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<dc:title xml:lang="fr">Étude des bases cérébrales de la maladie à corps de Lewy par IRM multimodale</dc:title>
<dcterms:alternative xml:lang="en">Cerebral bases of dementia with Lewy bodies : a multimodal MRI study</dcterms:alternative>
<dc:subject xml:lang="fr">Maladie à corps de Lewy</dc:subject>
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<dc:subject xml:lang="fr">Connectivité fonctionnelle</dc:subject>
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<dc:subject xml:lang="en">Dementia with Lewy bodies</dc:subject>
<dc:subject xml:lang="en">Fluctuations</dc:subject>
<dc:subject xml:lang="en">Morphometry</dc:subject>
<dc:subject xml:lang="en">Functional connectivity</dc:subject>
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<tef:elementdEntree autoriteExterne="07707405X" autoriteSource="Sudoc">Démence à corps de Lewy</tef:elementdEntree>
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<tef:elementdEntree autoriteExterne="031306977" autoriteSource="Sudoc">Neurobiologie moléculaire</tef:elementdEntree>
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<dcterms:abstract xml:lang="fr">Deuxième pathologie neurodégénérative cognitive la plus fréquente après la maladie d’Alzheimer (MA), lamaladie à corps de Lewy (MCL) demeure pourtant mal connue et constitue encore aujourd’hui un réelchallenge, à la fois sur les plans clinique et scientifique et en matière de santé publique. L’imagerie parrésonance magnétique (IRM), technique non invasive et multimodale, constitue une approche particulièrementprometteuse pour enrichir la compréhension des mécanismes cérébraux sous-jacents à cette maladie. Dans lecadre de ce travail de thèse, nous nous sommes intéressés aux modifications cérébrales fonctionnelles,structurelles et microstructurelles survenant chez les patients MCL aux stades précoces, comparés à despatients MA et des sujets sains âgés, et à leur liens avec certains symptômes-clés de la MCL tels que lesfluctuations cognitives. Les études réalisées comprenaient des analyses de connectivité fonctionnelle au coursd’un paradigme visuoperceptif et à l’état de repos, des analyses morphométriques, ainsi que des analysesquantitatives multiparamétriques. Les résultats obtenus mettent en évidence chez les patients MCL aux stadesprécoces des perturbations de la connectivité fonctionnelle au repos entre le réseau de saillance, le réseau pardéfaut et les réseaux attentionnels, probablement secondaires à des dysconnexions précoces à l’intérieur duréseau de saillance. Ces changements de connectivité, associés à des modifications subtiles du volume dematière grise au sein du système cholinergique, pourraient contribuer à l’émergence des fluctuationscaractérisant la MCL. Enfin, les patients MCL présentent des anomalies de diffusion au sein de la substancegrise dans les régions frontales et le cortex cingulaire antérieur, et de la substance blanche dans les régionsoccipitales et pariétales, susceptibles de favoriser les anomalies de connectivité fonctionnelle.</dcterms:abstract>
<dcterms:abstract xml:lang="en">Despite being the second most common cognitive neurodegenerative disorder after Alzheimer’s disease (AD),dementia with Lewy bodies (DLB) is still poorly understood and represents a major scientific, clinical andpublic health problem. Magnetic resonance imaging (MRI), as a non-invasive and multimodal technique,constitutes a promising approach to improve the understanding of the underlying cerebral bases of thisdisease. In this thesis project we addressed the functional, structural and microstructural cerebral changes inpatients in the early stages of DLB compared with AD patients and healthy elderly subjects. We alsoinvestigated the links between these changes and some key-symptoms of DLB such as cognitive fluctuations.For that purpose, we combined functional connectivity analyses during a visual-perceptual paradigm andduring resting-state, morphometric analyses and quantitative multiparametric analyses. DLB patients showedsignificant functional connectivity disturbances between the salience network, the default mode network andattentional networks, that could arise from early disconnections within the salience network. Theseconnectivity changes, along with subtle grey matter volume reductions in regions of the cholinergic system,could contribute to the fluctuations characterizing DLB. In addition, we found gray matter diffusion changesin frontal regions and in the anterior cingulate cortex, associated with white matter diffusion changes inparietal and occipital regions in DLB patients, that could contribute to the functional connectivityabnormalities</dcterms:abstract>
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