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Papers by Mihaela Vlaicu Bustuchina

The New England Journal of Medicine, Jul 2, 2020

Variant CJD in a Laboratory Technician Variant Creutzfeldt–Jakob disease was identified in a tech... more Variant CJD in a Laboratory Technician Variant Creutzfeldt–Jakob disease was identified in a technician who had cut her thumb while handling brain sections of mice infected with adapted BSE 7.5 yea...

Multiple Sclerosis and Related Disorders

Neuromodulation en Neurologie et en Psychiatrie

The Journal of Headache and Pain, 2021

Background New treatments are currently offering new opportunities and challenges in clinical man... more 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 Federation (EHF) issued a Consensus document to propose criteria to approach difficult-to-treat migraine patients in a standardized way. The Consensus proposed well-defined criteria for resistant migraine (i.e., patients who do not respond to some treatment but who have residual therapeutic opportunities) and refractory migraine (i.e., patients who still have debilitating migraine despite maximal treatment efforts). The aim of this study was to better understand the perceived impact of resistant and refractory migraine and the attitude of physicians involved in migraine care toward those conditions. Methods We conducted a web-questionnair...

D’enormes progres ont ete realises ces dernieres annees vers une comprehension de la perception m... more D’enormes progres ont ete realises ces dernieres annees vers une comprehension de la perception musicale. Les processus neurologiques responsables de la perception ou de la production de musique sont communs a beaucoup d’autres regions. L’emotion provoquee par la musique peut etre actuellement etudiee. En tant que tel, la musique promet de rester un outil interessant pour l’etude du cerveau. Les bases biologiques de la musicalite humaine sont actuellement a l’etude. Les decouvertes dans le domaine genetique, les nouveau genes « candidats » impliquee dans notre musicalite vont probablement changer notre comprehension du « cerveau musical ».

Multiple sclerosis and related disorders, Jan 2, 2018

Though the Expanded Disability Status Scale (EDSS) is commonly used to assess disability level in... more Though the Expanded Disability Status Scale (EDSS) is commonly used to assess disability level in relapsing-remitting multiple sclerosis (RRMS), the criteria defining disability progression are used for patients with a wide range of baseline levels of disability in relatively short-term trials. As a result, not all EDSS changes carry the same weight in terms of future disability, and treatment benefits such as decreased risk of reaching particular disability milestones may not be reliably captured. The objectives of this analysis are to assess the probability of confirmed disability worsening to specific EDSS milestones (i.e., EDSS scores ≥3.0, ≥4.0, or ≥6.0) at 288 weeks in the Tysabri Observational Program (TOP) and to examine the impact of relapses occurring during natalizumab therapy in TOP patients who had received natalizumab for ≥24 months. TOP is an ongoing, open-label, observational, prospective study of patients with RRMS in clinical practice. Enrolled patients were naive ...

Clinical Neuroradiology, 2021

In approximately 30% of the patients, brain arteriovenous malformations (bAVMs) are revealed by s... more In approximately 30% of the patients, brain arteriovenous malformations (bAVMs) are revealed by seizures, which may alter the patients' quality of life. Our objective was to evaluate the benefits of exclusion treatment (radiosurgery, embolization and/or surgery) on posttherapeutic epilepsy in bAVM patients without intracranial hemorrhage prior to treatment. Our retrospective observational single-center study included all consecutive adult patients with an unruptured bAVM and epilepsy, treated at our institution from 1995 to 2019 and who were followed for at least 1 year. Data on angioarchitectural characteristics of bAVMs, on epilepsy and posttreatment modified Rankin Scale (mRS) were collected. The primary endpoint was a seizure-free status (defined as Engel class IA) after exclusion treatment versus conservative management. In this study one hundred and one consecutive adult patients with bAVMs, epilepsy and without bAVM rupture before any treatment were included; 21 (21%) in the conservative management group vs. 80 (79%) in the exclusion treatment group. After exclusion treatment, 55% of the patients from the group were Engel IA after treatment vs. 10% of the conservative management group (odds ratio [OR] 11.37, 95% confidence interval [CI] 2.48-107.24, p < 0.001). Our results suggest that exclusion treatment in unruptured bAVMs with epilepsy is associated with a higher seizure-free rate in comparison with conservative management. Data from randomized controlled studies are necessary to confirm these findings.

VizieR Online Data Catalog, Oct 1, 2019

The New England Journal of Medicine, Jul 2, 2020

Variant CJD in a Laboratory Technician Variant Creutzfeldt–Jakob disease was identified in a tech... more Variant CJD in a Laboratory Technician Variant Creutzfeldt–Jakob disease was identified in a technician who had cut her thumb while handling brain sections of mice infected with adapted BSE 7.5 yea...

Multiple Sclerosis and Related Disorders

Neuromodulation en Neurologie et en Psychiatrie

The Journal of Headache and Pain, 2021

Background New treatments are currently offering new opportunities and challenges in clinical man... more 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 Federation (EHF) issued a Consensus document to propose criteria to approach difficult-to-treat migraine patients in a standardized way. The Consensus proposed well-defined criteria for resistant migraine (i.e., patients who do not respond to some treatment but who have residual therapeutic opportunities) and refractory migraine (i.e., patients who still have debilitating migraine despite maximal treatment efforts). The aim of this study was to better understand the perceived impact of resistant and refractory migraine and the attitude of physicians involved in migraine care toward those conditions. Methods We conducted a web-questionnair...

D’enormes progres ont ete realises ces dernieres annees vers une comprehension de la perception m... more D’enormes progres ont ete realises ces dernieres annees vers une comprehension de la perception musicale. Les processus neurologiques responsables de la perception ou de la production de musique sont communs a beaucoup d’autres regions. L’emotion provoquee par la musique peut etre actuellement etudiee. En tant que tel, la musique promet de rester un outil interessant pour l’etude du cerveau. Les bases biologiques de la musicalite humaine sont actuellement a l’etude. Les decouvertes dans le domaine genetique, les nouveau genes « candidats » impliquee dans notre musicalite vont probablement changer notre comprehension du « cerveau musical ».

Multiple sclerosis and related disorders, Jan 2, 2018

Though the Expanded Disability Status Scale (EDSS) is commonly used to assess disability level in... more Though the Expanded Disability Status Scale (EDSS) is commonly used to assess disability level in relapsing-remitting multiple sclerosis (RRMS), the criteria defining disability progression are used for patients with a wide range of baseline levels of disability in relatively short-term trials. As a result, not all EDSS changes carry the same weight in terms of future disability, and treatment benefits such as decreased risk of reaching particular disability milestones may not be reliably captured. The objectives of this analysis are to assess the probability of confirmed disability worsening to specific EDSS milestones (i.e., EDSS scores ≥3.0, ≥4.0, or ≥6.0) at 288 weeks in the Tysabri Observational Program (TOP) and to examine the impact of relapses occurring during natalizumab therapy in TOP patients who had received natalizumab for ≥24 months. TOP is an ongoing, open-label, observational, prospective study of patients with RRMS in clinical practice. Enrolled patients were naive ...

Clinical Neuroradiology, 2021

In approximately 30% of the patients, brain arteriovenous malformations (bAVMs) are revealed by s... more In approximately 30% of the patients, brain arteriovenous malformations (bAVMs) are revealed by seizures, which may alter the patients' quality of life. Our objective was to evaluate the benefits of exclusion treatment (radiosurgery, embolization and/or surgery) on posttherapeutic epilepsy in bAVM patients without intracranial hemorrhage prior to treatment. Our retrospective observational single-center study included all consecutive adult patients with an unruptured bAVM and epilepsy, treated at our institution from 1995 to 2019 and who were followed for at least 1 year. Data on angioarchitectural characteristics of bAVMs, on epilepsy and posttreatment modified Rankin Scale (mRS) were collected. The primary endpoint was a seizure-free status (defined as Engel class IA) after exclusion treatment versus conservative management. In this study one hundred and one consecutive adult patients with bAVMs, epilepsy and without bAVM rupture before any treatment were included; 21 (21%) in the conservative management group vs. 80 (79%) in the exclusion treatment group. After exclusion treatment, 55% of the patients from the group were Engel IA after treatment vs. 10% of the conservative management group (odds ratio [OR] 11.37, 95% confidence interval [CI] 2.48-107.24, p < 0.001). Our results suggest that exclusion treatment in unruptured bAVMs with epilepsy is associated with a higher seizure-free rate in comparison with conservative management. Data from randomized controlled studies are necessary to confirm these findings.

VizieR Online Data Catalog, Oct 1, 2019

Neuromodulation en Neurologie et en Psychiatrie, 2023

“Neuromodulation in Psychiatry and Neurology” is a first book covering most aspects of the rapidl... more “Neuromodulation in Psychiatry and Neurology” is a first book covering most aspects of the rapidly growing area of neuromodulation.

After some notions of neuroanatomy, neurophysiology and imaging, the authors provide a useful clinical presentation of the different methods of neuromodulation. Essential advice is provided to clinicians on how to use them, which requires a fundamental understanding of these techniques, a thorough evaluation of their effectiveness and safety.

Applications of neuromodulation in neurology (chronic pain, migraine, motion disorders, epilepsy, Alzheimer’s dementia, rehabilitation) and psychiatry (treatment-resistant depression, OCD, ADHD, addiction, schizophrenia) are discussed in specific chapters.

The world of neuromodulation is changing very rapidly. Moreover, the main idea that emanates from this book is the one that encourages us to practice in the near future a «interventional» psychiatry and neurology, modern and especially «personalized».

This book offers a snapshot of clinical neuromodulation in 2023 and was designed as a useful scientific support for professionals interested in understanding and modern treatments of brain disorders. This book is an indispensable guide for all neurologists, neurosurgeons, algologists, psychiatrists, rehabilitation doctors. For all these treatments, the future will depend in part on emerging scientific evidence about the neural base, nature and impact on neuroplasticity. It will not be the last word on neuromodulation, but it is a work to prepare for a future in continuous change.