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Glaser B.,University of Geneva | Lothe A.,Center Dexploration Et Of Recherche Medicale Par Emission Of Positons Cermep | Chabloz M.,University of Geneva | Dukes D.,University of Geneva | And 3 more authors.
American Journal on Intellectual and Developmental Disabilities | Year: 2012

The authors developed a computerized program, Vis-à-Vis (VAV), to improve socioemotional functioning and working memory in children with developmental disabilities. The authors subsequently tested whether participants showed signs of improving the targeted skills. VAV is composed of three modules: Focus on the Eyes, Emotion Recognition and Understanding, and Working Memory. Ten children with idiopathic developmental delay completed four 20-min weekly sessions of VAV for 12 weeks with an adult. Participants were evaluated before (Time 0) and after (Time 1) training and 6 months after remediation (Time 2). Subjects improved on all three modules during training and on emotion recognition and nonverbal reasoning post-VAV. These gains were still present at Time 2. VAV is a promising new tool for working on socioemotional impairments in hardto- treat pediatric populations. © EAAIDD.

Galanaud D.,University Pierre and Marie Curie | Perlbarg V.,University Pierre and Marie Curie | Gupta R.,Massachusetts General Hospital | Stevens R.D.,Johns Hopkins University | And 18 more authors.
Anesthesiology | Year: 2012

BACKGROUND:: Existing methods to predict recovery after severe traumatic brain injury lack accuracy. The aim of this study is to determine the prognostic value of quantitative diffusion tensor imaging (DTI). METHODS:: In a multicenter study, the authors prospectively enrolled 105 patients who remained comatose at least 7 days after traumatic brain injury. Patients underwent brain magnetic resonance imaging, including DTI in 20 preselected white matter tracts. Patients were evaluated at 1 yr with a modified Glasgow Outcome Scale. A composite DTI score was constructed for outcome prognostication on this training database and then validated on an independent database (n = 38). DTI score was compared with the International Mission for Prognosis and Analysis of Clinical Trials Score. RESULTS:: Using the DTI score for prediction of unfavorable outcome on the training database, the area under the receiver operating characteristic curve was 0.84 (95% CI: 0.75-0.91). The DTI score had a sensitivity of 64% and a specificity of 95% for the prediction of unfavorable outcome. On the validation-independent database, the area under the receiver operating characteristic curve was 0.80 (95% CI: 0.54-0.94). On the training database, reclassification methods showed significant improvement of classification accuracy (P < 0.05) compared with the International Mission for Prognosis and Analysis of Clinical Trials score. Similar results were observed on the validation database. CONCLUSIONS:: White matter assessment with quantitative DTI increases the accuracy of long-term outcome prediction compared with the available clinical/radiographic prognostic score. © 2012, the American Society of Anesthesiologists, Inc.

Fort A.,INRETS | Martin R.,ISH Inc | Jacquet-Andrieu A.,French National Center for Scientific Research | Combe-Pangaud C.,ISH Inc | And 4 more authors.
Brain Research | Year: 2010

It is a well-known fact that attention is crucial for driving a car. This innovative study aims to assess the impact of attentional workload modulation on cerebral activity during a simulated driving task using magnetoencephalography (MEG). A car simulator equipped with a steering wheel, turn indicators, an accelerator and a brake pedal has been specifically designed to be used with MEG. Attentional demand has been modulated using a radio broadcast. During half of the driving scenarios, subjects could ignore the broadcast (simple task, ST) and during the other half, they had to actively listen to it in order to answer 3 questions (dual task, DT). Evoked magnetic responses were computed in both conditions separately for two visual stimuli of interest: traffic lights (from green to amber) and direction signs (arrows to the right or to the left) shown on boards. The cortical sources of these activities have been estimated using a minimum-norm current estimates modeling technique. Results show the activation of a large distributed network similar in ST and DT and similar for both the traffic lights and the direction signs. This network mainly involves sensory visual areas as well as parietal and frontal regions known to play a role in selective attention and motor areas. The increase of attentional demand affects the neuronal processing of relevant visual information for driving, as early as the perceptual stage. By demonstrating the feasibility of recording MEG activity during an interactive simulated driving task, this study opens new possibilities for investigating issues regarding drivers' activity. © 2010 Elsevier B.V. All rights reserved.

Maillet A.,Joseph Fourier University | Maillet A.,French Institute of Health and Medical Research | Maillet A.,French National Center for Scientific Research | Thobois S.,French National Center for Scientific Research | And 20 more authors.
Human Brain Mapping | Year: 2015

Gait disturbances, including freezing of gait, are frequent and disabling symptoms of Parkinson's disease. They often respond poorly to dopaminergic treatments. Although recent studies have shed some light on their neural correlates, their modulation by dopaminergic treatment remains quite unknown. Specifically, the influence of levodopa on the networks involved in motor imagery (MI) of parkinsonian gait has not been directly studied, comparing the off and on medication states in the same patients. We therefore conducted an [H2150] Positron emission tomography study in eight advanced parkinsonian patients (mean disease duration: 12.3±3.8 years) presenting with levodopa-responsive gait disorders and FoG, and eight age-matched healthy subjects. All participants performed three tasks (MI of gait, visual imagery and a control task). Patients were tested off, after an overnight withdrawal of all antiparkinsonian treatment, and on medication, during consecutive mornings. The order of conditions was counterbalanced between subjects and sessions. Results showed that imagined gait elicited activations within motor and frontal associative areas, thalamus, basal ganglia and cerebellum in controls. Off medication, patients mainly activated premotor-parietal and pontomesencephalic regions. Levodopa increased activation in motor regions, putamen, thalamus, and cerebellum, and reduced premotor-parietal and brainstem involvement. Areas activated when patients are off medication may represent compensatory mechanisms. The recruitment of these accessory circuits has also been reported for upper-limb movements in Parkinson's disease, suggesting a partly overlapping pathophysiology between imagined levodopa-responsive gait disorders and appendicular signs. Our results also highlight a possible cerebellar contribution in the pathophysiology of parkinsonian gait disorders through kinesthetic imagery. Hum Brain Mapp 36:959-980, 2015. © 2014 Wiley Periodicals, Inc.

Ballanger B.,French National Center for Scientific Research | Klinger H.,University of Lyon | Eche J.,Hospices Civils de Lyon | Lerond J.,Hospices Civils de Lyon | And 9 more authors.
Movement Disorders | Year: 2012

Depression is frequent in Parkinson's disease, but its pathophysiology remains unclear. Two recent studies have investigated the role of serotonergic system at the presynaptic level. The objective of the present study was to use positron emission tomography and [ 18F]MPPF to investigate the role of postsynaptic serotonergic system dysfunction in the pathophysiology of depression in Parkinson's disease. Four parkinsonian patients with depression and 8 parkinsonian patients without depression were enrolled. Each patient underwent a scan using [ 18F]MPPF, a selective serotonin 1A receptor antagonist. Voxel-by-voxel statistical comparison of [ 18F]MPPF uptake of the 2 groups of parkinsonian patients and with 7 matched normal subjects was made using statistical parametric mapping (P uncorrected < .001). Compared with nondepressed parkinsonian patients, depressed patients exhibited reduced tracer uptake in the left hippocampus, the right insula, the left superior temporal cortex, and the orbitofrontal cortex. Compared with controls, nondepressed parkinsonian patients presented reduced [ 18F]MPPF uptake bilaterally in the inferior frontal cortex as well as in the right ventral striatum and insula. Compared with controls, [ 18F]MPPF uptake was decreased in depressed parkinsonian patients in the left dorsal anterior cingulate and orbitofrontal cortices, in the right hippocampic region, and in the temporal cortex. The present imaging study suggests that abnormalities in serotonin 1A receptor neurotransmission in the limbic system may be involved in the neural mechanisms underlying depression in patients with Parkinson's disease. © 2011 Movement Disorder Society.

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