
Xavier MoissetCentre Hospitalier Universitaire de Clermont-Ferrand, Inserm U1107 - NeuroDol · Neurology
Xavier Moisset
MD - PhD
About
161
Publications
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Introduction
Xavier Moisset currently works at Centre Hospitalier Universitaire de Clermont-Ferrand, Neurology department, Inserm U1107 - NeuroDol.
Xavier does research in Neurology (neuropathic pain, headaches and multiple sclerosis).
Publications
Publications (161)
Background
Increasing transparency in clinical research is crucial to avoid misleading conclusions. Registering clinical trials prior to participant enrolment is mandatory, and the publication of trial protocols could further enhance transparency. However, the impact of protocol publication on primary outcomes (PO) and sample sizes (SS) remains unc...
The higher incidence of migraines in women compared with men has led to the inclusion of female animals in pain research models. However, the critical role of the hormonal cycle is frequently overlooked, despite its clear correlation with migraine occurrences. In this study, we show in a rat model of migraine induced by repeated dural infusions of...
Background and Objectives
Previous literature has been diverging on cancer risk in people with multiple sclerosis (PwMS). Therefore, this study compared the risk of cancer in PwMS and a matched sample from the French general population.
Methods
This 10-year nationwide retrospective matched cohort study (2012–2021) used data from the national Frenc...
The diagnosis of subarachnoid hemorrhage (SAH) is extremely important for appropriate management. Cerebral computed tomography (CT), used as the first-line investigation to detect bleeding, has excellent sensitivity if performed promptly, but its sensitivity falls sharply with the time elapsed since the onset of SAH. Oxyhemoglobin and bilirubin, th...
Background
Varied responses to acute migraine medications have been observed, with over one‐third (34.5%) of patients reporting insufficient headache relief. Sumatriptan‐naproxen sodium, a single, fixed‐dose combination tablet comprising sumatriptan 85 mg and naproxen sodium 500 mg, was developed with the rationale of targeting multiple putative me...
Objectives
To assess the variations and diagnostic performance of serum biomarkers of neurodegenerative diseases.
Methods
In this monocentric prospective study, neurofilament light (NFL), T-tau, p-tau181, p-tau217, Aβ40, and Aβ42 were measured in serum collected from orthopedic patients (control group, n=114) and patients in the neurology departme...
Background and objectives:
People with multiple sclerosis (MS) have an increased risk of severe coronavirus infection due to their level of motor disability or exposure to certain immunosuppressive treatments. Thus, patients with MS have had priority access to coronavirus disease 2019 (COVID-19) vaccination. However, relapses after vaccination hav...
Background and objectives:
Progressive multifocal leukoencephalopathy (PML) is a severe neurologic disease resulting from JC virus reactivation in immunocompromised patients. Certain multiple sclerosis (MS) disease-modifying therapies (DMTs) are associated with PML risk, such as natalizumab and, more rarely, sphingosine-1-phosphate receptor modula...
Purpose:
To report a case of uveitis associated with multiple sclerosis (MS) that was refractory to multiple lines of therapy but achieved remission with tocilizumab.
Methods:
We conducted a retrospective analysis of the patient's medical record including clinical, biological and imaging data.
Results:
A 33-year-old female patient with a histo...
Background
Epidemiological data reveal that 45% of persons with multiple sclerosis (PwMS) in France are more than 50 years. This population more than 50 is more susceptible to cancer, and this risk may be increased by frequent use of immunosuppressive drugs. Consequently, concerns have arisen about the potential increased risk of cancer in PwMS and...
Parkinson disease (PD) affects up to 2% of the general population older than 65 years and is a major cause offunctional loss. Chronic pain is a common nonmotor symptom that affects up to 80% of patients with (Pw) PD bothin prodromal phases and during the subsequent stages of the disease, negatively affecting patient’s quality of lifeand function. P...
Introduction
Bipolar Disorder (BD) is a common psychiatric disease. It has been demonstrated a long time ago that bipolar patients are more painful than the healthy subjects. Substance use disorder is a frequent comorbidity in BD, but also in painful patients. The aim of our study was to analyze if bipolar patients with a painful expression have mo...
IntroductionMigraine and bipolar disorder (BD) are two chronic and recurrent disorders with a major impact on patient’s quality of life. It is now well known that affective disorders and migraine are often comorbid (Leo et al. Scand J Pain. 2016; 11:136-145). Starting from these observations, we can hypothesis that BD patients with comorbid migrain...
Parkinson disease (PD) affects up to 2% of the general population older than 65 years and is a major cause of functional loss. Chronic pain is a common nonmotor symptom that affects up to 80% of patients with (Pw) PD both in prodromal phases and during the subsequent stages of the disease, negatively affecting patient's quality of life and function...
Neuropathic pain is a much more common pain disorder than usually thought, affecting up 10% of the general population worldwide. It encompasses a large number of conditions, such as sciatica, postsurgical pain, painful neuropathies, postherpetic neuralgia, multiple sclerosis, spinal cord injury, and stroke. However, neuropathic pain is still consid...
Neuropathic pain is a much more common pain disorder than usually thought, affecting up 10% of the general population worldwide. It encompasses a large number of conditions, such as sciatica, postsurgical pain, painful neuropathies, postherpetic neuralgia, multiple sclerosis, spinal cord injury, and stroke. However, neuropathic pain is still consid...
ANTI-CALCITONIN GENE-RELATED PEPTIDE (CGRP) THERAPIES FOR MIGRAINE. Currently, four monoclonal antibodies targeting the CGRP (calcitonin gene-related peptide) pathway have been shown to be effective as migraine prophylactics: eptinezumab, erenumab, fremanezumab and galcanezumab. Unlike the usual preventive treatments, they are administered parenter...
Multiple sclerosis (MS) is the most common chronic inflammatory neurological disease. The emergence of disease-modifying therapies (DMTs) has greatly improved disease activity control and progression of disability in MS patients. DMTs differ in their mode of action, route of administration, efficacy, and safety profiles, offering multiple options f...
Background
In relapsing-remitting multiple sclerosis (RRMS), early identification of suboptimal responders can prevent disability progression.
Objective
We aimed to develop and validate a dynamic score to guide the early decision to switch from first- to second-line therapy.
Methods
Using time-dependent propensity scores (PS) from a French cohort...
Background:
In 2020, the French Multiple Sclerosis (MS) Society (SFSEP) decided to develop a national evidence-based consensus on pregnancy in MS. As neuromyelitis optica spectrum disorders (NMOSD) shares a series of commonalities with MS, but also some significant differences, specific recommendations had to be developed.
Objectives:
To establi...
Objective:
The objective of this study was to develop evidence-based recommendations on pregnancy management for persons with multiple sclerosis (MS).
Background:
MS typically affects young women in their childbearing years. Increasing evidence is available to inform questions raised by MS patients and health professionals about pregnancy issues...
Les douleurs neuropathiques sont fréquentes dans la population générale et d’évolution chronique chez 7 à 10 % des adultes. Actuellement, la méthode de référence pour évaluer un traitement correspond aux essais randomisés contrôlés. Néanmoins, de telles études ne peuvent être mises en place que pour des échantillons de population limités et pendant...
Background
Until recently, few therapeutic options, other than symptomatic treatment, were available for patients with primary progressive multiple sclerosis (PPMS). Ocrelizumab is the only approved treatment in this indication, and only since 2017. However, many patients in France are receiving off-label treatments for PPMS, mainly rituximab, myco...
Introduction
La littérature rapporte de nombreux cas d’infarctus médullaires dont les caractéristiques radiologiques habituelles ont été établies permettant généralement de les distinguer des myélites.
Observation
Un patient de 44 ans, hypertendu et en surpoids, a présenté des paresthésies brutales de l’hémicorps droit, ainsi que des cervicalgies....
L’objectif de cette session est de voir quelques-uns des principaux articles publiés en 2021–2022 concernant la thématique des céphalées. La priorité sera donnée aux articles concernant la physiopathologie et l’épidémiologie. Les nouveautés thérapeutiques seront abordées lors de la session d’actualités du vendredi matin.
Lumbar puncture (LP) is stressful and often painful. We evaluated the efficacy of a fixed 50% nitrous oxide–oxygen mixture (50%N2O-O2) versus placebo to reduce immediate procedural pain and anxiety during LP performed in an emergency setting. We conducted a randomized controlled trial involving adults who needed a cerebrospinal fluid analysis in an...
Among the many symptoms (motor, sensory, and cognitive) associated with multiple sclerosis (MS), chronic pain is a common disabling condition. In particular, neuropathic pain symptoms are very prevalent and debilitating, even in early stages of the disease. Unfortunately, chronic pain still lacks efficient therapeutic agents. Progress is needed (i)...
Background and Objectives
Progressive multifocal leukoencephalopathy (PML) is a disabling neurologic disorder resulting from the infection of the CNS by JC polyomavirus in immunocompromised individuals. For the last 2 decades, increasing use of immunotherapies leads to iatrogenic PML. Iatrogenic PML is often associated with signs of inflammation at...
Introduction
Recent studies suggested that anti-CD20 and fingolimod may be associated with lower anti-spike protein-based immunoglobulin-G response following COVID-19 vaccination. We evaluated if COVID-19 occurred despite vaccination among patients with multiple sclerosis (MS) and neuromyelitis optica (NMO), using the COVISEP registry.
Case series...
Background
New treatments are currently offering new opportunities and challenges in clinical management and research in the migraine field. There is the need of homogenous criteria to identify candidates for treatment escalation as well as of reliable criteria to identify refractoriness to treatment. To overcome those issues, the European Headache...
In this issue of the European Journal of Pain you will find the article by Oguz‐Akarsu and collaborators entitled “Insight into Pain Syndromes in Acute Phase of Mild‐to‐Moderate COVID‐19: Frequency, Clinical Characteristics, and Associated Factors” (Oguz‐Akarsu et al., 2021). This observational cohort was one of the handful yet to have described in...
Background
In multiple sclerosis (MS) studies, the most appropriate model for the distribution of the number of relapses was shown to be the negative binomial (NB) distribution.
Objective
To determine whether the sample-size estimation (SSE) and the analysis of annualized relapse rates (ARRs) in randomized controlled trials (RCTs) were aligned and...
Studies comparing different drug treatments for chronic neuropathic pain (NP) are very limited. We, therefore, examined 4 recommended treatments, namely, antidepressants (duloxetine, venlafaxine, and tricyclic antidepressants), antiepileptics (gabapentine and pregabalin), weak opioids, and strong opioids, among patients with NP evaluated before fir...
Neuropathic pain is frequent in the general population, with 7 to 10% of adults presenting with chronic neuropathic pain. To date, the gold standard to evaluate treatments is based on randomized controlled trials. Nonetheless, such design is run on a limited sample and for a limited period. Moreover, many treatments will never be compared directly...
Migraine is a very prevalent disease worldwide and is a major cause of disability. As known for a long time, migraine is associated with neurogenic inflammation. Epidemiological studies have shown that migraine is comorbid with several chronic inflammatory diseases, including multiple sclerosis (MS), chronic inflammatory rheumatic diseases (CIRDs)...
Neuropathic pain remains a significant unmet need. French recommendations were updated in 2020. The goal of this minireview is to provide an update on these published guidelines. Despite newer relevant studies, our proposed algorithm remains relevant. First-line treatments include serotonin-noradrenaline reuptake inhibitors (duloxetine and venlafax...
Regular and frequent use of analgesics and acute antimigraine drugs can increase the frequency of headache, and induce the transition from episodic to chronic migraine or medication-overuse headache (MOH). The one-year prevalence of this condition is between 1% and 2% in Europe, provoking substantial burden. MOH is more prevalent in people with com...
The French Headache Society proposes updated French guidelines for the management of migraine. This article presents the second part of the guidelines, which is focused on the pharmacological treatment of migraine, including both the acute treatment of attacks and the prophylaxis of episodic migraine as well as chronic migraine with and without med...
The French Headache Society proposes updated French guidelines for the management of migraine. The first part of these recommendations is focused on the diagnosis and assessment of migraine. First, migraine needs to be precisely diagnosed according to the currently validated criteria of the International Classification of Headache Disorders, 3d ver...
The French Headache Society proposes updated French guidelines for the management of migraine. This article presents the third part of the guidelines, which is focused on the non-pharmacological treatment of migraine, including physical exercise, dietary supplements and plants, diets, neuromodulation therapies, acupuncture, behavioral interventions...
Background:
Disease modifying therapies (DMTs), have an impact on relapses and disease progression. Nonetheless, many patients with multiple sclerosis (pwMS) remain untreated. The objective of the present study was to determine the proportion of untreated patients with multiple sclerosis (pwMS) followed in expert centers in France and determine th...
Background
This study determines the prevalence and particularities of headache and pain with neuropathic characteristics (NC) in a large French group of patients with pituitary adenoma (PA).
Methods
Analysis of validated self‐administered questionnaires, radiological characteristics, and treatment strategies of PA was performed.
Results
Of the 2...
Background
Massive screening campaigns for SARS‐CoV‐2 are currently carried out throughout the world, relying on reverse‐transcriptase‐polymerase chain reaction (RT‐PCR) following nasopharyngeal swabbing performed by a healthcare professional. Yet, due to the apprehension of pain induced by nasopharyngeal probing, poor adhesion to those screening c...
Background
Several neuromodulation methods exists for migraine treatment. The aim of the present study was to perform a systematic review and meta-analysis of randomized controlled trials (RCTs) focusing on migraine treatment using neurostimulation methods.
Methods
We searched Medline and Embase up to July 1, 2020 for RCTs reporting acute or preve...
Background:
Central neuropathic pain (CNP) is often refractory to available therapeutic strategies and there are few evidence-based treatment options. Many patients with neuropathic pain are not diagnosed or treated properly. Thus, consensus-based recommendations, adapted to the available drugs in the country, are necessary to guide clinical decisi...
Objectives:
To evaluate the safety and efficacy of ketamine-magnesium combination to reduce attacks in a series of patients with refractory chronic cluster headache (rCCH).
Background:
Refractory chronic cluster headache (CCH) is a rare but highly debilitating condition that needs new treatment options. A previous publication reported that a sin...
High-dose biotin (HDB) is a therapy used in non-active progressive multiple sclerosis (PMS). Several reports have suggested that HDB treatment may be associated with an increased risk of relapse. We aimed to determine whether HDB increases the risk of clinical relapse in PMS and describe the characteristics of the patients who experience it. We con...
Introduction
L’hypotension intracrânienne spontanée est responsable de céphalées positionnelles et peut survenir même en l’absence de geste invasif à risque d’effraction durale, dont la ponction lombaire. Il existe un risque de complications comme la thrombophlébite cérébrale.
Observation
Nous rapportons le cas d’un patient de 41 ans, sans antécéd...
Les techniques de neuromodulation, bien connues dans le domaine du traitement de la douleur chronique, ont été évaluées pour le traitement prophylactique de la migraine. Cette revue de la littérature présente ces différentes techniques et les résultats principaux des études contrôlées et/ou comparatives. L’analyse souligne l’hétérogénéité des proto...
Des techniques de neuromodulation, dont certaines sont bien connues pour leur utilisation dans le cadre de la douleur chronique, ont été développées pour le traitement de la crise migraineuse, et pourraient élargir notre palette thérapeutique. Cette brève revue de la littérature présente ces différentes techniques et les résultats des études princi...
Les dernières années ont été marquées par le développement de nouvelles thérapeutiques originales et spécifiques à la maladie migraineuse. Les traitements les plus avancés ont en commun de bloquer la voie du calcitonin gene-related peptide (CGRP). À la différence de nombreux traitements antimigraineux, dont l’efficacité a été découverte par hasard,...
Objectives:
To document the prevalence of new headaches in patients with Covid-19 infection and the potential association with other neuro-sensorial symptoms (anosmia and ageusia). The persistence of these symptoms 1 month after recovery was also documented.
Background:
Headaches are a very common symptom of viral infections. Surprisingly, early...
To investigate the physiopathology of pain in chronic inflammatory rheumatic diseases (CIRDs), we assessed the prevalence of migraine and neuropathic pain in 499 patients with CIRDs. We studied 238 patients with rheumatoid arthritis, 188 with spondyloarthritis (SpA), 72 with psoriatic arthritis (PsA), and 1 unclassified. Migraine was diagnosed acco...
Les douleurs neuropathiques (DN) restent très difficiles à soulager. Plusieurs recommandations ont été proposées au cours de ces dernières années, mais aucune n’a pris en compte à ce jour l’ensemble des approches thérapeutiques disponibles. Nous avons réalisé une revue systématique portant sur toutes les études concernant le traitement des DN périp...
The goal of this narrative review was to give an up-to-date overview of the peripheral and central neurostimulation methods that can be used to treat chronic pain. Special focus has been given to three pain conditions: neuropathic pain, nociplastic pain and primary headaches. Both non-invasive and invasive techniques are briefly presented together...
Neuropathic pain remains a significant unmet medical need. Several recommendations have recently been proposed concerning pharmacotherapy, neurostimulation techniques and interventional management, but no comprehensive guideline encompassing all these treatments has yet been issued. We performed a systematic review of pharmacotherapy, neurostimulat...
Importance
Risk of developing progressive multifocal leukoencephalopathy (PML) is the major barrier to using natalizumab for patients with multiple sclerosis (MS). To date, the association of risk stratification with PML incidence has not been evaluated.
Objective
To describe the temporal evolution of PML incidence in France before and after intro...
Background:
The posterior insula and the medial parietal operculum (PIMO) are part of the pain network. Pain can be induced by direct stimulation of the PIMO, but the clinical consequence of lesions in this brain area is not well-known.
Case report:
We report the case of a patient with multiple sclerosis (MS) who presented a relapse characterize...
Background
Atraumatic needles are proposed to lower complication rates after lumbar puncture (LP). Only a minority of physicians use such needles. Here we aimed to assess the impact of specific training in LP during clinical clerkship on the proportion of medical students using atraumatic needles.
Methods
We performed a case-control study comparin...
Among the different types of pain observed in Parkinson's disease, parkinsonian central pain (PCP) has the highest severity, and is poorly characterized and difficult to describe not only by patients but also by neurologists. Thus PCP remains not strictly defined and is difficult to distinguish from other types of pain on the basis of clinical desc...
Endometriosis concerns more than 10% of women of reproductive age, frequently leading to chronic pelvic pain. Repetitive transcranial magnetic stimulation (rTMS) over the primary motor cortex (M1) induces an analgesic effect. This effect on chronic pelvic pain is yet to be evaluated. The objective of this study was to assess the feasibility and eff...