Cognitive and cerebral correlates of language and thought disorders : study in bipolar disorder and hypomanic personality traits.

Notre travail de thèse porte sur les troubles du langage et de la pensée rencontrés chez des personnes souffrant de trouble bipolaire mais aussi, à un moindre degré, chez des personnes présentant des traits de personnalité hypomaniaque. Afin d’explorer les processus sémantiques qui sous-tendent ces troubles, nous avons réalisé plusieurs études à l’aide d’une tâche de résolution d’ambiguïté sémantique couplée à l’enregistrement de l’activité cérébrale (EEG et IRMf) afin de repérer des marqueurs nous aidant à la compréhension des mécanismes sous-tendant l’expression clinique ou sub-clinique de certains symptômes du trouble bipolaire.Nos travaux montrent des difficultés d’inhibition sémantique dans les deux populations qui se traduisent, sur le plan électrophysiologique, par une réduction de l’amplitude de la composante N400 en condition d’inhibition sémantique, corrélée au score de Vitalité Sociale (traits de personnalité hypomaniaque) en population générale et au score d’hypomanie chez les patients bipolaires. Des activations cérébrales sont également corrélées à la présence de traits de personnalité hypomaniaque au niveau du gyrus frontal supérieur et du lobule pariétal inférieur. Ces régions sont activées également chez les patients bipolaires comparativement au groupe contrôle, ainsi que d’autres régions fronto-temporales latéralisées à droite. Nos résultats vont dans le sens d’une modification du processus d’inhibition sémantique observable chez les patients bipolaires et dès la présence de traits de personnalité hypomaniaque. Nos travaux, associés à la littérature, nous suggèrent que les modulations de la composante N400 ou que les activations fronto-pariéto-temporales retrouvées pourraient être des marqueurs transnosographiques correspondant à la dimension clinique des troubles du langage et de la pensée dans le cadre du spectre bipolaire, mais également dans d’autres pathologies telles que les troubles du spectre de la schizophrénie.Our thesis explores the underlying mechanisms of thought and language disorders commonly observed in patients suffering from bipolar disorder, but also to a lesser degree, in people with hypomanic personality traits. To explore the underlying semantic processes, we conducted four studies with a semantic ambiguity resolution task coupled with event-related potentials recording and fMRI. Our aim was to identify biomarkers for a better comprehension of clinical or subclinical symptoms associated with bipolar disorder.Through our studies, we have shown difficulties to handle semantic inhibition in the two explored populations with, at an electrophysiological level, a reduced N400 amplitude during semantic inhibition process, correlated to Social Vitality score (hypomanic personality traits) in non-clinic population, and to hypomania score in bipolar patients. In the fMRI studies, activations of the superior frontal gyrus and of the inferior parietal lobule were correlated to hypomanic traits and were also found in bipolar patients when compared to the control group. Supplementary right fronto-temporal activations were observed in bipolar patients. Our results imply an impairment of the semantic inhibition process already present in people with bipolar disorders and people with hypomanic traits. These results combined with the existing literature suggest that N400 modulations and fronto-temporo-parietal activations found might be transnosographic biomarkers of thought and language disorders, in bipolar spectrum disorders but also in other disorders like schizophrenia spectrum disorders

Neural Correlates of Semantic Inhibition in Relation to Hypomanic Traits: An fMRI Study

ObjectivesLanguage modifications are a core feature of mania, but little is known about the semantic mechanisms behind these disturbances. The aim of the present study was thus to identify deficits in semantic inhibition and their respective neural activation patterns in a sample of individuals assessed for hypomanic personality traits.MethodsThirty-six young adults with no neurological or psychiatric diagnoses were assessed for hypomanic personality traits with the Hypomanic Personality Scale (HPS) and underwent an fMRI task of semantic ambiguity resolution.ResultsRegression analyses revealed a positive association between the HPS score and activity in the left superior frontal gyrus, left inferior parietal lobule, and anterior cingulate gyrus during semantic ambiguity resolution.ConclusionWe found a link between HPS scores and brain areas that are part of the cognitive control loop and semantic memory network during language processing in a nonclinical sample of individuals. The hyperactivation of these regions may reflect a compensatory neural response in a population with greater vulnerability to BD

Functional outcome and social cognition in bipolar disorder: Is there a connection?

International audienc

Verbal fluency in bipolar disorders: A systematic review and meta-analysis

International audienc

Les interventions psychosociales destinées aux personnes composant avec un premier épisode psychotique : une revue narrative et critique

Objectifs Les guides de soins pour le traitement des troubles psychotiques recommandent plusieurs interventions basées sur les données probantes. Celles-ci ciblent différents domaines, incluant notamment l’autogestion des symptômes cliniques, les relations sociales, familiales et amoureuses ainsi que le fonctionnement cognitif. Toutefois, ces guides généraux ne soulignent pas les données probantes spécifiques aux personnes composant avec un premier épisode psychotique (PEP). L’objectif de cette revue narrative et critique est de présenter les données soutenant les interventions validées auprès des personnes composant avec un PEP, en considérant particulièrement les interventions validées en langue française.Méthode Suivant les guides cliniques internationaux et nationaux, une revue narrative et critique des écrits scientifiques réalisée chez les personnes composant avec un PEP et portant sur 2 interventions recommandées pour les troubles psychotiques, la thérapie cognitive-comportementale pour la psychose (TCCp) et la remédiation cognitive (RC), a été effectuée. Par ailleurs, l’engagement via des modalités d’administration adaptées au profil des participants étant central dans ce type d’intervention, nous avons exploré 2 modalités prometteuses dans le PEP, le format groupal et l’utilisation des technologies numériques.Résultats L’utilisation de la TCCp auprès des personnes composant avec un PEP est appuyée par plusieurs études, notamment une québécoise. Les bénéfices apportés par la RC semblent moindres pour les PEPs, comparativement aux stades ultérieurs des troubles psychotiques (p. ex. schizophrénie). Néanmoins, ces études présentent des limites et les personnes composant avec un PEP semblent pouvoir bénéficier de certains acquis spécifiques. Concernant les interventions groupales ainsi que les technologies numériques, la plupart des interventions actuellement disponibles nécessitent d’être validées de façon plus systématique, et répliquées par d’autres groupes de chercheurs afin d’obtenir un soutien empirique plus probant.Conclusion Cette revue narrative et critique souligne la validité empirique de la TCCp et de la RC chez les personnes composant avec un PEP. La modalité groupale, dispensée dans plusieurs interventions dédiées à cette population, présage des résultats encourageants, alors que les interventions utilisant les technologiques numériques, ayant montré leur acceptabilité et faisabilité, restent à valider en termes d’efficacité. En plus de contribuer au rétablissement symptomatique, les interventions psychosociales soutiennent le rétablissement fonctionnel et personnel des personnes composant avec un PEP. Malgré tout, des limites sont notées sur le plan de l’accessibilité à ces interventions. Alors que différentes interventions ne sont actuellement pas disponibles en français, certaines interventions probantes et disponibles ne sont pas appliquées de façon systématisée. Ces limites suggèrent l’importance de développer une science de la mise en oeuvre des interventions afin de favoriser le transfert des données issues de la recherche vers les milieux cliniques ainsi qu’une organisation des soins favorisant l’accès à des professionnels de la santé dédiés à ces approches.Objective Treatment guidelines for the treatment of psychotic disorders suggest evidence-based interventions. These interventions target several domains such as self-management of clinical symptoms, social, familial and love relationships as well as cognitive functioning. However, these general guidelines do not provide specific evidence for people with a first-episode psychosis (FEP). The objective of this narrative and critical review is to present evidence supporting the interventions suggested by the treatment guidelines that were validated in people with a FEP, particularly those interventions validated in French.Method Based on the international and national treatment guidelines, a narrative and critical review of the scientific literature conducted in people with FEP and focusing on two recommended interventions for psychotic disorders, cognitive-behavioral therapy for psychosis (CBTp) and cognitive remediation (CR), was performed. Administration modalities adapted to the participant’s profile are important to consider in this type of intervention. We thus explored two promising modalities in people with FEP, the group format and the use of digital technologies.Results Several studies support the use of CBTp in people with FEP, including one Quebec study. The effects of CR are less promising in people with FEP compared to those with a chronic evolution of their psychotic illness (e.g. schizophrenia). However, some limitations of the included studies are identified and the specific improvements in people with FEP are presented. Regarding the group format and the digital technologies, most interventions currently available need to be systematically validated, and the results need to be replicated by other groups of researchers to obtain evidence-based results.Conclusion This narrative and critical review of the literature highlights the evidence available for CBTp and CR in people with FEP. The group format used in several interventions with this population reveals encouraging results, while interventions using digital technologies have shown their acceptability and feasibility, but the efficacy remains to be assessed. In addition to contributing to symptomatic recovery, psychosocial interventions also support functional and personal recovery in people with FEP. Nonetheless, some limitations are observed regarding the accessibility of such interventions. While some interventions are currently not available in French, other available evidence-based interventions are not currently systematically used in clinical settings. These limitations call for the importance of developing an implementation science for these interventions to improve the transfer of results from research to clinical settings as well as a service organization model that promote or facilitate access to such interventions

Self-defining memories in recently detoxified alcohol-dependent patients

Patients with alcohol dependence have been shown to be impaired in recalling specific autobiographical events, yet little is known on how changes in the memory of these events may impact their self-representation. In this study, we examined Self-Defining Memories (SDMs), a specific type of autobiographical memory that plays a key role in the construction of personal identity, in 25 patients with alcohol dependence, abstinent from alcohol from 10 days to 6 months, compared to 28 control subjects. We observed that SDMs in patients were significantly less specific and included more reference to alcohol than those of controls. Patients also reported more SDMs with negative emotional valence and higher emotional intensity. These results suggest that recently abstinent alcohol-dependent patients may be prone to define themselves by negative events referring to alcohol consumption, which may contribute to an unfavorable perception of their self and subsequently of their ability to remain abstinent. These findings should be taken into account to optimize psychological approaches in the treatment of alcohol-dependence. © 2016 Elsevier Ireland Lt

Contributing roles of depression, anxiety, and impulsivity dimensions in eating behaviors styles in surgery candidates

International audienceAbstract Background Even if bariatric surgery is considered the most effective therapeutic approach, it is not equally successful among individuals suffering from severe obesity and candidates for this weight loss surgery. Among the factors that influence postsurgical outcomes, eating behaviors styles are known to play a key role in relapses. The aim of our study was to assess eating behaviors styles and several modulating psychopathological factors in patients suffering from severe obesity. Methods Patients seeking bariatric surgery (N = 127) completed a set of standardized tools assessing eating behaviors (Dutch Eating Behavior Questionnaire), comorbid psychiatric conditions (Mini International Neuropsychiatric Interview), depression, and anxiety scores (Beck Depression Inventory, State-Trait Anxiety Inventory), and impulsivity scores (UPPS-P Impulsive Behavior Scale). Results We detected significant correlations between DEBQ Emotional Eating (EmoE) and depression, state and trait anxiety, and all dimensions of impulsivity. Significant correlations were also present between DEBQ External Eating (ExtE) and depression, state and trait anxiety and UPPS-P positive urgency, lack of perseverance and sensation seeking. Regression analyses identified sex (female), trait anxiety, and lack of perseverance as explanatory factors for EmoE, and depression severity score and positive urgency for ExtE. Conclusions EmoE might be a means of dealing with negative emotions and/or intrusive thoughts, while ExtE might result from a mechanism associated with depression. These results should help to improve patients’ outcomes by defining specific therapeutic targets in psychological interventions. Plain English summary After bariatric surgery, some patients regain weight. This is likely due to various factors, including a return of maladaptive eating styles, such as emotional eating (which occurs as a response to negative emotions, like depression, anxiety, anger, sadness, and discouragement), external eating (which refers to the tendency to eat in response to positive external cues, regardless of internal signals of hunger and satiety), and restraint eating (implying to make efforts to develop and maintain strategies to control calories intake, associated with weight loss after lifestyle intervention). Our goal in this research project was to explore associated factors (particularly depression, anxiety, and impulsivity) to these eating styles in patients suffering from obesity prior to bariatric surgery. Individuals seeking bariatric surgery were asked questions about their eating styles and their levels of depression, anxiety, and impulsivity using standardized questionnaires. We found that emotional eating might be a means of dealing with negative emotions and/or intrusive thoughts (e.g. about food or body dissatisfaction), while external eating might result from a mechanism associated with depression. We detected no association between restraint eating and any of the dimensions of impulsivity, nor depression and anxiety. Therapies aimed at improving patients’ abilities to regulate negative affects seem promising among subjects suffering from obesity and those seeking bariatric surgery. If well learned, these therapies might also help them to maintain weight loss after surgery by limiting maladaptive eating styles

Neural Correlates of Semantic Inhibition in Relation to Hypomanic Traits: An fMRI Study

International audienc

Disentangling the role of social cognition processes at early steps of alcohol abuse: The influence of affective theory of mind.

Excessive alcohol use among adolescents has become a pressing challenge among Western societies. Accordingly, one of the current research objectives is to identify the processes associated with this harmful habit. Although numerous studies have underlined the role of executive and motivational processes, few have explored emotional and interpersonal abilities at early steps of alcohol abuse. The present study evaluated the role of two social cognition processes, namely theory of mind (ability to infer others' mental states at cognitive and affective levels) and empathy (ability to understand others' feelings at cognitive and affective levels) in adolescents' alcohol consumption. Two hundred and two adolescents (13-20 years old) performed a behavioral task evaluating theory of mind and filled in questionnaires measuring personal data, empathy, alcohol consumption (alcohol abuse and specific binge drinking), as well as depressive and anxiety symptoms. Findings showed that cognitive and affective empathy were negatively associated with alcohol consumption in youth whereas affective theory of mind was related to specific binge drinking. Importantly, affective theory of mind predicted binge drinking in adolescents, even after controlling for age, gender, and education level. These results emphasized the role of social cognition in early alcohol abuse and showed that, beyond inhibition, interpersonal abilities might precipitate excessive drinking in youth

Transdiagnostic Cognitive Biases in Psychiatric Disorders

Systematic review and meta-analysis on the presence and specificity of cognitive biases in transdiagnostic psychiatric disorder