Guillain‐Barré syndrome in France: a nationwide epidemiological analysis based on hospital discharge data (2008–2013)

Guillain‐Barré syndrome (GBS) is potentially life threatening and typically occurs after an infection. No detailed information is available concerning the epidemiological characteristics of GBS in France. We estimated age‐ and sex‐specific incidence rates (IRs) based on a French nationwide hospital discharge database. All patients hospitalized for GBS between 2008 and 2013 were identified by International Classification of Diseases‐10 code G61.0 as principal diagnosis. Patients previously hospitalized for GBS in 2006 and 2007 were excluded. Sensitivity analyses were performed by considering alternative case definitions, based on more restrictive sets of codes. A total of 9,391 patients were identified, leading to an overall crude IR of 2.42 per 100,000 person‐years (world standardized IR = 2.00). IRs increased with age, reaching a peak in the 70–79‐year age group. IR was 46% higher in men than in women, and 44% higher in winter than in summer. In children, the highest IR was observed at the age of 2 years. These patterns were not modified by the use of alternative case definitions. This French nationwide study showed similar GBS epidemiological patterns in adults to those reported in other countries. We also report a childhood incidence peak around the age of 2 years, as previously observed in Latin American and Chinese populations.     

Risk factors for incident mild cognitive impairment – results from the German Study on Ageing,Cognition and Dementia in Primary Care Patients (AgeCoDe)

Luck T, Riedel‐Heller SG, Luppa M, Wiese B, Wollny A, Wagner M, Bickel H, Weyerer S, Pentzek M, Haller F, Moesch E, Werle J, Eisele M, Maier W, van den Bussche H, Kaduszkiewicz H for the AgeCoDe Study Group. Risk factors for incident mild cognitive impairment – results from the German Study on Ageing, Cognition and Dementia in Primary Care Patients (AgeCoDe). Objectives: To provide age‐ and gender‐specific incidence rates of MCI among elderly general practitioner (GP) patients (75+ years) and to identify risk factors for incident MCI. Method: Data were derived from the longitudinal German Study on Ageing, Cognition and Dementia in Primary Care Patients (AgeCoDe). Incidence was calculated according to the ‘person‐years‐at‐risk’ method. Risk factors were analysed using multivariate logistic regression models. Results: During the 3‐year follow‐up period, 350 (15.0%) of the 2331 patients whose data were included in the calculation of incidence developed MCI [person‐years (PY) = 6198.20]. The overall incidence of MCI was 56.5 (95% confidence interval = 50.7–62.7) per 1000 PY. Older age, vascular diseases, the apoE ε4 allele and subjective memory complaints were identified as significant risk factors for future MCI. Conclusion: Mild cognitive impairment is frequent in older GP patients. Subjective memory complaints predict incident MCI. Especially vascular risk factors provide the opportunity of preventive approaches.     

One‐year survival of demented stroke patients: data from the Dijon Stroke Registry,France (1985–2008)

Background and purpose: Dementia is a frequent condition after stroke that may affect the prognosis of patients. Our aim was to determine whether post‐stroke dementia was a predictor of 1‐year case‐fatality and to evaluate factors that could influence survival in demented stroke patients. Methods: From 1985 to 2008, all first‐ever strokes were recorded in the population‐based stroke registry of Dijon, France (150 000 inhabitants). Dementia was diagnosed during the first month following stroke, according to DSM‐III and DSM‐IV criteria. Survival was evaluated at 1 year and multivariate analyses were performed using Cox proportional hazards to identify independent predictive factors. Results: We recorded 3948 first‐ever strokes. Among these stroke patients, 3201 (81%) were testable, and of these, 653 (20.4%) had post‐stroke dementia (337 women and 316 men). Demented patients had lower 1‐year survival than patients without dementia (82.9% vs. 86.9%, P = 0.013). However, in multivariate analysis, dementia did not appear as an independent predictor of 1‐year death. In demented stroke patients, age >80 years old, severe handicap at discharge, recurrent stroke within the first year and subarachnoid haemorrhage were associated with a higher risk of 1‐year death, and the risk was lower in the study period 2003–2008. Conclusions: Dementia after stroke is not independently associated with an increased risk of death at 1 year. In recent years, 1‐year case‐fatality decreased in demented as well as in and non‐demented patients suggesting that improvements in the management of stroke also benefited the most fragile patients.     

Laminar distribution of the pathological changes in sporadic frontotemporal lobar degeneration with transactive response (TAR) DNA‐binding protein of 43 kDa (TDP‐43) proteinopathy: a quantitative study using polynomial curve fitting

R. A. Armstrong, R. L. Hamilton, I. R. A. Mackenzie, J. Hedreen and N. J. Cairns (2013) Neuropathology and Applied Neurobiology 39, 335–347 Laminar distribution of the pathological changes in sporadic frontotemporal lobar degeneration with transactive response (TAR) DNA‐binding protein of 43 kDa (TDP‐43) proteinopathy: a quantitative study using polynomial curve fitting Aims: Previous data suggest heterogeneity in laminar distribution of the pathology in the molecular disorder frontotemporal lobar degeneration (FTLD) with transactive response (TAR) DNA‐binding protein of 43 kDa (TDP‐43) proteinopathy (FTLD‐TDP). To study this heterogeneity, we quantified the changes in density across the cortical laminae of neuronal cytoplasmic inclusions, glial inclusions, neuronal intranuclear inclusions, dystrophic neurites, surviving neurones, abnormally enlarged neurones, and vacuoles in regions of the frontal and temporal lobe. Methods: Changes in density of histological features across cortical gyri were studied in 10 sporadic cases of FTLD‐TDP using quantitative methods and polynomial curve fitting. Results: Our data suggest that laminar neuropathology in sporadic FTLD‐TDP is highly variable. Most commonly, neuronal cytoplasmic inclusions, dystrophic neurites and vacuolation were abundant in the upper laminae and glial inclusions, neuronal intranuclear inclusions, abnormally enlarged neurones, and glial cell nuclei in the lower laminae. TDP‐43‐immunoreactive inclusions affected more of the cortical profile in longer duration cases; their distribution varied with disease subtype, but was unrelated to Braak tangle score. Different TDP‐43‐immunoreactive inclusions were not spatially correlated. Conclusions: Laminar distribution of pathological features in 10 sporadic cases of FTLD‐TDP is heterogeneous and may be accounted for, in part, by disease subtype and disease duration. In addition, the feedforward and feedback cortico‐cortical connections may be compromised in FTLD‐TDP.