A Fragile Balance: Perturbation of GABA Mediated Circuit in Prefrontal Cortex Generates High Intraindividual Performance Variability

High intraindividual performance variability is one of the most robust findings to emerge in cognitive-experimental research of attention deficit hyperactivity disorder (ADHD). Evidences from studies incorporating structural or functional human brain mapping methods indicate that this increased intraindividual variability is not simply a sequel of general brain dysfunction, but is likely related to the functioning of neural circuits that engage the prefrontal cortex, particularly the dorsolateral areas (dlPFC). In order to examine further the anatomical and pharmacological substrate responsible for this high intraindividual variability disorder, we injected GABAA antagonist (bicuculline) or GABAA agonist (muscimol) in the dlPFC of monkeys performing a reflexive oculomotor task. Here we show that, whereas GABAA agonist injection induced no or minimal impairments, injection of GABAA antagonist dramatically increased the intraindividual variability of saccade response time and of saccade spatial accuracy (amplitude and direction). Overall, this study demonstrates that the balance between excitatory/inhibitory activities in the dlPFC is fragile but crucial, since local micro-injection of GABAA antagonist can induce marked behavioural effects. It also reveals that higher cognitive areas such as the dlPFC are markedly capable to influence the productions and metrics of reflexive movements. Altogether, this study provides promising perspectives for the development of new therapeutic strategies for the treatment of diseases in which high intravariability disorders are a prominent feature

COVID-19 symptoms at hospital admission vary with age and sex: results from the ISARIC prospective multinational observational study

Background: The ISARIC prospective multinational observational study is the largest cohort of hospitalized patients with COVID-19. We present relationships of age, sex, and nationality to presenting symptoms. Methods: International, prospective observational study of 60 109 hospitalized symptomatic patients with laboratory-confirmed COVID-19 recruited from 43 countries between 30 January and 3 August 2020. Logistic regression was performed to evaluate relationships of age and sex to published COVID-19 case definitions and the most commonly reported symptoms. Results: ‘Typical’ symptoms of fever (69%), cough (68%) and shortness of breath (66%) were the most commonly reported. 92% of patients experienced at least one of these. Prevalence of typical symptoms was greatest in 30- to 60-year-olds (respectively 80, 79, 69%; at least one 95%). They were reported less frequently in children (≤ 18 years: 69, 48, 23; 85%), older adults (≥ 70 years: 61, 62, 65; 90%), and women (66, 66, 64; 90%; vs. men 71, 70, 67; 93%, each P < 0.001). The most common atypical presentations under 60 years of age were nausea and vomiting and abdominal pain, and over 60 years was confusion. Regression models showed significant differences in symptoms with sex, age and country. Interpretation: This international collaboration has allowed us to report reliable symptom data from the largest cohort of patients admitted to hospital with COVID-19. Adults over 60 and children admitted to hospital with COVID-19 are less likely to present with typical symptoms. Nausea and vomiting are common atypical presentations under 30 years. Confusion is a frequent atypical presentation of COVID-19 in adults over 60 years. Women are less likely to experience typical symptoms than men

Pharmacologie de la distractibilité (étude chez l'homme et le singe)

PARIS-BIUP (751062107) / SudocSudocFranceF

La distractibilité (bases neurales, pharmacologie et modèles expérimentaux)

La distractibilité est un syndrome qui se caractérise par une réactivité exagérée d un individu vis-à-vis de son environnement. Il a été démontré que des atteintes limitées au cortex préfrontal dorsolatéral (CPFDL) sont responsables d un tel syndrome chez l homme. Ce trouble peut être quantifié par un test spécifique et sensible appelé test des antisaccades . Ce syndrome se rencontre dans de nombreuses pathologies neurodégénératives telles que la Paralysie supranucléaire progressive (PSP) ou encore psychiatriques telles que la schizophrénie. L objectif de cette recherche est de tenter de mieux comprendre ce syndrome de distractibilité à la fois sur le plan anatomique et pharmacologique. Le projet anatomique débute par une étude chez l homme de lésions au niveau sous cortical pour déterminer l implication réelle du sous cortex dans ce syndrome. Afin d apporter des données indiscutables sur le rôle du CPFDL dans la distractibilité, nous avons réalisé une étude chez le primate de microinjections intracérébrales de muscimol au niveau de cette aire cérébrale. L approche pharmacologique a consisté à réaliser un modèle animal de distractibilité en reproduisant chez le primate ce syndrome par administration de kétamine à dose subanesthésique. Celle-ci est connue pour induire des symptômes shizophréniques like avec des troubles liés à un dysfonctionnement du cortex préfrontal. La seconde étude a pour but d évaluer l effet d un inhibiteur de l acétylcholine estérase sur le syndrome de distractibilité chez des patients atteints de PSP. Cette recherche, en particulier les études chez le primate devraient permettre à terme de développer une thérapeutique pour enrayer ce trouble.PARIS-BIUSJ-Thèses (751052125) / SudocPARIS-BIUSJ-Physique recherche (751052113) / SudocSudocFranceF

Neuromimetic model of saccades for localizing deficits in an atypical eye-movement pathology.

International audienceBACKGROUND: When patients with ocular motor deficits come to the clinic, in numerous situations it is hard to relate their behavior to one or several deficient neural structures. We sought to demonstrate that neuromimetic models of the ocular motor brainstem could be used to test assumptions of the neural deficits linked to a patient's behavior. METHODS: Eye movements of a patient with unexplained neurological pathology were recorded. We analyzed the patient's behavior in terms of a neuromimetic saccadic model of the ocular motor brainstem to formulate a pathophysiological hypothesis. RESULTS: Our patient exhibited unusual ocular motor disorders including increased saccadic peak velocities (up to ~1000 deg/s), dynamic saccadic overshoot, left-right asymmetrical post-saccadic drift and saccadic oscillations. We show that our model accurately reproduced the observed disorders allowing us to hypothesize that those disorders originated from a deficit in the cerebellum. CONCLUSION: Our study suggests that neuromimetic models could be a good complement to traditional clinical tools. Our behavioral analyses combined with the model simulations localized four different features of abnormal eye movements to cerebellar dysfunction. Importantly, this assumption is consistent with clinical symptoms