140 research outputs found
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 Parkinsonâs 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 aprÚs un accident vasculaire cérébral ischémique (AVCi) est un phénomÚne 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 symptÎmes 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'impulsivitĂ© est une dimension transnosographique frĂ©quemment retrouvĂ©e en psychiatrie et ses consĂ©quences sur les soins sont majeures. AprĂšs avoir exposĂ© les corrĂ©lats neurobiologiques de l'impulsivitĂ© grĂące Ă une revue de littĂ©rature, il a Ă©tĂ© rĂ©alisĂ© une Ă©tude de cohorte, prospective, observationnelle et analytique sur les consĂ©quences de l'impulsivitĂ© sur l'adhĂ©sion aux soins dans trois services d'hospitalisation spĂ©cialisĂ©s en addictologie. La population Ă©tudiĂ©e comprenait 85 patients ĂągĂ©s de 18 Ă 70 ans, hospitalisĂ©s Ă l'Etablissement Public de SAntĂ© Mentale du MOrbihan pour une ou plusieurs addictions. L'impulsivitĂ© a Ă©tĂ© Ă©valuĂ©e Ă l'aide de la BIS-11 en dĂ©but de prise en charge pour tous les patients inclus. La mesure de l'adhĂ©sion thĂ©rapeutique rĂ©alisĂ©e Ă l'issue de la cure a nĂ©cessitĂ© la crĂ©ation d'une Ă©chelle d'Ă©valuation composĂ©e de l'Ă©valuation numĂ©rique simple pour les Ă©quipes soignantes, les psychiatres et le rapport entre durĂ©e de soins rĂ©alisĂ©e et prĂ©vue. Le rĂ©sultat principal de l'Ă©tude rĂ©vĂšle une corrĂ©lation nĂ©gative significative entre la dimension motrice de l'impulsivitĂ© et l'adhĂ©sion aux soins (r=-0,37 et p=0,001). Les autres dimensions de l'impulsivitĂ© ont Ă©galement Ă©tĂ© Ă©valuĂ©es, sans rĂ©sultat significatif, de mĂȘme que les diffĂ©rentes modalitĂ©s d'hospitalisation, qui n'ont pas prouvĂ© avoir de consĂ©quences sur l'adhĂ©sion thĂ©rapeutique. Ces rĂ©sultats 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 santĂ© 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 SantĂ© (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
Troubles du transit chez les patients schizophrÚnes traités par antipsychotiques (étude observationnelle, évaluation du risque de survenue et proposition de prise en charge préventive)
Les troubles du transit induits par les antipsychotiques sont un effet secondaire frĂ©quemment rencontrĂ© lors de la prise en charge des patients schizophrĂšnes. Pourtant, en dĂ©pit de leur frĂ©quence Ă©levĂ©e, ces troubles ont fait l'objet de trĂšs peu d'Ă©tudes. Notre Ă©tude, rĂ©alisĂ©e au sein du PĂŽle Hospitalo-Universitaire du Centre Hospitalier Guillaume RĂ©gnier de Rennes, a pour objectif premier d'Ă©valuer les risques de survenue des troubles du transit sous antipsychotiques puis de proposer une stratĂ©gie de prĂ©vention de l'apparition des troubles et, dans les cas oĂč cette stratĂ©gie s'avĂšre insuffisante, de proposer un protocole de prise en charge de ces troubles afin d'Ă©viter la survenue de complications potentiellement graves. Il ressort de cette Ă©tude que le facteur de risque principal de survenue de troubles du transit est le choix d'un antipsychotique Ă fortes propriĂ©tĂ©s anticholinergiques, en particulier la clozapine, ce qui concorde avec les donnĂ©es actuelles de la littĂ©rature. Nous proposons une stratĂ©gie de prise en charge des troubles du transit par les antipsychotiques ainsi qu'un protocole spĂ©cifique pour les patients traitĂ©s par clozapine.Bowel movement disorders induced by antipsychotic drugs are a common side-effect in schizophrenic patients. However, despite their high prevalence, such disorders have been the subject of very few studies. The aim of the study we carried out in the University Hospital Department of Psychiatry in Rennes was to assess the risk of occurrence of bowel movement disorders on antipsychotic medication and to propose a prevention strategy. Should such disorders occur, we suggest a protocol for their management in order to avoid potentially serious complications. Our study shows that the main risk factor for the occurrence of bowel movement disorders lies in the prescription of antipsychotic drugs with strong anticholinergic properties, particularly clozapine. Our findings are in keeping with the data found in the current literature. We suggest a management strategy of antipsychotic-induced bowel movement disorders together with a specific protocol for patients on clozapine.RENNES1-BU SantĂ© (352382103) / SudocSudocFranceF
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