Alain Duhamel

University of Lille Nord de France, Lille, Nord-Pas-de-Calais, France

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Publications (301)1057.28 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Apathy is a frequent and disabling behavioral disorder in patients with Parkinson's disease (PD). Its prevalence in treatment-naive patients with early-stage PD has not been extensively investigated. Moreover, whether apathy is related to other non-motor symptoms in early-stage PD is unknown. Our objective was to determine the prevalence and features of apathy and associated factors in a group of treatment-naive patients with early-stage PD. Ninety-five treatment-naive patients with early-stage PD participated in the study. Apathy, depression, motor symptoms, and overall cognitive efficiency were assessed. The presence of the main non-motor symptoms was checked during a detailed clinical interview. Group comparisons were carried out to investigate the association with apathy. Eighteen patients (18.95%) were diagnosed as apathetic, and five of the latter had concomitant depression. Apathetic patients had significantly more severe motor symptoms (P < 0.001) and a lower cognitive status (P = 0.032) than non-apathetic patients. When considering non-motor symptoms, apathy was significantly associated only with fatigue (P = 0.007) and anhedonia (P = 0.010), both of which were more prevalent in apathetic patients than in non-apathetic patients. In treatment-naive patients with early-stage PD, apathy was significantly associated with more severe motor symptoms and a lower cognitive status. After adjustment for these factors, apathy appeared to be a relatively isolated, independent symptom because the only other associated non-motor symptoms were fatigue and anhedonia. © 2014 International Parkinson and Movement Disorder Society
    Movement Disorders 11/2014; · 5.63 Impact Factor
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    ABSTRACT: To assess the impact of neoadjuvant chemoradiotherapy (NCRT) on anastomotic leakage (AL) and other postoperative outcomes after esophageal cancer (EC) resection.
    Annals of surgery. 11/2014; 260(5):764-771.
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    ABSTRACT: Objective: The question of whether breastfeeding has a protective effect against the development of overweight or obesity later in life remains controversial, especially during adolescence. The objective was to assess the relationship between breastfeeding and adolescents' body composition. Methods: The HELENA study is a cross-sectional study involving 3,528 adolescents from 10 European cities. The outcome measures were body weight and height, subscapular skinfolds as well as waist circumferences. Breastfeeding, smoking status, and parental socioeconomic status were assessed by self-administered questionnaires. Dietary intake was recorded using two 24-hour recall surveys. Two adjustment approaches were used: i) covariance analysis adjusted for confounding factors (propensity score adjustment) and ii) multivariate quantile regression. Results: After adjustment, no significant associations were observed between breastfeeding and body composition parameters (BMI Z-score; sum of skinfolds; waist-to-height ratio). An adjusted quantile regression analysis showed a non-significant trend for a protective effect of breastfeeding toward the highest percentiles of adiposity in boys but not in girls. This is of particular interest with respect to the superiority of the waist-to-height ratio over waist circumference and BMI for detecting cardiometabolic risk factors. Conclusion: This first European study, including a large set of factors influencing adolescents' body composition, showed a non-significant trend toward a protective effect of breastfeeding on highest percentiles of adolescent's abdominal adiposity. © 2014 S. Karger GmbH, Freiburg.
    Obesity Facts 10/2014; 7(5):289-301. · 1.58 Impact Factor
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    ABSTRACT: Can cluster analysis can be used to identify a homogeneous subpopulation of women with polycystic ovarian morphology (PCOM) within a very large population of control women in a non-subjective way?
    Human reproduction (Oxford, England). 09/2014;
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    ABSTRACT: To assess the relevance of the International Study Group of Liver Surgery (ISGLS) definition of posthepatectomy liver failure compared with 2 well-established criteria, 50-50 and PeakBili >7, as early predictors of posthepatectomy outcome.
    Annals of surgery. 09/2014;
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    ABSTRACT: In an attempt to reduce the incidence of chronic GVHD (cGVHD) after reduced-intensity conditioning (RIC), we used BM instead of PBSC and added melphalan 100 mg/m(2) to the classical association of fludarabine, 30 mg/m(2)/day for 3 days and TBI, 200 cGy (FLUIM regimen). Between 2000 and 2012, 51 patients received BM with the FLUIM regimen (group A), and 124 received BM (n=22) or PBSC (n=102) with another RIC regimen (group B). Donors were siblings (n=123) or HLA-matched 10/10 unrelated (n=52). Full donor-type chimerism at day 100 was more often recorded in group A (86%) than in group B (62%); P<0.001. There was no difference between the two groups in terms of OS and EFS, acute GVHD, relapse and non-relapse mortality incidence. cGVHD occurred more often in group B (41%) than in group A (23%); P=0.021. In multivariate analysis, the two risk factors associated with the development of cGVHD were conditioning in group B (hazard ratio (HR)=2.871, 95% confidence interval (CI) (1.372-6.006); P=0.005) and CD34(+) count (HR=1.009, 95% CI (1.006-1.011); P<0.001). In conclusion, the FLUIM regimen followed by BM leads to more frequent full-donor chimerism and a reduced incidence of cGVHD without compromising relapse and survival.Bone Marrow Transplantation advance online publication, 15 September 2014; doi:10.1038/bmt.2014.193.
    Bone marrow transplantation. 09/2014;
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    ABSTRACT: Auditory-verbal hallucinations (AVHs) are associated with an impaired connectivity of large-scale networks. To examine the relationship between white-matter integrity and AVHs, we conducted a meta-analysis of diffusion-tensor-imaging studies that compared patients with schizophrenia and AVHs with matched healthy controls (HCs). Five studies were retained gathering 256 DTI data points, divided into AVHs (n = 106) and HCs (n = 150). The meta-analysis demonstrated a reduced fractional anisotropy in the left Arcuate Fasciculus (AF) of hallucinators (hg = − 0.42; CI[− 0.69,− 0.16]; p < 10− 3). The current meta-analysis confirmed disruptions of white matter integrity in the left AF bundle of schizophrenia patients with AVHs.
    Schizophrenia Research 08/2014; · 4.59 Impact Factor
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    ABSTRACT: Background The aim of the authors was to reassess the impact of a positive surgical margin (R1) after a liver resection for colorectal liver metastases (CLMs) on survival in the era of modern chemotherapy, through their own experience and a literature review.Methods Inclusion criteria were: R1 or R0 resection with no local treatment modalities, extra-hepatic metastases or other cancer.ResultsAmong 337 patients operated between 2000 and 2010, 273 patients were eligible (214 R0/59 R1). The mean follow-up was 43 ± 29 months. Compared with a R0 resection, a R1 resection offered a lower 5-year overall (39.1% versus 54.2%, P = 0.010), disease-free (15.2% versus 31.1%, P = 0.021) and progression-free (i.e. time to the first non-curable recurrence; 33.1% versus 47.3%, P = 0.033) survival rates. Metastases in the R1 group were more numerous, larger and more frequently synchronous. Independent factors of poor survival were: number, size and short-time interval of CLM occurrence, N status, rectal primary, absence of adjuvant chemotherapy, but not a R1 resection. With the more-systematic administration of chemotherapy since 2005, the intergroup difference in progression-free survival disappeared (P = 0.264).ConclusionA R1 resection had no prognostic value per se but reflected a more severe disease. The recent change in the prognostic value of a R1 resection may be linked to the beneficial effect of chemotherapy.
    HPB 08/2014; · 1.94 Impact Factor
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    ABSTRACT: Benefits of recombinant human growth hormone (rhGH) alone or combined with glutamine in patients with intestinal failure because of short-bowel syndrome remain controversial.
    American Journal of Clinical Nutrition 07/2014; · 6.50 Impact Factor
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    ABSTRACT: Objective: Patients with temporal lobe epilepsy (TLE) have impaired theory of mind (ToM). However, ToM involves a variety of processes, such as understanding a person's intentions ("cognitive" ToM) and emotional states ("affective" ToM). The objectives of the present study were to characterize ToM disorders in TLE patients, identify patients at risk of ToM disorders, and study the relationships between psychobehavioral and quality of life factors and ToM disorders. Method: Fifty TLE patients and 50 controls performed ToM tasks assessing their understanding of verbal clumsiness (faux pas), sarcastic remarks, and mentalistic actions. Demographic, cognitive, and psychobehavioral data, and (for TLE patients) clinical and quality of life factors, were recorded. Results: Compared with controls, TLE patients showed impairments in all ToM tasks: 84% misunderstood faux pas, and around 50% misunderstood sarcasm. A long duration of epilepsy and young age at onset were risk factors for ToM impairments. In TLE patients, ToM impairments were associated with impaired empathy and anhedonia. Their affective states were less positively and more negatively valenced than in controls. Low positive affectivity was predictive of greater cognitive and affective ToM impairments for the faux pas task, and high negative affectivity was predictive of greater cognitive ToM abilities for the sarcasm task. The lack of social support was correlated with impaired ToM but was not a predictive factor. Conclusions: Both cognitive and affective ToM processes are impaired in TLE patients. Impaired ToM has an impact on empathy abilities and is related to affective disturbances in TLE patients. (PsycINFO Database Record (c) 2014 APA, all rights reserved).
    Neuropsychology 07/2014; · 3.58 Impact Factor
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    ABSTRACT: Multiple organ dysfunction, not respiratory failure, is the major cause of death in children with acute lung injury or acute respiratory distress syndrome. This study was undertaken to estimate the predictive value of death of the nonrespiratory Pediatric Logistic Organ Dysfunction-2 in children with acute respiratory failure.
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    ABSTRACT: Before introducing 70-kVp settings in the low-kilovoltage strategies for pediatric examinations, it was mandatory to demonstrate, at similar dose levels, an equivalence of image quality at 70 kVp and 80 kVp.
    Pediatric Radiology 06/2014; · 1.57 Impact Factor
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    ABSTRACT: Background Because of growing body of interest on the association between fibrosing idiopathic interstitial pneumonias (f-IIP) and ischemic heart disease, we initiated this prospective study to evaluate the prevalence of asymptomatic coronary artery disease (CAD) in patients with f-IIP. Methods 42 patients with f-IIP underwent noninvasive screening for CAD that included (a) a chest CT examination enabling calculation of the coronary artery calcium (CAC) score, then depiction of coronary artery stenosis; and (b) stress myocardial perfusion scintigraphy (MPS). Patients with significant coronary abnormalities, defined by a CAC score >400 or coronary artery stenosis >50% at CT and/or perfusion defect > 5% at MPS, were referred to the cardiologist. Coronary angiography was indicated in presence of a perfusion defect > 10% at MPS or significant left main or proximal left anterior descending stenosis whatever MPS findings. Results Combining CT and MPS, significant abnormalities were detected in 32/42 patients (76%). The cardiologist: (a) did not consider further investigation in 21 patients (CT abnormalities but no ischemia at MPS: 12/21; false-positive findings at MPS: 3/21; poor respiratory condition: 6/21); (b) proceeded to coronary angiography in 11 patients which confirmed significant stenoses in 5 patients (5/42; 12%). In the worst-case-scenario (i.e., inclusion of 6 patients with significant coronary artery abnormalities who were not investigated due to poor respiratory condition), the prevalence of CAD reached 26% (11/42). Conclusion In the studied population of patients with f-IIP, asymptomatic CAD ranged between 12% and 26%.
    European Journal of Radiology 06/2014; · 2.51 Impact Factor
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    ABSTRACT: Cytoreduction prior-to-allogeneic stem cell transplantation (allo-SCT) for patients with myelodysplastic syndromes remains debated. After excluding patients who had received preconditioning induction chemotherapy, we analyzed 128 consecutive patients with MDS who received reduced intensity or nonmyeloablative conditioning (RIC/NMA) allo-SCT. Among them, 40 had received AZA before transplant (AZA-group) while 88 were transplanted upfront (BSC-group). At diagnosis, 55 patients had intermediate-2 or high-risk IPSS and 33 had high cytogenetic risk-score. Progression to a more advanced disease before allo-SCT was recorded in 22 patients. Source of stem cells were blood (n=112) or marrow (n=16) from sibling (n=78) or HLA-matched unrelated (n=50) donors. With a median follow-up of 60 months, 3-year overall survival, relapse-free survival, cumulative incidence of relapse and non-relapse mortality were 53% versus 53% (p=0.69), 37% versus 42% (p=0.78), 35% versus 36% (p=.99) and 20% versus 23% (p=0.74), for AZA-group and BSC-group, respectively. Multivariate analysis confirmed the absence of statistical differences in outcome between AZA and BSC groups, after adjustment for potential confounders using propensity score approach. The absence of cytoreduction before RIC/NMA allo-SCT did not seem to alter the outcome. However, our results emphasize the need to perform prospective protocols in order to delineate the role of debulking strategy and to identify subsets of patients who may benefit from this approach.
    Biology of blood and marrow transplantation: journal of the American Society for Blood and Marrow Transplantation 05/2014; · 3.15 Impact Factor
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    ABSTRACT: Apathy is characterized by lack of interest, loss of initiative, and flattening of affect. It is a frequent, very disabling nonmotor complication of Parkinson's disease (PD). The condition may notably occur when dopaminergic medications are tapered after the initiation of subthalamic stimulation and thus can be referred to as “dopaminergic apathy.” Even in the absence of tapering, some patients may develop a form of apathy as PD progresses. This form is often related to cognitive decline and does not respond to dopaminergic medications (dopa-resistant apathy). We aimed at determining whether dopa-resistant apathy in PD is related to striatofrontal morphological changes. We compared the shape of the striatum (using spherical harmonic parameterization and sampling in a three-dimensional point distribution model [SPHARM-PDM]), cortical thickness, and fractional anisotropy (using tract-based spatial statistics) in 10 consecutive patients with dopamine-refractory apathy, 10 matched nonapathetic PD patients and 10 healthy controls. Apathy in PD was associated with atrophy of the left nucleus accumbens. The SPHARM-PDM analysis highlighted (1) a positive correlation between the severity of apathy and atrophy of the left nucleus accumbens, (2) greater atrophy of the dorsolateral head of the left caudate in apathetic patients than in nonapathetic patients, and (3) greater atrophy in the bilateral nucleus accumbens in apathetic patients than in controls. There were no significant intergroup differences in cortical thickness or fractional anisotropy. Dopa-resistant apathy in PD was associated with atrophy of the left nucleus accumbens and the dorsolateral head of the left caudate. © 2014 International Parkinson and Movement Disorder Society
    Movement Disorders 05/2014; · 5.63 Impact Factor
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    ABSTRACT: Adult patients with cystic fibrosis (CF) frequently have reduced exercise tolerance, which is multifactorial but mainly due to bronchial obstruction. The aim of this retrospective analysis was to determine the mechanisms responsible for exercise intolerance in patients with mild-to-moderate or severe disease.
    BMC Pulmonary Medicine 04/2014; 14(1):74. · 2.76 Impact Factor
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    ABSTRACT: The objective of the present study was to investigate the time course of long-interval intracortical inhibition (LICI) and late cortical disinhibition (LCD) as a function of the motor task (index abduction, thumb-index precision grip). Motor-evoked potentials were recorded from the first dorsal interosseus (FDI) muscle of the dominant limb in 13 healthy subjects. We used paired-pulse transcranial magnetic stimulation (TMS) paradigms in which a test pulse was preceded by a suprathreshold priming pulse (130% of the resting motor threshold) with varying interstimulus intervals (ISIs). In each task, double pulses were delivered with ISIs ranging from 30% of the corresponding silent period (SP; ~ 45 ms) to 220% of the SP (~ 330 ms). In both tasks, we found that LICI was followed by LCD (namely a period of increased cortical excitability lasting until ~ 200% of the SP). The time-dependent modulation of LICI and LCD differed in the two tasks; LICI was shorter (i.e. disinhibition occurred earlier) and LCD was more intense during precision grip than during index abduction. Long-interval intracortical inhibition disappeared well before the end of the SP in the precision grip task, suggesting that the mechanisms underlying these two inhibitory phenomena are distinct. Our data suggest that disinhibition might reflect adaptation of neural circuit excitability to the functional requirements of the motor task.
    European Journal of Neuroscience 02/2014; · 3.75 Impact Factor
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    ABSTRACT: The aim of the study was to evaluate left atrial (LA) volume in smokers according to the severity of emphysema, with the objective of providing indirect evidence of reduced pulmonary venous return due to capillary destruction. A total of 121 smokers underwent a high-pitch and high-temporal resolution computed tomography (CT) angiographic examination, enabling quantification of emphysema, total lung volume, and LA volume measurements normalized to body surface area. The CT phenotypes were as follows: emphysema predominant (group 1; n=57); airway predominant (group 2; n=30); a mixed pattern of emphysema and airway disease (group 3; n=15); and absence of bronchopulmonary CT abnormalities (group 4; n=19). A negative correlation was found between the indexed LA volume and the percentage of emphysema: (a) in the overall study group (P=0.032; r=-0.19); (b) in group 1 (P=0.0163; r=-0.32); and (c) in groups 1 and 3 when analyzed together (P=0.0492; r=-0.23). A negative correlation was found between the indexed LA volume and the total lung volume in the overall study group (P=0.039; r=-0.19) and in group 1 (P=0.048; r=-0.26), whereas no correlations were found in group 2 (P=0.44; r=-0.15), group 3 (P=0.52; r=-0.17), and groups 1 and 3 analyzed as a whole (P=0.14; r=-0.17). The indexed LA volume, impacting left ventricular preload, is correlated to the severity of emphysema.
    Journal of thoracic imaging 01/2014; · 1.42 Impact Factor
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    ABSTRACT: We investigated the impact of rabbit antithymocyte globulins (ATG) on patient outcome after allogeneic stem cell transplantation (allo-SCT) for progressive myelodysplastic syndrome (MDS). Of the 242 consecutive patients who underwent allo-SCT for progressive MDS between October 1999 and December 2009, 93 received ATG (ATG group) at the median dose of 5 mg/kg while 149 patients did not (no-ATG group). Donors were sibling (n=153) or HLA-matched unrelated (n=89). Patients received blood (n=90) or marrow (n=152) grafts following either myeloablative (n=109) or reduced intensity (n=133) conditioning. Three-year overall and event-free survival, nonrelapse mortality, relapse, and chronic graft-versus-host disease (GVHD) development were not significantly different between the two groups. In contrast, acute grade II-IV GVHD occurred more often in the no-ATG group (55% of the patients) than in the ATG group (27%, p<0.0001). Similar results were observed with acute grade III-IV GVHD (28% and 14% in the no-ATG group and ATG group, respectively; p=0.009). In multivariate analysis, after adjustment with propensity score, the absence of ATG was the strongest parameter associated with an increased risk of acute grade II-IV GVHD [HR=2.13, 95% CI: 1.35-3.37, p=0.001]. ATG had no impact on overall and event free survival or cumulative incidence of the relapse. In conclusion, the addition of ATG to allo-SCT conditioning did not increase the incidence of relapse of patients with progressive MDS. The incidence of acute GVHD was decreased without compromising outcomes.
    Biology of blood and marrow transplantation: journal of the American Society for Blood and Marrow Transplantation 01/2014; · 3.15 Impact Factor
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    ABSTRACT: Background Uncontrolled use of tanning beds is a major public health problem. The role of UV in skin carcinogenesis has in fact been clearly demonstrated. Aims The main purpose of the study was to assess the motivations and beliefs of the population concerning the use of indoor tanning. The secondary objectives were to compare the knowledge of users and non-users and to screen for addiction criteria among users. Patients and methods This was a transversal descriptive study conducted between April and June 2013 in Lille town center. The motivations of the participants were determined using a multiple-choice questionnaire. A Likert scale was used to assess beliefs and an m-CAGE questionnaire was used to screen for addiction. Results Of the 200 respondents, 30% (n = 60) had used tanning beds in a non-medical setting. The median age of first use was 23 years (15–59). 11.7% of respondents had started before the authorised age of 18 years. “To prepare the skin for exposure to the sun” was the main reason given (68.3%) for use of tanning beds. The population was aware that use of such apparatus favours onset of skin cancer and ageing of the skin. Users were more convinced than non-users that UV cabins “prepare the skin for exposure to the sun” (75% vs. 49.6%, P = 0.0009) and that they “favour skin cancer” (56.9% against 36.2%, P = 0.0444). Addictive behaviour was detected in 3.3% (2/60) of users. Conclusion Users are aware of the carcinogenic risk of UV cabins but expose themselves to such risk, as they believe it prepares their skin for sun exposure.
    Annales de Dermatologie et de Vénéréologie 01/2014; · 0.60 Impact Factor

Publication Stats

4k Citations
1,057.28 Total Impact Points


  • 2000–2014
    • University of Lille Nord de France
      Lille, Nord-Pas-de-Calais, France
  • 1999–2014
    • Centre Hospitalier Régional Universitaire de Lille
      • Division of Neurology
      Lille, Nord-Pas-de-Calais, France
  • 2013
    • Clinique de l'Yvette
      Longjumeau, Île-de-France, France
  • 2001–2013
    • Université du Droit et de la Santé Lille 2
      • Faculty of Medicine
      Lille, Nord-Pas-de-Calais, France
  • 2002–2011
    • Lille Catholic University
      Lille, Nord-Pas-de-Calais, France
  • 2001–2011
    • CHRU de Strasbourg
      Strasburg, Alsace, France
  • 2010
    • Université du Littoral Côte d'Opale (ULCO)
      Dunkirk, Nord-Pas-de-Calais, France
  • 2009
    • Centre Hospitalier Universitaire de Dijon
      Dijon, Bourgogne, France
  • 2004
    • Université Charles-de-Gaulle Lille 3
      Lille, Nord-Pas-de-Calais, France
    • University of Toulouse
      Tolosa de Llenguadoc, Midi-Pyrénées, France