Involvement of electrophysiological localization of the subthalamic nucleus in deep brain stimulation for Parkinson’s disease

We studied the involvement of the electrophysiological localization of the subthalamic nucleus (NST) using a multi-unit recording technique by means of semi-microelectrode in a set of thirty Parkinson’s patients who benefited from a bilateral stimulation of the NST and who were operated on under local or general anesthesia. The multi-unit recording technique by means of semi-microelectrodes appeared efficient,capable of improving the localization of the NST and leading to improvement in clinical results. We believe that the use of our technique will allow for time savings while providing good results, and that the choice of the angle of the trajectory will allow for improved localization of the NST and thus improved clinical results

Devenir paysagiste. Histoire de l’enseignement du paysage et du projet de paysage en France, en Europe et dans le monde (fin xixe-xxie siècle) : premiers jalons et perspectives – Introduction au numéro hors-série

International audienceLandscape architects are now recognised professionals. Among the latest arrivals in the field of space and living environment, they have progressively built a specific and diversified field of action and project, based on alternative ways of thinking and doing. Over the last few decades in particular, they have proved to be the bearers of a field action attentive to the ecological, cultural and aesthetic dimension of inhabited spaces and to the links forged over time between societies and their environment. The issues associated with this field of action have continued to multiply and grow in importance. Professional practices have followed and diversified, decompartmentalising the fields of knowledge and competence and integrating an experimental dimension. At the same time, training has evolved in ways that are still very poorly understood. In fact, the history of landscape teaching and landscape projects is a field of research that is just emerging.This special issue aims at proposing a first assessment in this field and at setting the milestones allowing a better understanding of the evolutions of a teaching which, in a little more than a century, has been deployed on all continents. It follows a symposium organised in Versailles on 16 and 17 June 2022 on the occasion of the Architecture and Landscape Biennale. On this occasion, about forty participants offered historical insights and testimonies informing the evolution of landscape architects' training since the end of the 19th century. A large number of them contribute to this issue, discussing the appearance of the first landscape training courses, characterising the trajectory of the actors who set them up and who supported them, emphasising the foundations on which their educational programmes and their teaching are based, in relation to various learning situations. The different contributions also look at the role played by professional organisations in the development of these courses, as well as the institutional frameworks in which the institutions that host them are located. Finally, they show how the historical, cultural, geopolitical, economic and social contexts, both national and international, have affected the pedagogical programmes of landscape training courses, as well as the importance of the circulation of modes of thought and action at national and international levels. One of the main objectives of this special issue is to highlight the importance of the inventory and classification of existing historical sources, as well as the collection and conservation of testimonies. It is also to show the interest of carrying out historical research on the teaching of landscape and landscape project in Europe and beyond, as well as to compare the training courses on an international scale.Les paysagistes, spécialistes du paysage et du projet de paysage, sont aujourd’hui des professionnels reconnus. Parmi les derniers venus dans le concert des métiers de l’espace et du cadre de vie, ils ont construit progressivement un champ d’action et de projet, spécifique et diversifié à la fois, fondé sur des manières alternatives de penser et de faire. Durant ces dernières décennies tout particulièrement, ils se sont avérés porteurs d’une action de terrain attentive à la dimension écologique, culturelle et esthétique des espaces habités et aux liens noués dans la durée entre les sociétés et leur environnement. Les enjeux associés à ce champ d’action n’ont cessé de se multiplier et de prendre de l’importance. Les pratiques professionnelles ont suivi, se sont diversifiées, décloisonnant les champs de savoir et de compétence et intégrant une dimension expérimentale. Parallèlement, les formations ont évolué selon des modalités qui restent encore très mal connues. De fait, l’histoire de l’enseignement du paysage et du projet de paysage est un champ de recherche tout juste émergent.Ce numéro hors-série ambitionne de proposer un premier bilan en la matière et de poser les jalons permettant de mieux cerner les évolutions d’un enseignement qui, en un peu plus d’un siècle, s’est déployé sur tous les continents. Il fait suite à un colloque organisé à Versailles les 16 et 17 juin 2022 à l’occasion de la Biennale de l’architecture et du paysage de l’Île de France. À cette occasion une quarantaine de participants ont proposé des éclairages historiques et des témoignages renseignant les évolutions des formations de paysagistes depuis la fin du XIXe siècle. Une grande partie d’entre eux contribuent à ce numéro, discutant de l’apparition des premières formations de paysagistes, caractérisant la trajectoire des acteurs qui les ont mises en place et qui les ont portées, mettant l’accent sur les fondements sur lesquels s’appuient leurs programmes pédagogiques et leurs enseignements, en lien avec des situations d’apprentissage variées. Les différentes contributions s’intéressent également au rôle joué par les organisations professionnelles dans le développement de ces formations, ainsi qu’aux cadres institutionnels dans lesquels s’insèrent les établissements qui les accueillent. Elles montrent enfin de quelle façon les contextes historiques, culturels, géopolitiques, économiques et sociaux, nationaux et internationaux, ont affecté les programmes pédagogiques des formations paysagistes, ainsi que toute l’importance des circulations, aux échelles nationales et internationales, des modes de pensée et d’action. L’un des objectifs principaux de cette numéro hors-série est de mettre en avant tout l’enjeu qui réside dans l’inventaire et le classement des sources historiques existantes, ainsi que le recueil et la conservation des témoignages. Il s’agit aussi de montrer tout l’intérêt d’effectuer des recherches historiques sur l’enseignement du paysage et du projet de paysage en Europe et au-delà, ainsi que de comparer les formations à l’échelle internationale

Descending volleys generated by efficacious epidural motor cortex stimulation in patients with chronic neuropathic pain

Epidural motor cortex stimulation (EMCS) is a therapeutic option for chronic, drug-resistant neuropathic pain, but its mechanisms of action remain poorly understood. In two patients with refractory hand pain successfully treated by EMCS, the presence of implanted epidural cervical electrodes for spinal cord stimulation permitted to study the descending volleys generated by EMCS in order to better appraise the neural circuits involved in EMCS effects. Direct and indirect (D- and I-waves) were produced depending on electrode polarity and montage and stimulus intensity. At low intensity, anodal monopolar EMCS generated D-waves, suggesting direct activation of corticospinal fibers, whereas cathodal EMCS generated I2-waves, suggesting transsynaptic activation of corticospinal tract. The bipolar electrode configuration used in chronic EMCS to produce maximal pain relief, generated mostly I3-waves. This result suggests that EMCS induces analgesia by activating top-down controls originating from intracortical horizontal fibers or interneurons but not by stimulating directly the pyramidal tract. The descending volleys elicited by bipolar EMCS are close to those elicited by transcranial magnetic stimulation using a coil with postero-anterior orientation. Different pathways are activated by EMCS according to stimulus intensity and electrode montage and polarity. Special attention should be paid to these parameters when programming EMCS for pain treatment

A reappraisal of the value of lateral spread response monitoring in the treatment of hemifacial spasm by microvascular decompression

International audiencePrimary hemifacial spasm (HFS) has specific electrophysiological features, like the existence of lateral spread responses (LSRs) to the stimulation of facial nerve branches. The curative treatment of HFS is based on surgical microvascular decompression (MVD), although the outcome of this procedure is not always satisfactory