Center Hospitalier le Vinatier

Bron, France

Center Hospitalier le Vinatier

Bron, France
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Eichenlaub J.-B.,Center Hospitalier Le Vinatier Bat 452 | Eichenlaub J.-B.,University Claude Bernard Lyon 1 | Nicolas A.,Center Hospitalier le Vinatier | Daltrozzo J.,Center Hospitalier Le Vinatier Bat 452 | And 5 more authors.
Neuropsychopharmacology | Year: 2014

Dreaming is still poorly understood. Notably, its cerebral underpinning remains unclear. Neuropsychological studies have shown that lesions in the temporoparietal junction (TPJ) and/or the white matter of the medial prefrontal cortex (MPFC) lead to the global cessation of dream reports, suggesting that these regions of the default mode network have key roles in the dreaming process (forebrain 'dream-on' hypothesis). To test this hypothesis, we measured regional cerebral blood flow (rCBF) using 15 OH 2 O positron emission tomography in healthy subjects with high and low dream recall frequencies (DRFs) during wakefulness (rest) and sleep (rapid eye movement (REM) sleep, N2, and N3). Compared with Low recallers (0.5±0.3 dream recall per week in average), High recallers (5.2±1.4) showed higher rCBF in the TPJ during REM sleep, N3, and wakefulness, and in the MPFC during REM sleep and wakefulness. We demonstrate that the resting states of High recallers and Low recallers differ during sleep and wakefulness. It coheres with previous ERP results and confirms that a high/low DRF is associated with a specific functional organization of the brain. These results support the forebrain 'dream-on' hypothesis and suggest that TPJ and MPFC are not only involved in dream recall during wakefulness but also have a role in dreaming during sleep (production and/or encoding). Increased activity in the TPJ and MPFC might promote the mental imagery and/or memory encoding of dreams. Notably, increased activity in TPJ might facilitate attention orienting toward external stimuli and promote intrasleep wakefulness, facilitating the encoding of the dreams in memory. © 2014 American College of Neuropsychopharmacology.


Cavezian C.,Rothschild | Valadao D.,University of Waterloo | Hurwitz M.,University of Waterloo | Saoud M.,University of Lyon | And 2 more authors.
Brain Research | Year: 2012

The line bisection task is used as a bedside test of spatial neglect patients who typically bisect lines to the right of true centre. To disambiguate the contribution of perceptual from motor biases in bisection, previous research has used the landmark task in which participants determine whether a transection mark is left or right of centre. One recent study using stimuli that reliably leads to leftward perceptual biases in healthy individuals, found that ocular judgements of centre were biased to the right of centre, whereas manual bisections were biased leftwards. Here we used behavioural measures and functional MRI in healthy individuals to investigate ocular and perceptual judgements of centre. Ocular judgements were made by having participants fixate the centre of a horizontal bar that was dark at one end and light at the other (i.e., a 'greyscale' stimulus), whereas perceptual responses were made by having participants indicate whether a transection mark on the greyscales stimuli was to the left or right of centre. Behavioural data indicated a leftward bias in the first, second and longest fixations for bisection. Moreover, greyscale orientation (i.e., dark extremity to the right or to the left), and stimulus position modulated fixations. In contrast, for the landmark task, initial fixations were attracted towards the transection mark, whereas subsequent fixations were closer to veridical centre. Imaging data showed a large bilateral network, including superior parietal and lingual cortex, that was active for bisection. The landmark task activated a predominantly right hemisphere network including superior and inferior parietal cortices. Taken together these results indicate that very different strategies and underlying neural networks are invoked by the bisection and landmark tasks. © 2011 Elsevier B.V.


Caharel S.,University of Lorraine | Leleu A.,University of Rouen | Leleu A.,French National Center for Scientific Research | Leleu A.,Center Hospitalier Le Vinatier | And 4 more authors.
International Journal of Psychophysiology | Year: 2013

The properties of the face-sensitive N170 component of the event-related brain potential (ERP) were explored through an orientation discrimination task using natural faces, objects, and Arcimboldo paintings presented upright or inverted. Because Arcimboldo paintings are composed of non-face objects but have a global face configuration, they provide great control to disentangle high-level face-like or object-like visual processes at the level of the N170, and may help to examine the implication of each hemisphere in the global/holistic processing of face formats. For upright position, N170 amplitudes in the right occipito-temporal region did not differ between natural faces and Arcimboldo paintings but were larger for both of these categories than for objects, supporting the view that as early as the N170 time-window, the right hemisphere is involved in holistic perceptual processing of face-like configurations irrespective of their features. Conversely, in the left hemisphere, N170 amplitudes differed between Arcimboldo portraits and natural faces, suggesting that this hemisphere processes local facial features. For upside-down orientation in both hemispheres, N170 amplitudes did not differ between Arcimboldo paintings and objects, but were reduced for both categories compared to natural faces, indicating that the disruption of holistic processing with inversion leads to an object-like processing of Arcimboldo paintings due to the lack of local facial features. Overall, these results provide evidence that global/holistic perceptual processing of faces and face-like formats involves the right hemisphere as early as the N170 time-window, and that the local processing of face features is rather implemented in the left hemisphere. © 2013 Elsevier B.V.


Poulin H.,University of Québec | Bruhova I.,State University of New York at Buffalo | Timour Q.,University of Lyon | Theriault O.,University of Québec | And 5 more authors.
Molecular Pharmacology | Year: 2014

The voltage-gated Nav1.5 channel is essential for the propagation of action potentials in the heart. Malfunctions of this channel are known to cause hereditary diseases. It is a prime target for class 1 antiarrhythmic drugs and a number of antidepressants. Our study investigated the Nav1.5 blocking properties of fluoxetine, a selective serotonin reuptake inhibitor. Nav1.5 channels were expressed in HEK-293 cells, and Na+currents were recorded sing the patch-clamp technique. Dose-response curves of racemic fluoxetine (IC50=39 μM) and its optical isomers had a similar IC50[40 and 47 μM for the (+) and (-) isomers, respectively]. Norfluoxetine, a fluoxetine metabolite, had a higher affinity than fluoxetine, with an IC50of 29 μM. Fluoxetine inhibited currents in a frequency-dependent manner, shifted steady-state inactivation to more hyperpolarized potentials, and slowed the recovery of Nav1.5 from inactivation. Mutating a phenylalanine (F1760) and a tyrosine (Y1767) in the S6 segment of domain (D) IV (DIVS6) significantly reduced the affinity of fluoxetine and its frequency-dependent inhibition. We used a noninactivating Nav1.5 mutant to show that fluoxetine displays open-channel block behavior. The molecular model of fluoxetine in Nav1.5 was in agreement with mutational experiments in which F1760 and Y1767 were found to be the key residues in binding fluoxetine. We concluded that fluoxetine blocks Nav1.5 by binding to the class 1 antiarrhythmic site. The blocking of cardiac Na+ channels should be taken into consideration when prescribing fluoxetine alone or in association with other drugs that may be cardiotoxic or for patients with conduction disorders. Copyright © 2014 by The American Society for Pharmacology and Experimental Therapeutics.


Aguera P.-E.,Center Hospitalier le Vinatier | Aguera P.-E.,University of Lyon | Jerbi K.,Center Hospitalier le Vinatier | Jerbi K.,University of Lyon | And 4 more authors.
Computational Intelligence and Neuroscience | Year: 2011

The recent surge in computational power has led to extensive methodological developments and advanced signal processing techniques that play a pivotal role in neuroscience. In particular, the field of brain signal analysis has witnessed a strong trend towards multidimensional analysis of large data sets, for example, single-trial time-frequency analysis of high spatiotemporal resolution recordings. Here, we describe the freely available ELAN software package which provides a wide range of signal analysis tools for electrophysiological data including scalp electroencephalography (EEG), magnetoencephalography (MEG), intracranial EEG, and local field potentials (LFPs). The ELAN toolbox is based on 25 years of methodological developments at the Brain Dynamics and Cognition Laboratory in Lyon and was used in many papers including the very first studies of time-frequency analysis of EEG data exploring evoked and induced oscillatory activities in humans. This paper provides an overview of the concepts and functionalities of ELAN, highlights its specificities, and describes its complementarity and interoperability with other toolboxes. © 2011 Pierre-Emmanuel Aguera et al.


Franck N.,Center Hospitalier Le Vinatier
Journal de Therapie Comportementale et Cognitive | Year: 2012

Cognitive disorders (memory, attention, executive functions, metacognition and social cognition disorders) are frequently associated with chronic psychoses particularly schizophrenia. These cognitive disorders greatly compromise the ability of afflicted patients to care for themselves and also significantly affect their social functioning. Furthermore, they manifest with the first psychotic episode. While these symptoms are not as obvious as the defining psychotic symptoms (e.g., hallucinations and delusions), their behavioral consequences can be just as detrimental. Social interactions, work, and leisure activities can all involve basic cognitive activities such as repeating a phone number, integrating interlocutor speech, or organizing one's own behavior towards defined goals; all the while having to take context into account. The persistence of criticizing delusions or stabilization of verbal hallucinations through treatment are frequently less incapacitating than even moderate cognitive dysfunction. The nature of the cognitive deficit, as revealed by the neuropsychological assessment, can identify the type of functional impairment in a given patient. Deficits in attention and working memory can result in an alteration of occupational functioning. Executive function disorders have an impact on behavior in relationships. Processing speed, attention span and working memory all have an impact on social skills. Cognitive impairment is not necessarily directly linked to functional disability, yet its effects may mediated by other variables such as a patient's ability to manage a variety of tasks: daily life, social skills, social cognition performances, symptoms, intrinsic motivation and metacognition. Although functional disability is greater for schizophrenia than for bipolar disorder, cognitive impairments are predictive of overall disability for both disorders. Antipsychotics have little beneficial effect on cognitive disorders. While they certainly can alleviate secondary cognitive deficits (e.g., attention disorder resulting from an intense hallucinatory activity), they may also generate iatrogenic cognitive impairments. Cognitive side effects are even more consequential given that antipsychotics are not systematically prescribed with the minimum effective dose; cognitive side effects may be present even in low dosage of antipsychotics when the drug has additional antihistamine or anticholergentic effects. Iatrogenic effects can be aggravated if an antiparkinsonian or a benzodiazepine corrector is associated because of their adverse effects on attention and, additionally, adverse effects on memory abilities for drugs with anticholinergic or GABAergic action. Cognitive remediation was developed to reduce the cognitive deficits or compensate for their consequences by developing alternative skills. The goal of cognitive remediation is concrete intending to promote a professional or social reintegration focusing on an intermediate variable that constitutes itself cognitive performance. To achieve this goal, cognitive remediation targets attention, memory, language and executive processes, as well as social cognition disorders. Improving performances in these areas appears to have a positive impact on functional deficits that affect daily life. Cognitive remediation is not an alternative to psychotropic treatments and/or psychotherapy, but is intended to supplement their effects. These three methods of treatment act at different levels. In practice, cognitive remediation provides an improvement in cognitive functioning, either directly by retraining the impaired functions, or indirectly through the functions developed in order to compensate. Taking into account the patient's vulnerability aids in reducing his handicap and encouraging recovery, through validation of the various situations he or she faces in daily life. Cognitive remediation is an essential therapeutic tool that can promote psychosocial rehabilitation in a patient with chronic psychotic disorder. Ideally it should be associated with other rehabilitating tools, like social skills training, psychoeducation, role playing (using a non-threatening situation), and family support. Cognitive remediation is indicated for patients whose clinical condition is stable and for whom medication is reduced to the minimum effective dose. In the ideal scenario, it is advisable to treat only the primary symptoms linked to cognitive disorders (rather than the secondary ones) or iatrogenic cognitive impairments. In some cases, the patients under care of are still symptomatic or suffering from iatrogenic cognitive effects. Should some symptoms remain under antipsychotic medication, cognitive remediation is fully justified when the benefit-risk ratio has been clearly determined. It is, however, necessary that patient condition remain stable and that some practical benefits can be attained. © 2012 Association française de thérapie comportementale et cognitive.


While the laws of 1975 saw the creation of a true medical-social sector, different from that of health services, the hospital reform law of 21st July 2009 relating to patients, health and the territories brought back together the field of disability and health. A move away from compartmentalisation and the creation of an interface between the outpatient, hospital and medical-social services are necessary and should be encouraged while respecting the different cultures of each one. A specific form of management adapted to the different medical-social services can then be put in place by the healthcare manager. © 2013 Elsevier Masson SAS.


Gestin A.,Center Hospitalier le Vinatier
Soins Cadres de Sante | Year: 2013

Generations follow on from each other and mix in with the working population. The context of the health system itself is sensitive to cyclical transformations which can also be qualifi ed as "generational". In this mosaic, does the healthcare manager have any other choice than to fi nd a balance between the institutional demands and the different expectations of the generations which make up the healthcare team for which he or she is responsible? © 2013 Elsevier Masson SAS. All rights reserved.


Topouzkhanian S.,Center Hospitalier le Vinatier | Mijiyawa M.,Ecole Nationale des Auxiliaires Medicaux
International Journal of Speech-Language Pathology | Year: 2013

In West Africa, as in Majority World countries, people with a communication disability are generally cut-off from the normal development process. A long-term involvement of two partners (Orthophonistes du Monde and Handicap International) allowed the implementation in 2003 of the first speech-language pathology qualifying course in West Africa, within the Ecole Nationale des Auxiliaires Medicaux (ENAM, National School for Medical Auxiliaries) in Lome, Togo. It is a 3-year basic training (after the baccalaureate) in the only academic training centre for medical assistants in Togo. This department has a regional purpose and aims at training French-speaking African students. French speech-language pathology lecturers had to adapt their courses to the local realities they discovered in Togo. It was important to introduce and develop knowledge and skills in the students' system of reference. African speech-language pathologists have to face many challenges: creating an African speech and language therapy, introducing language disorders and their possible cure by means other than traditional therapies, and adapting all the evaluation tests and tools for speech-language pathology to each country, each culture, and each language. Creating an African speech-language pathology profession (according to its own standards) with a real influence in West Africa opens great opportunities for schooling and social and occupational integration of people with communication disabilities. © 2013 The Speech Pathology Association of Australia Limited.


Rouviere S.,Center Hospitalier le Vinatier
Soins Psychiatrie | Year: 2015

"Gaspard is a warrior" is a metaphor highlighting the long battle undertaken by mental health patients to recover from their condition. At each stage, Gaspard, a fictional character embodying many of the patients seen by professionals, is given several therapeutic tools to help him carry out his fight. In the background, nurses, thanks to their key role and position, are important allies as they support the person with mental health problems on their path towards rehabilitation. This article reflects on the clinical approach. © 2015 Elsevier Masson SAS. All rights reserved.

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