Subthalamic Nucleus Stimulation Affects Theory of Mind Network: A PET Study in Parkinson's Disease

Background: There appears to be an overlap between the limbic system, which is modulated by subthalamic nucleus (STN) deep brain stimulation (DBS) in Parkinson’s disease (PD), and the brain network that mediates theory of mind (ToM). Accordingly, the aim of the present study was to investigate the effects of STN DBS on ToM of PD patients and to correlate ToM modifications with changes in glucose metabolism. Methodology/Principal Findings: To this end, we conducted 18 FDG-PET scans in 13 PD patients in pre- and post-STN DBS conditions and correlated changes in their glucose metabolism with modified performances on the Eyes test, a visual ToM task requiring them to describe thoughts or feelings conveyed by photographs of the eye region. Postoperative PD performances on this emotion recognition task were significantly worse than either preoperative PD performances or those of healthy controls (HC), whereas there was no significant difference between preoperative PD and HC. Conversely, PD patients in the postoperative condition performed within the normal range on the gender attribution task included in the Eyes test. As far as the metabolic results are concerned, there were correlations between decreased cerebral glucos

Use of very-high-dose olanzapine in treatment-resistant schizophrenia

International audienc

Neurofeedback en psychiatrie : une technique du présent ? [Neurofeedback: one of today's techniques in psychiatry?]

International audienceObjectivesNeurofeedback is a technique that aims to teach a subject to regulate a brain parameter measured by a technical interface to modulate his/her related brain and cognitive activities. However, the use of neurofeedback as a therapeutic tool for psychiatric disorders remains controversial. The aim of this review is to summarize and to comment the level of evidence of electroencephalogram (EEG) neurofeedback and real-time functional magnetic resonance imaging (fMRI) neurofeedback for therapeutic application in psychiatry.MethodLiterature on neurofeedback and mental disorders but also on Brain Computer Interfaces (BCI) used in the field of neurocognitive science has been considered by the group of expert of the NExT (Neurofeedback Evaluation & Training) section of the French Association of Biological Psychiatry and Neuropsychopharmacology (AFPBN).ResultsResults show a potential efficacy of EEG-neurofeedback in the treatment of attentional-deficit/hyperactivity disorder (ADHD) in children, even if this is still debated. For other mental disorders, there is too limited research to warrant the use of EEG-neurofeedback in clinical practice. Regarding fMRI-neurofeedback, the level of evidence remains too weak, for now, to justify clinical use. The literature review highlights various unclear points, such as indications (psychiatric disorders, pathophysiologic rationale), protocols (brain signals targeted, learning characteristics), and techniques (EEG, fMRI, signal processing). ConclusionThe field of neurofeedback involves psychiatrists, neurophysiologists and researchers in the field of brain-computer-interfaces. Future studies should determine the criteria for optimizing neurofeedback sessions. A better understanding of the learning processes underpinning neurofeedback could be a key element to develop the use of this technique in clinical practice

Accidents ischémiques et dépression

National audienceDepression after an ischemic cerebrovascular accident is a frequent phenomenon that occurs in 30 to 50% of the patients. Depression negatively impacts stroke outcome with increased morbidity, poorer functional recovery and may aggravate mortality. Post-stroke depression diagnosis is made difficult by the motor and cognitive consequences of the stroke, but also by the overlap between depressive symptoms and some of the stroke symptoms. Several mechanisms are involved in its complex pathophysiology, including physiological reaction to the sudden handicap, but also psychological, biological (with monoamine hypothesis), inflammatory and anatomic dysfunctions. The treatment of choice must combine antidepressants (serotonin reuptake inhibitors) associated to cognitive behavioral psychotherapy. Cerebral neuromodulation techniques may also be used in this indication. © 2022 l'Académie nationale de médecineLa dépression après un accident vasculaire cérébral ischémique (AVCi) est un phénomène fréquent dont la prévalence est évaluée à 30 à 50% des cas. Elle a un impact direct sur les capacités de récupération fonctionnelles et de réhabilitation des patients souffrant d'un AVCi et peut aggraver la mortalité. Le diagnostic de cette dépression est rendu difficile par les conséquences motrices et cognitives de l'AVCi, mais aussi par la superposition des symptômes de l'AVCi et de la dépression. Sa physiopathologie est complexe, comprenant les éléments de réaction physiologique au handicap brutal à des mécanismes monoaminergiques, inflammatoires et anatomiques. Sa prise en charge doit associer des éléments de psychothérapie cognitivo-comportementale et la prescription d'antidépresseurs. © 2022 l'Académie nationale de médecin

La dépression chronique et résistante (Etude en IRM par Arterial Spin Labeling)

RENNES1-BU Santé (352382103) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

L'impulsivité (quelles conséquences sur l'adhésion aux soins?)

L'impulsivité est une dimension transnosographique fréquemment retrouvée en psychiatrie et ses conséquences sur les soins sont majeures. Après avoir exposé les corrélats neurobiologiques de l'impulsivité grâce à une revue de littérature, il a été réalisé une étude de cohorte, prospective, observationnelle et analytique sur les conséquences de l'impulsivité sur l'adhésion aux soins dans trois services d'hospitalisation spécialisés en addictologie. La population étudiée comprenait 85 patients âgés de 18 à 70 ans, hospitalisés à l'Etablissement Public de SAnté Mentale du MOrbihan pour une ou plusieurs addictions. L'impulsivité a été évaluée à l'aide de la BIS-11 en début de prise en charge pour tous les patients inclus. La mesure de l'adhésion thérapeutique réalisée à l'issue de la cure a nécessité la création d'une échelle d'évaluation composée de l'évaluation numérique simple pour les équipes soignantes, les psychiatres et le rapport entre durée de soins réalisée et prévue. Le résultat principal de l'étude révèle une corrélation négative significative entre la dimension motrice de l'impulsivité et l'adhésion aux soins (r=-0,37 et p=0,001). Les autres dimensions de l'impulsivité ont également été évaluées, sans résultat significatif, de même que les différentes modalités d'hospitalisation, qui n'ont pas prouvé avoir de conséquences sur l'adhésion thérapeutique. Ces résultats originaux permettent de se poser la question de l'adaptation des soins addictologiques aux patients impulsifs sur le plan moteur, vers des cures plus courtes et plus efficaces sur le plan de la santé publiqueImpulsivity is a transnosographic dimension to wich psychiatrists are frequently confronted and that has major consequences on medical. After a review of the litterature that exposes the neurobiological correlates of impulsivity, a prospective study has been made to find what are the consequences of impulsivity on compliance in three addiction care hospitalisation units. The studied population was composed of 85 patients aged from 18 to 70 years, hospitalized for one or more addiction disorder in the EPSM (public mental hospital) of the Morbihan. Impulsivity was mesured with the BIS-11 in the begining of the rehab program for all patients. A scale, used in the end of the hospitalisation, was made to mesure the compliance and was composed of the nurses evalution with a simple numeric scale, a psychiatrists numeric scale and the quoefficient between made and planed duration of hospitalisation. The main result found a negative and statistical significative correlation between the motor dimension of impulsivity and compliance (r = -0.37 and p = 0.001). Other dimensions of impulsivity showed no significative result, as did the different modalities of hospitalisation on compliance. These original results shows us the need of adapting rehab programs to impulsive patients. These adaptations could make the programs shorters and more efficient for the public health.RENNES1-BU Santé (352382103) / SudocSudocFranceF

Conséquences psychiatriques de la stimulation cérébrale profonde dans la maladie de Parkinson (comparaison des effets à long terme en fonction de la cible)

RENNES1-BU Santé (352382103) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Trouble déficit de l'attention/hyperactivité de l'adulte (place nosographique?)

RENNES1-BU Santé (352382103) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Corrélats métaboliques de l'apathie dans la maladie de Parkinson

RENNES1-BU Santé (352382103) / SudocSudocFranceF