impact Factor
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    ABSTRACT: Objective To establish Guidelines for the management of Concussions for Professional and High Level (International) Rugby in France.Material and methodsLiterature from the last ten years, IRB recommendations and consensus statements on concussions in sports were analysed by a group of experts and adapted to the practice of Professional and High Level (international) Rugby in France.ResultsThe guidelines contain the description of the clinical signs and symptoms for the concussion sideline diagnosis justifying the definitive exit of the player, the immediate management recommandations, the organisation of a specialized consultation beyond 48 hours of strict rest to establish a prognostic classification and the conditions and delay of the return to play which can be made only after a new specialized consultation.Conclusion These recommendations are intended to be already applied and may evolve according to the scientific data which will be annually followed by the group of experts.
    Journal de Traumatologie du Sport 12/2011; 28(4):227–242. DOI:10.1016/j.jts.2011.10.005
  • Cancer/Radiothérapie 10/2011; 15(6):614-615. DOI:10.1016/j.canrad.2011.07.152 · 1.11 Impact Factor
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    ABSTRACT: A computed tomography (CT) scan has high sensitivity in detecting intracranial injury in patients with minor head injury but is costly, exposes patients to high radiation doses, and reveals clinically relevant lesions in less than 10% of cases. We evaluate S100-B protein measurement as a screening tool in a large population of patients with minor head injury. We conducted a prospective observational study in the emergency department of a teaching hospital (Bordeaux, France). Patients with minor head injury (2,128) were consecutively included from December 2007 to February 2009. CT scans and plasma S100-B levels were compared for 1,560 patients. The main outcome was to evaluate the diagnostic value of the S100-B test, focusing on the negative predictive value and the negative likelihood ratio. CT scan revealed intracranial lesions in 111 (7%) participants, and their median S100-B protein plasma level was 0.46 μg/L (interquartile range [IQR] 0.27 to 0.72) versus 0.22 μg/L (IQR 0.14 to 0.36) in the other 1,449 patients. With a cutoff of 0.12 μg/L, traumatic brain injuries on CT were identified with a sensitivity of 99.1% (95% confidence interval [CI] 95.0% to 100%), a specificity of 19.7% (95% CI 17.7% to 21.9%), a negative predictive value of 99.7% (95% CI 98.1% to 100%), a positive likelihood ratio of 1.24 (95% CI 1.20 to 1.28), and a negative likelihood ratio of 0.04 (95% CI 0.006 to 0.32). Measurement of plasma S100-B on admission of patients with minor head injury is a promising screening tool that may be of help to support the clinician's decision not to perform CT imaging in certain cases of low-risk head injury.
    Annals of emergency medicine 09/2011; 59(3):209-18. DOI:10.1016/j.annemergmed.2011.07.027 · 4.33 Impact Factor

Publication Stats

1k Citations
347.78 Total Impact Points

Institutions

  • 1987–2013
    • University of Bordeaux
      Burdeos, Aquitaine, France
  • 2000–2011
    • Université Victor Segalen Bordeaux 2
      • • Institut de Santé Publique d'Epidémiologie et de Développement (ISPED)
      • • Centre de Résonance Magnétique des Systèmes Biologiques
      Burdeos, Aquitaine, France
    • Institut Universitaire de France
      Lutetia Parisorum, Île-de-France, France
  • 2001–2010
    • Institut Bergonié
      Burdeos, Aquitaine, France
  • 2007–2009
    • Centre Hospitalier Universitaire de Bordeaux
      Burdeos, Aquitaine, France
  • 2005
    • Centre Hospitalier Universitaire de Dijon
      Dijon, Bourgogne, France
  • 2004
    • Centre Hospitalier Universitaire de Toulouse
      • Service de Neurochirurgie
      Tolosa de Llenguadoc, Midi-Pyrénées, France
  • 1988
    • French National Centre for Scientific Research
      Lutetia Parisorum, Île-de-France, France