Manon Auffret

• PharmD, PhD
• Researcher at FDE / Université de Rennes / CHU de Rennes

The present paper consists of a comprehensive review of the literature on apomorphine pharmacological properties and its usefulness in Parkinson’s disease (PD). The chemistry, structure–activity relationship, pharmacokinetics and pharmacodynamics of apomorphine are described with regard to its effects on PD symptoms, drug interactions, interindivid...

Apomorphine is now recognized as the oldest antiparkinsonian drug on the market. Though still underused, it is increasingly prescribed in Europe for patients with advanced Parkinson’s disease (PD) with motor fluctuations. However, its history is far from being limited to movement disorders. This paper traces the history of apomorphine, from its ear...

Despite clinical evidence of poor oral health and hygiene in Parkinson’s disease (PD) patients, the mouth is often overlooked by both patients and the medical community, who generally focus on motor or psychiatric disorders considered more burdensome. Yet, oral health is in a two-way relationship with overall health—a weakened status triggering a d...

Importance The integration of palliative care in neurology, or neuropalliative care, is an emerging area of practice focused on holistically improving quality of life and reducing the burden of suffering for people living with serious neurologic disease and their care partners. Major neurology and palliative care societies have recognized the need...

Dysphagia for medication in Parkinson's disease: an assessment of the professional practices of speech therapists and community pharmacists in France

Neuroscience research has shown that specific brain patterns can relate to creativity during multiple tasks but also at rest. Nevertheless, the electrophysiological correlates of a highly creative brain remain largely unexplored. This study aims to uncover resting-state networks related to creative behavior using high-density electroencephalography...

Parkinson’s disease (PD) progresses with motor fluctuations emerging several years after treatment initiation. Initially managed with oral medications, these fluctuations may later necessitate device-aided therapy (DATs). Globally, various DATs options are available, including continuous subcutaneous apomorphine infusion, deep brain stimulation, le...

Multidimensional, chronic, progressive and incurable, Parkinson's disease is, by definition, a palliative disease, and this from the moment of diagnosis. This vision, relatively new to neurology, calls for a paradigm shift, as well as a dual medical-paramedical and home-hospital alliance. This approach allows us to better understand the specificiti...

Anxiety is a common non-motor symptom in Parkinson’s disease (PD) occurring in up to 31% of the patients and affecting their quality of life. Despite the high prevalence, anxiety symptoms in PD are often underdiagnosed and, therefore, undertreated. To date, functional and structural neuroimaging studies have contributed to our understanding of the...

Background There are currently no recommendations on the therapeutic management of Parkinson’s disease (PD) patients at the end of life. Objective To describe a cohort of patients with PD who benefited from continuous subcutaneous apomorphine infusion (CSAI) initiation at the end of their life as comfort care. Methods This real-life cohort includ...

Neuroscience research has shown that specific functional brain patterns can be related to creativity during multiple tasks but also at rest. Nevertheless, the electrophysiological correlates of a highly creative brain remain largely unexplored. This study aims to uncover resting-state networks related to real-life creativity using high-density elec...

Device-aided therapies (DAT), which include deep brain stimulation and pump-based continuous dopaminergic stimulation with either levodopa or apomorphine, are among the major advances in the clinical management of Parkinson’s disease (PD). Although DAT are being increasingly offered earlier in the disease course, their classical indication remains...

Background: Parkinson's disease (PD) patients present with a heterogeneous clinical phenotype, including motor, cognitive, sleep, and affective disruptions. However, this heterogeneity is often either ignored or assessed using only clinical assessments. Objectives: We aimed to identify different PD sub-phenotypes in a longitudinal follow-up anal...

Dopaminergic therapies dominate the treatment of the motor and non-motor symptoms of Parkinson’s disease (PD) but there have been no major advances in therapy in many decades. Two of the oldest drugs used appear more effective than others—levodopa and apomorphine—but the reasons for this are seldom discussed and this may be one cause for a lack of...

Anxiety is a common non-motor symptom in Parkinson's disease (PD) occurring in up to 31% of the patients and affecting their quality of life. Despite the high prevalence, anxiety symptoms in PD are often underdiagnosed and, therefore, undertreated. To date, functional and structural neuroimaging studies have contributed to our understanding of the...

Bien que couramment rencontrée à l’officine, la maladie de Parkinson demeure souvent un sujet complexe pour l’équipe officinale, tant dans l’accompagnement des patients et de leurs proches, que dans le conseil associé aux traitements. Cet ouvrage a pour objectif de remettre à niveau les connaissances de l’équipe officinale, indispensables à un acc...

Background: Tracking longitudinal functional brain dysconnectivity in Parkinson's disease (PD) is a key element to decoding the underlying physiopathology and understanding PD progression. Objectives: The objectives of this follow-up study were to explore, for the first time, the longitudinal changes in the functional brain networks of PD patien...

Introduction La prise en charge thérapeutique des patients atteints de maladie de Parkinson (MP) au stade terminal ne fait aujourd’hui l’objet d’aucune recommandation. Objectifs Décrire le bénéfice de la pompe à apomorphine et du suivi conjoint neurologique et palliatif chez 7 patients MP au stade terminal. Patients et méthodes Les données cliniq...

Introduction Les pénuries de médicaments posent un problème majeur de santé publique et concernent aussi bien des médicaments d’usage quotidien que ceux d’intérêt vital, comme le Sinemet® (six mois en 2018–2019). Objectifs Les objectifs de ce travail étaient de déterminer : (i) comment les informations concernant cette rupture ont été relayées aux...

Introduction The main objective is to validate a French translation of the Alcohol Urge Questionnaire (AUQ) that measures craving in patients with alcohol dependence entering a detoxification program. Methods: All patients aged >18 years who were hospitalized for alcohol detoxification from February to May 2019 in the alcohol unit of the Rennes u...

This chapter focuses on apomorphine therapy, a device-aided strategy in Parkinson's disease. Apomorphine is a nonnarcotic and nonspecific dopaminergic agonist (D1-like and D2-like receptors) indicated in the case of suboptimal therapeutic response to oral antiparkinsonian medication. Two approaches are possible—either as a rescue therapy with acute...

Apomorphine is a 150-year old nonspecific dopaminergic agonist, currently indicated for treating motor fluctuations in Parkinson's disease. At the era of drug repurposing, its pleiotropic biological functions suggest other possible uses. To further explore new therapeutic and diagnostic applications, the available literature up to July 2018 was rev...

In the original publication, the name of the author in T.

Abstract topic: History of Neurology Title: The many faces of apomorphine: lessons from the past and challenges for the future Authors: Auffret Manon (PharmD, PhD), Sophie Drapier (MD), Marc Vérin (MD, PhD) OBJECTIVE: The aim of this research was to trace the rich and eventful history of apomorphine, bringing to light some of the forgotten names a...

Introduction: Continuous subcutaneous apomorphine infusion (CSAI) is increasingly used in Parkinson's disease (PD), notably in patients contraindicated for subthalamic deep brain stimulation. Although it has been suggested that CSAI is safe regarding cognition, few studies have actually investigated its effect, especially on cognitive control whic...

Introduction: Patients with advanced Parkinson's disease (PD) and contraindications for subthalamic nucleus deep brain stimulation (DBS) could particularly benefit from subcutaneous infusion therapy with apomorphine. This original study was designed to evaluate the general efficacy of add-on apomorphine in motor and nonmotor symptoms in advanced P...

Several studies have investigated the age-related impact in cognitive action control. However, to our knowledge, none has focused on the effect of moderate age on the strength of automatic activation according to the activation suppression model. We therefore investigated the effect of moderate age on cognitive action control using an oculomotor ve...

According to embodied simulation theory, understanding other people's emotions is fostered by facial mimicry. However, studies assessing the effect of facial mimicry on the recognition of emotion are still controversial. In Parkinson's disease (PD), one of the most distinctive clinical features is facial amimia, a reduction in facial expressiveness...

EMG responses to emotion displayed: dataset. Group = healthy controls (HC) and PD patients (PD); Subject = subject number; Trial = trial number (e01—e36); Emotion = emotion displayed (Angry, Happy, Neutral); Avatar = identification code of the avatar; Muscle = recorded muscle (Corru = corrugator supercilii, Zygo = zygomaticus major and Orbi = orbic...

Characteristics of the patients’ medication. Type: L = patients under L-dopa medication only (levodopa + carbidopa and/or levodopa + benserazide and/or levodopa + carbidopa + entacapone), A = under dopamine agonists only, or L+A = under a combination of L-dopa and dopamine agonists; MAO/COMT: Some patients also took monoamine oxidase (MAO) B and/or...

Inter-emotions comparisons of EMG responses recorded on sequential 100 ms intervals of stimulus exposure in the healthy controls. Test statistics (χ²) are shown in brackets. Figures in bold denote statistically significant differences (p value<0.05). ns = non statistically significant = p value>0.1. (DOC)

Inter-muscles comparisons of the EMG responses recorded on sequential 100 ms intervals of stimulus exposure in the PD patients. CORRU = corrugator supercilii; ZYGO = zygomaticus major; ORBI = orbicularis oculi. Test statistics (χ²) are shown in brackets. Figures in bold denote significant differences (p value<0.05). ns = non significant = p value>0...

Inter-muscle comparisons. (DOC)

Inter-emotions comparisons of EMG responses recorded on sequential 100 ms intervals of stimulus exposure in the PD patients. Test statistics (χ²) are shown in brackets. Figures in bold denote statistically significant differences (p value<0.05). ns = non statistically significant = p value>0.1. (DOC)

Detailed description of the procedure and the stimulus material. (DOC)

Effects of clinical characteristics of the patients on facial reactions to emotion (α = 0.05). (DOC)

Effect of facial reactions on emotion decoding accuracy (α = 0.05). (DOC)

Sociodemographic, neuropsychological and clinical characteristics of the participants: dataset. Group = healthy controls (HC) and PD patients (PD); Subject = subject number; Sex = participant’s gender (W = woman and M = man); Age = participant’s age at inclusion; STAI_state = state anxiety score on the State-Trait Anxiety Inventory; STAI_trait = tr...

Performances on the facial emotion recognition task: dataset. Group = healthy controls (HC) and PD patients (PD); Subject = subject number; Trial = trial number (e01—e36); Emotion = emotion displayed (Angry, Happy, Neutral); Avatar = identification code of the avatar; Decoding_Accuracy = accurately identified expressions were coded as 1 and misiden...

Inter-muscles comparisons of the EMG responses recorded on sequential 100 ms intervals of stimulus exposure in the healthy controls. CORRU = corrugator supercilii; ZYGO = zygomaticus major; ORBI = orbicularis oculi. Test statistics (χ²) are shown in brackets. Figures in bold denote significant differences (p value<0.05). ns = non significant = p va...

EMG data management. For each trial, the last second before stimulus onset was considered as baseline. Then, to examine the temporal profiles of facial reactions to emotions, the EMG amplitudes were averaged on sequential 100 ms intervals (x 20) of stimulus exposure (top panel A) and expressed as a relative percentage of the mean amplitude from bas...

Selon la théorie de la simulation intégrée, comprendre les émotions d’autres personnes est favorisé par la mimique faciale. Toutefois, les résultats des études évaluant l’effet de la mimique faciale dans la reconnaissance des émotions restent encore controversés. Dans la maladie de Parkinson, une des caractéristiques cliniques est l’amimie faciale,...

Cognitive action control has been extensively studied using conflict tasks such as the Simon task. In most recent studies, this process has been investigated in the light of the dual route hypothesis and more specifically of the activation-suppression model using distributional analyses. Some authors have suggested that cognitive action control ass...

Résumé La perfusion continue sous-cutanée d’apomorphine est actuellement utilisée dans le traitement des fluctuations motrices et des dyskinesies dopa-induites dans la maladie de Parkinson. Son utilisation demeure encore rare malgré de nombreuses études démontrant son efficacité et une relative bonne tolérance. Cet article fait une mise au point su...

Agoniste dopaminergique le plus ancien et le plus puissant, l’apomorphine n’en reste pas moins sous-utilisée dans la maladie de Parkinson, malgré une efficacité reconnue. Cet article fournit des éléments de compréhension de la pharmacologie et de la pharmacocinétique de cette molécule, à même d’expliquer les effets cliniques ainsi que les différenc...

Objectives: Non-motor symptoms of Parkinson’s disease (PD) severely impair functional and social patients’ daily life. For elderly PD patients contra-indicated for deep brain stimulation, one of the few remaining therapeutic options is continuous dopaminergic stimulation with subcutaneous apomorphine (APO). Our study aimed to identify motor, non-mo...

P 2.085 http://www.prd-journal.com/article/S1353-8020(15)00661-6/abstract

Sir, Capnocytophaga spp. have a role in the pathogenesis of various forms of periodontal disease and systemic infections, particularly severe in neutropenic cancer patients. The prevalence of β-lactam-resistant oral bacteria is increasing in clinical isolates [1]. All of the reported β-lactam-resistant Capnocytophaga isolates are β-lactamase-produ...