Publications by authors named "Nicolás Franck"

109 Publications

When Alterations in Social Cognition Meet Subjective Complaints in Autism Spectrum Disorder: Evaluation With the "ClaCoS" Battery.

Front Psychiatry 2021 26;12:643551. Epub 2021 Aug 26.

Centre Universitaire de Pédopsychiatrie, CHRU de Tours, Centre d'Excellence Autisme et Troubles du Neuro-développement-Tours exac.t, Tours, France.

Deficit in social communication is a core feature in Autism Spectrum Disorder but remains poorly assessed in classical clinical practice, especially in adult populations. This gap between needs and practice is partly due to a lack of standardized evaluation tools. The multicentric Research group in psychiatry GDR3557 (Institut de Psychiatrie) developed a new battery for social cognitive evaluation named "ClaCoS," which allows testing the main components of social cognition: Emotion Recognition, Theory of Mind, Attributional Style, and Social Perception and Knowledge. It further provides an assessment of subjective complaints in social cognition. We compared the social cognition abilities of 45 adults with Autism Spectrum Disorder without intellectual disability and 45 neurotypically developed volunteers using the "ClaCoS" battery, in order to determine its relevance in the evaluation of social cognition impairments in autism. A correlational approach allowed us to test the links between subjective complaints and objectively measured impairments for the different components of social cognition. As expected, the Autism Spectrum Disorder group showed deficits in all four components of social cognition. Moreover, they reported greater subjective complaints than controls regarding their social abilities, correlated to the neuropsychological assessments. The "ClaCoS" battery is an interesting tool allowing to assess social impairments in autism and to specify the altered components, for a better adjustment of tailored social cognition training programs. Our results further suggest that people with Autism Spectrum Disorder have a good social cognitive insight, i.e., awareness into social cognitive functioning, and may thus benefit from social cognitive training tools.
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http://dx.doi.org/10.3389/fpsyt.2021.643551DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8426662PMC
August 2021

Tomato Cultivars With Variable Tolerances to Water Deficit Differentially Modulate the Composition and Interaction Patterns of Their Rhizosphere Microbial Communities.

Front Plant Sci 2021 13;12:688533. Epub 2021 Jul 13.

Laboratorio de Genómica y Genética de Interacciones Biológicas (LG2IB), Instituto de Nutrición y Tecnología de los Alimentos, Universidad de Chile, Santiago, Chile.

Since drought is the leading environmental factor limiting crop productivity, and plants have a significant impact in defining the assembly of plant-specific microbial communities associated with roots, we aimed to determine the effect of thoroughly selected water deficit tolerant and susceptible cultivars on their rhizosphere microbiome and compared their response with plant-free soil microbial communities. We identified a total of 4,248 bacterial and 276 fungal different operational taxonomic units (OTUs) in soils by massive sequencing. We observed that tomato cultivars significantly affected the alpha and beta diversity of their bacterial rhizosphere communities but not their fungal communities compared with bulk soils (BSs), showing a plant effect exclusively on the bacterial soil community. Also, an increase in alpha diversity in response to water deficit of both bacteria and fungi was observed in the susceptible rhizosphere (SRz) but not in the tolerant rhizosphere (TRz) cultivar, implying a buffering effect of the tolerant cultivar on its rhizosphere microbial communities. Even though water deficit did not affect the microbial diversity of the tolerant cultivar, the interaction network analysis revealed that the TRz microbiota displayed the smallest and least complex soil network in response to water deficit with the least number of connected components, nodes, and edges. This reduction of the TRz network also correlated with a more efficient community, reflected in increased cooperation within kingdoms. Furthermore, we identified some specific bacteria and fungi in the TRz in response to water deficit, which, given that they belong to taxa with known beneficial characteristics for plants, could be contributing to the tolerant phenotype, highlighting the metabolic bidirectionality of the holobiont system. Future assays involving characterization of root exudates and exchange of rhizospheres between drought-tolerant and susceptible cultivars could determine the effect of specific metabolites on the microbiome community and may elucidate their functional contribution to the tolerance of plants to water deficit.
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http://dx.doi.org/10.3389/fpls.2021.688533DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8313812PMC
July 2021

["Rehabilitation circuits for people with schizophrenia"].

Authors:
Nicolas Franck

Rev Prat 2021 01;71(1):62-63

"Pôle Centre rive gauche, Centre ressource de réhabilitation psychosociale, centre hospitalier Le Vinatier, UMR 5229, CNRS et université Lyon-1, université de Lyon, Lyon, France".

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January 2021

[Psychiatric rehabilitation in schizophrenia].

Authors:
Nicolas Franck

Rev Prat 2021 Jan;71(1):52-57

"Pôle Centre rive gauche, Centre ressource de réhabilitation psychosociale, centre hospitalier Le Vinatier, UMR 5229, CNRS et université Lyon-1, université de Lyon, Lyon, France".

"Psychiatric rehabilitation In schizophrenia Psychiatric rehabilitation is based, on the one hand, on a conception of care oriented towards the search for recovery and, on the other hand, on specific evaluation and therapeutic tools (cognitive remediation, psychoeducation and social skills training in particular) designed to highlight and strengthen the decision-making and action capacities of people with schizophrenia or, more generally, a serious mental illness. The implementation of psychiatric rehabilitation includes 5 steps: commitment to care, which makes it possible to establish a positive therapeutic relationship and assess availability for rehabilitation; multidisciplinary evaluation, which highlights the capacities and limitations, as well as the objectives and needs of the person; co-construction of the psychiatric rehabilitation and recovery project; psychiatric rehabilitation care (including: psychoeducation, cognitive remediation and social skills training); generalization and transfer based on the implementation of the benefits of the treatment sessions in the person's life context. Overall, psychiatric rehabilitation takes into account the needs and demands of people and promotes the success of their own projects."
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January 2021

Sex Differences in Recovery-Related Outcomes and Needs for Psychiatric Rehabilitation in People With Schizophrenia Spectrum Disorder.

J Clin Psychiatry 2021 05 18;82(4). Epub 2021 May 18.

Centre Référent de Réhabilitation psychosociale et de Remédiation cognitive (C3R), Centre Hospitalier Alpes Isère, Grenoble, France.

Background: Female sex/gender has been associated with better longitudinal outcomes in schizophrenia spectrum disorders (SSDs). Few studies have investigated the relationships between female gender and recovery-related outcomes. Women's specific psychiatric rehabilitation needs remain largely unknown.

Objective: The objectives of the present study are to investigate sex differences in (1) objective and subjective aspects of recovery and (2) psychiatric rehabilitation needs in a multicenter non-selected psychiatric rehabilitation SSD sample.

Methods: 1,055 outpatients with SSD (DSM-5) were recruited from the French National Centers of Reference for Psychiatric Rehabilitation (REHABase) cohort between January 2016 and November 2019. Evaluation included standardized scales for quality of life, satisfaction with life, and well-being and a broad cognitive battery. Socially valued roles at enrollment were recorded. Functional recovery was measured using the Global Assessment of Functioning scale (GAF) and personal recovery with the Stages of Recovery Instrument (STORI).

Results: Female sex was the best predictor of having more than 2 socially valued roles in the multivariate analysis (P < .001; OR [95% CI] = 5.42 [2.34-13.06]). No sex differences were found for functional recovery or personal recovery. Female gender was positively associated with self-stigma (P = .036) and suicidal history (P < .001) and negatively correlated with quality of life (P = .004) and satisfaction with interpersonal relationships (P = .029), an area in which women reported more unmet needs (P = .004).

Conclusions: The present study found that women had poorer subjective recovery-related outcomes and more unmet needs than men. It would therefore be beneficial to develop recovery-oriented interventions addressing women's specific needs and implement these in psychiatric rehabilitation services.
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http://dx.doi.org/10.4088/JCP.20m13732DOI Listing
May 2021

Numerical simulations of paper-based electrophoretic separations with open-source tools.

Electrophoresis 2021 Aug 27;42(16):1543-1551. Epub 2021 May 27.

Centro de Investigación en Métodos Computacionales (CIMEC), Universidad Nacional del Litoral-CONICET, Santa Fe, Argentina.

A new tool for the solution of electromigrative separations in paper-based microfluidics devices is presented. The implementation is based on a recently published complete mathematical model for describing these types of separations, and was developed on top of the open-source toolbox electroMicroTransport, based on OpenFOAM , inheriting all its features as native 3D problem handling, support for parallel computation, and a GNU GPL license. The presented tool includes full support for paper-based electromigrative separations (including EOF and the novel mechanical and electrical dispersion effects), compatibility with a well-recognized electrolyte database, and a novel algorithm for computing and controlling the electric current in arbitrary geometries. Additionally, the installation on any operating system is available due to its novel installation option in the form of a Docker image. A validation example with data from literature is included, and two extra application examples are provided, including a 2D free-flow IEF problem, which demonstrates the capabilities of the toolbox for dealing with computational and physicochemical modeling challenges simultaneously. This tool will enable efficient and reliable numerical prototypes of paper-based electrophoretic devices to accompany the contemporary fast growth in paper-based microfluidics.
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http://dx.doi.org/10.1002/elps.202000315DOI Listing
August 2021

Impact of insight and metacognition on vocational rehabilitation of individuals with severe mental illness: A systematic review.

Psychiatr Rehabil J 2021 Apr 15. Epub 2021 Apr 15.

Centre Ressource de Rehabilitation Psychosociale et de Remediation Cognitive.

Objective: Identifying specific insight and/or metacognitive measures predicting vocational outcomes would lead to a refinement of cognitive and behavioral assessment and treatment of people with severe mental illness.

Methods: We conducted a systematic review of empirical research following preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. Studies published in PubMed and PsycINFO from January 1, 2000 to April 30, 2020 and including words referring to "vocational outcomes", "insight," and "metacognition" were screened.

Results: Twenty-eight studies were included, 19 assessing insight and 9 assessing metacognition and their relationships with vocational outcomes in patients with severe mental illness. Thirteen studies (68%) identified statistically significant relationships between insight scores and vocational outcomes. Five studies (56%) identified statistically significant relationships between metacognition scores or metacognitive training and vocational outcomes. The most common tools whose measures were significantly related to vocational outcomes were the Schedule for the Assessment of Insight, the Scale to assess Unawareness of Mental Disorder and the Metacognition Assessment Scale-Abbreviated.

Conclusions And Implications For Practice: Insight and metacognition appeared to be related to the vocational outcomes of people with severe mental illness. However, due to the heterogeneity of variables used to operationalize insight, metacognition, and vocational outcomes, it was not possible to determine the overall effect of insight and metacognition. Nevertheless, assessment including the measures of insight and metacognition would be relevant in vocational rehabilitation centers and in centers providing care through employment. The literature lacks predictive models of employment variables including insight and metacognition, so further studies should address this. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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http://dx.doi.org/10.1037/prj0000481DOI Listing
April 2021

The spatial distribution of eye movements predicts the (false) recognition of emotional facial expressions.

PLoS One 2021 26;16(1):e0245777. Epub 2021 Jan 26.

Laboratoire Développement, Individu, Processus, Handicap, Éducation (DIPHE), Département Psychologie du Développement, de l'Éducation et des Vulnérabilités (PsyDEV), Institut de Psychologie, Université de Lyon (Lumière Lyon 2), Lyon, France.

Recognizing facial expressions of emotions is a fundamental ability for adaptation to the social environment. To date, it remains unclear whether the spatial distribution of eye movements predicts accurate recognition or, on the contrary, confusion in the recognition of facial emotions. In the present study, we asked participants to recognize facial emotions while monitoring their gaze behavior using eye-tracking technology. In Experiment 1a, 40 participants (20 women) performed a classic facial emotion recognition task with a 5-choice procedure (anger, disgust, fear, happiness, sadness). In Experiment 1b, a second group of 40 participants (20 women) was exposed to the same materials and procedure except that they were instructed to say whether (i.e., Yes/No response) the face expressed a specific emotion (e.g., anger), with the five emotion categories tested in distinct blocks. In Experiment 2, two groups of 32 participants performed the same task as in Experiment 1a while exposed to partial facial expressions composed of actions units (AUs) present or absent in some parts of the face (top, middle, or bottom). The coding of the AUs produced by the models showed complex facial configurations for most emotional expressions, with several AUs in common. Eye-tracking data indicated that relevant facial actions were actively gazed at by the decoders during both accurate recognition and errors. False recognition was mainly associated with the additional visual exploration of less relevant facial actions in regions containing ambiguous AUs or AUs relevant to other emotional expressions. Finally, the recognition of facial emotions from partial expressions showed that no single facial actions were necessary to effectively communicate an emotional state. In contrast, the recognition of facial emotions relied on the integration of a complex set of facial cues.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0245777PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7837501PMC
June 2021

Self-stigma in Serious Mental Illness: A Systematic Review of Frequency, Correlates, and Consequences.

Schizophr Bull 2021 Aug;47(5):1261-1287

Centre de Neurosciences Cognitive, UMR 5229, CNRS & Université Lyon 1, Lyon, France.

Self-stigma is associated with poor clinical and functional outcomes in Serious Mental Illness (SMI). There has been no review of self-stigma frequency and correlates in different cultural and geographic areas and SMI. The objectives of the present study were: (1) to review the frequency, correlates, and consequences of self-stigma in individuals with SMI; (2) to compare self-stigma in different geographical areas and to review its potential association with cultural factors; (3) to evaluate the strengths and limitations of the current body of evidence to guide future research. A systematic electronic database search (PubMed, Web of Science, PsycINFO, Scopus, and Ovid SP Cumulative Index to Nursing and Allied Health Literature [CINAHL]) following PRISMA guidelines, was conducted on the frequency, correlates, and consequences of self-stigma in SMI. Out of 272 articles, 80 (29.4%) reported on the frequency of self-stigma (n = 25 458), 241 (88.6%) on cross-sectional correlates of self-stigma and 41 (15.0%) on the longitudinal correlates and consequences of self-stigma. On average, 31.3% of SMI patients reported high self-stigma. The highest frequency was in South-East Asia (39.7%) and the Middle East (39%). Sociodemographic and illness-related predictors yielded mixed results. Perceived and experienced stigma-including from mental health providers-predicted self-stigma, which supports the need to develop anti-stigma campaigns and recovery-oriented practices. Increased transition to psychosis and poor clinical and functional outcomes are both associated with self-stigma. Psychiatric rehabilitation and recovery-oriented early interventions could reduce self-stigma and should be better integrated into public policy.
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http://dx.doi.org/10.1093/schbul/sbaa181DOI Listing
August 2021

Precise electroosmotic flow measurements on paper substrates.

Electrophoresis 2021 Apr 22;42(7-8):975-982. Epub 2021 Jan 22.

Instituto de Física del Litoral (IFIS Litoral, UNL-CONICET)., Guemes 3450, Santa Fe, S3000GLN, Argentina.

A novel method for electroosmotic flow (EOF) measurement on paper substrates is presented; it is based on dynamic mass measurements by simply using an analytical balance. This technique provides a more reliable alternative to other EOF measurement methods on porous media. The proposed method is used to increase the amount and quality of the available information about physical parameters that characterize fluid flow on microfluidic paper-based analytical devices (μPADs). Measurements were performed on some of the most frequently used materials for μPADs, i.e., Whatman #1 , S&S, and Muntktell 00A filter paper. Obtained experimental results are consistent with the few previously reported data, either experimental or numerical, characterizing EOF in paper substrates. Moreover, a thorough analysis is presented for the quantification of the different effects that affect the measurements such as Joule effect and evaporation. Experimental results enabled, for the first time, to establish well-defined electroosmotic characteristics for the three substrates in terms of the magnitude of EOF as funtion of pH, enabling researchers to make a rational choice of the substrate depending on the electrophoretic technique to be implemented. The measurement method can be described as robust, reliable, and affordable enough for being adopted by researchers and companies devoted to electrophoretic μPADs and related technologies.
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http://dx.doi.org/10.1002/elps.202000271DOI Listing
April 2021

Characteristics associated with self-reported medication adherence in persons with psychosis referred to psychosocial rehabilitation centers.

Eur Arch Psychiatry Clin Neurosci 2020 Nov 10. Epub 2020 Nov 10.

Centre Ressource de Réhabilitation Psychosociale et de Remédiation Cognitive (CRR), Hôpital Le Vinatier, Centre National de la Recherche Scientifique (CNRS) et Université Claude Bernard, Lyon 1, Lyon, France.

The aim of the present study was to explore the characteristics of psychotropic treatment and of psychosocial functioning associated with self-reported medication adherence in persons with psychosis engaged in rehabilitation. The study was performed in the REHABase cohort including persons referred to a French network of psychosocial rehabilitation centers. Treatment adherence was assessed using the Medication Adherence Rating Scale (MARS). The associations between MARS score (categorized as "low" < 7 vs. "high" ≥ 7) and functioning or psychotropic treatment characteristics were explored using multivariate analyses in 326 participants with schizophrenia spectrum disorders. Regarding psychotropic treatment, high anticholinergic load was the only characteristic associated with poor medication adherence (adjusted OR, aOR 1.98, 95% CI 1.07-3.66). Regarding functioning measures, participants with poor medication adherence were more likely to present with lower stage of recovery (aOR 2.38, 95% CI 1.31-4.32), poor quality of life (aOR 2.17, 95% CI 1.27-3.71), mental well-being (aOR 1.68, 95% CI 1.03-2.72) and self-esteem (aOR 1.74, 95% CI 1.05-2.87), and higher internalized stigma (aOR 1.88, 95% CI 1.09-3.23). Self-reported poor medication adherence is a marker of poor functioning in persons with psychosis. The MARS is a quick and simple measure of adherence that may be helpful in clinical and rehabilitation settings to identify persons with specific rehabilitation needs.
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http://dx.doi.org/10.1007/s00406-020-01207-xDOI Listing
November 2020

Convergent and Concurrent Validity between Clinical Recovery and Personal-Civic Recovery in Mental Health.

J Pers Med 2020 Oct 12;10(4). Epub 2020 Oct 12.

Yale Program for Recovery & Community Health, Erector Square, Building 1, 319 Peck Street, New Haven, CT 06513, USA.

Several instruments have been developed by clinicians and academics to assess clinical recovery. Based on their life narratives, measurement tools have also been developed and validated through participatory research programs by persons living with mental health problems or illnesses to assess personal recovery. The main objective of this project is to explore possible correlations between clinical recovery, personal recovery, and citizenship by using patient-reported outcome measures. All study participants are currently being treated and monitored after having been diagnosed either with (a) psychotic disorders or (b) anxiety and mood disorders. They have completed questionnaires for clinical evaluation purposes (clinical recovery) will further complete the Recovery Assessment Scale and Citizenship Measure (personal-civic recovery composite index). Descriptive and statistical analyses will be performed to determine internal consistency for each of the subscales, and assess convergent-concurrent validity between clinical recovery, citizenship and personal recovery. Recovery-oriented mental health care and services are particularly recognizable by the presence of Peer Support Workers, who are persons with lived experience of recovery. Upon training, they can personify personalized mental health care and services, that is to say services that are centered on the person's recovery project and not only on their symptoms. Data from our overall research strategy will lay the ground for the evaluation of the effects of the intervention of Peer Support Workers on clinical recovery, citizenship and personal recovery.
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http://dx.doi.org/10.3390/jpm10040163DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7712080PMC
October 2020

Who maintains good mental health in a locked-down country? A French nationwide online survey of 11,391 participants.

Health Place 2020 11 15;66:102440. Epub 2020 Sep 15.

Centre Ressource de Réhabilitation Psychosociale et de Remédiation Cognitive (Ressource Center for Psychosocial Rehabilitation and Cognitive Remediation), Hôpital Le Vinatier, France; UMR, 5229, CNRS & Université Lyon 1, Université de Lyon, Lyon, France.

Lockdown measures can differentially affect mental wellbeing in populations depending on individual determinants. We aim to investigate the sociodemographic and environmental determinants of wellbeing on the French population during lockdown due to the SARS-CoV-2 pandemic with an online survey. Among 11,391 participants who completed the questionnaire, various factors negatively impacted wellbeing: being a female, a student, disabled, having no access to outdoor spaces, or living in a small home. Conversely, being employed and having more social contacts had a positive impact. During lockdowns, authorities should consider the vulnerability of specific populations, especially when they live in constrained housing conditions.
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http://dx.doi.org/10.1016/j.healthplace.2020.102440DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7490637PMC
November 2020

Global Changes and Factors of Increase in Caloric/Salty Food Intake, Screen Use, and Substance Use During the Early COVID-19 Containment Phase in the General Population in France: Survey Study.

JMIR Public Health Surveill 2020 09 18;6(3):e19630. Epub 2020 Sep 18.

CH Le Vinatier, Pôle Centre Rive Gauche, Bron, France.

Background: The international outbreak of coronavirus disease (COVID-19) has led many countries to enforce drastic containment measures. It has been suggested that this abrupt lockdown of populations will foster addiction-related habits such as caloric/salty food intake, screen use, and substance use.

Objective: Our aim was to assess the global changes and factors of increase in addiction-related habits during the early COVID-19 containment phase in France.

Methods: A web-based survey was provided from day 8 to day 13 of the containment and was completed by 11,391 participants. The questions explored sociodemographic features, psychiatric/addiction history, material conditions of lockdown, general stress, mental well-being, and reported changes in several addiction-related behaviors. Global changes were described and factors of increase were explored using population-weighted and adjusted logistic regression models, providing adjusted odds ratios (aORs) and their 95% confidence intervals.

Results: Overall, the respondents reported more increases in addiction-related habits than decreases, specifically 28.4% (caloric/salty food intake), 64.6% (screen use), 35.6% (tobacco use), 24.8% (alcohol use), and 31.2% (cannabis use). Reduced well-being scores and increased stress scores were general factors of increase in addiction-related habits (P<.001 for all habits). Factors of increase in caloric/salty food intake (n=10,771) were female gender (aOR 1.62, 95% CI 1.48-1.77), age less than 29 years (P<.001), having a partner (aOR 1.19, 95% CI 1.06-1.35), being locked down in a more confined space (per 1 square meter/person decrease: aOR 1.02, 95% CI 1.01-1.03), being locked down alone (aOR 1.29, 95% CI 1.11-1.49), and reporting current (aOR 1.94, 95% CI 1.62-2.31) or past (aOR 1.27, 95% CI 1.09-1.47) psychiatric treatment. Factors of increase in screen use (n=11,267) were female gender (aOR 1.31, 95% CI 1.21-1.43), age less than 29 years (P<.001), having no partner (aOR 1.18, 95% CI 1.06-1.32), being employed (P<.001), intermediate/high education level (P<.001), being locked down with no access to an outdoor space (aOR 1.16, 95% CI 1.05-1.29), being locked down alone (aOR 1.15, 95% CI 1.01-1.32), living in an urban environment (P<.01), and not working (P<.001). Factors of increase in tobacco use (n=2787) were female gender (aOR 1.31, 95% CI 1.11-1.55), having no partner (aOR 1.30, 95% CI 1.06-1.59), intermediate/low education level (P<.01), and still working in the workplace (aOR 1.47, 95% CI 1.17-1.86). Factors of increase in alcohol use (n=7108) were age 30-49 years (P<.05), a high level of education (P<.001), and current psychiatric treatment (aOR 1.44, 95% CI 1.10-1.88). The only significant factor of increase in cannabis use (n=620) was intermediate/low level of education (P<.001).

Conclusions: The early phase of COVID-19 containment in France led to widespread increases in addiction-related habits in the general population. Reduced well-being and increased stress were universal factors of increase. More specific factors were associated with increases in each of the explored habits.
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http://dx.doi.org/10.2196/19630DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7505683PMC
September 2020

Dysfunctional connectivity in posterior brain regions involved in cognitive control in schizophrenia: A preliminary fMRI study.

J Clin Neurosci 2020 Aug 22;78:317-322. Epub 2020 May 22.

Centre Ressource de Rehabilitation Psychosociale, Centre Hospitalier le Vinatier & UMR 5229, CNRS & Université Lyon 1, France.

Cognitive control, the ability to use goal-directed information to guide behaviour, is impaired in schizophrenia, and mainly related to dysfunctions within the fronto-posterior brain network. However, cognitive control is a broad cognitive function encompassing distinct sub-processes that, until now, studies have failed to separate and relate to specific brain regions. The goal of this preliminary fMRI study is to investigate the functional specialization of posterior brain regions, and their functional interaction with lateral prefrontal cortex (LPFC) regions, in schizophrenia. Fourteen healthy participants and 15 matched schizophrenic patients participated in this fMRI study. We used a task paradigm that differentiates two cognitive control sub-processes according to the temporal framing of information, namely the control of immediate context (present cues) vs. temporal episode (past instructions). We found that areas activated during contextual and episodic controls were in dorsal posterior regions and that activations did not significantly differ between schizophrenic patients and healthy participants. However, while processing contextual signals, patients with schizophrenia failed to show decreased connectivity between caudal LPFC and areas located in ventral posterior regions. The absence of group difference in the functional specialization of posterior regions is difficult to interpret due to our small sample size. One interpretation for our connectivity results is that patients present an inefficient extinction of posterior regions involved in attention shifting by prefrontal areas involved in the top-down control of contextual signals. Further studies with larger sample sizes will be needed to ascertain those observations.
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http://dx.doi.org/10.1016/j.jocn.2020.04.089DOI Listing
August 2020

Impact of anticholinergic load on functioning and cognitive performances of persons with psychosis referred to psychosocial rehabilitation centers.

Psychol Med 2020 May 22:1-9. Epub 2020 May 22.

Centre Ressource de Réhabilitation Psychosociale et de Remédiation Cognitive (CRR), Hôpital Le Vinatier, Centre National de la Recherche Scientifique (CNRS) et Université de Lyon, Lyon, France.

Background: Few studies have explored whether high-anticholinergic load may hamper rehabilitation in persons with schizophrenia. We aim to explore the associations between anticholinergic load of psychotropic treatment and functioning or cognitive performances of persons with psychosis engaged in psychosocial rehabilitation.

Methods: The study was performed using data collected at baseline assessment in the REHABase cohort including persons referred to a French network of psychosocial rehabilitation centers. The composite-rating scale developed by Salahudeen et al. was used to rate the anticholinergic load of psychotropic drugs prescribed at baseline assessment. The associations between total anticholinergic load score (categorized as 'low' <3 v. 'high' ⩾3) and functioning or cognitive characteristics were explored using multivariate analyses.

Results: Of the 1012 participants with schizophrenia spectrum disorders identified in the REHABase, half used at least two psychotropic drugs with anticholinergic activity and one out of three was prescribed at least one psychotropic drug with high-anticholinergic activity. High-anticholinergic load was significantly associated with lower stage of recovery [odds ratio (OR) = 1.70, 95% confidence interval (CI) 1.05-2.76, p = 0.03], poor mental well-being (OR = 1.55, 95% CI 1.02-2.33, p = 0.04) and poor self-rated medication adherence (OR = 2.14, 95% CI 1.29-3.53, p = 0.003). Regarding cognition, a high-anticholinergic score was associated with poorer delayed-episodic memory (OR = 1.69, 95% CI 1.01-2.85, p = 0.05) and at the trend level with faster completion time on the test exploring executive performance (OR = 0.67, 95% CI 0.43-1.04, p = 0.07).

Conclusions: The psychosocial rehabilitation plan of persons with psychosis should integrate optimization of psychotropic treatment in order to lessen the functional and cognitive impact of high-anticholinergic load.
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http://dx.doi.org/10.1017/S0033291720001403DOI Listing
May 2020

Ecological study of the association between mental illness with human development, income inequalities and unemployment across OECD countries.

BMJ Open 2020 04 20;10(4):e035055. Epub 2020 Apr 20.

Centre Hospitalier le Vinatier & UMR 5229, CNRS & Université Lyon 1, Lyon, France.

Objectives: Recent studies have demonstrated worsened mental health in relatively highly developed countries impacted by social inequalities and unemployment. Here, we investigate (1) whether mental health issues are differently or similarly affected by these social factors and (2) whether their effects on mental health are related or unrelated to each other.

Setting: Analysis at the country level among Organization for Economic Cooperation and Development (OECD) countries (n=36). Data on social indicators were collected from OECD and the United Nations Development Programme databases. Data on the prevalence of mental issues were obtained from the Institute for Health Metrics and Evaluation's Global Burden of Disease study 2017.

Participants: No involvement of participants.

Primary And Secondary Outcome Measures: Using linear regression models, we investigated the relative contribution played by human development (as measured by the Human Development Index (HDI)), social inequalities (Gini index) and unemployment (unemployment rate) on the prevalence of 10 mental health issues. We then measured the relationship between the socioeconomic factors' effects on mental issues using 2×2 Pearson's correlation test and principal component analysis.

Results: First, the overall effect of each socioeconomic factor on a combination of mental health disorders was large (r range: 0.51 to 0.76; p<0.002). However, the influence of social factors on mental health was relative to each mental issue (r range: -0.34 to 0.74). Second, the socioeconomic factors' effects on mental health showed strong interdependence (r=0.93, r=0.81, r=0.84; p<0.001. Principal component analysis demonstrated that the first principal component of the three variables (r, r, r) explained 91.5% of the variance.

Conclusion: These results implore a reanalysis of the socioeconomic determinants of mental health where (1) the heterogeneity of mental health issues would be taken into account and (2) each socioeconomic indicator's effect would be analysed and interpreted in conjunction with the others.
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http://dx.doi.org/10.1136/bmjopen-2019-035055DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7204933PMC
April 2020

Determinants of Therapeutic Alliance With People With Psychotic Disorders: A Systematic Literature Review.

J Nerv Ment Dis 2020 04;208(4):329-339

Centre Ressource de Réhabilitation Psychosociale et de Remédiation Cognitive, Centre Hospitalier Le Vinatier, CNRS UMR 5229 & Université de Lyon, Lyon, France.

Therapeutic alliance determines medical treatment adherence, the success of psychotherapy, and the effectiveness of care. This systematic review aims at better understanding its determinants. The electronic databases Pubmed, Cochrane Library, and Web of Science were searched, using combinations of terms relating to psychosis and therapeutic alliance. Studies were selected and data were extracted using a PRISMA statement. Forty-one studies were selected, including 20 cross-sectional studies, 10 cohort studies, five randomized controlled trials, four literature reviews, and two retrospective studies. The quality of therapeutic alliance correlates with clinical symptoms, insight, social and family support, the therapist's qualities, the availability of shared therapeutic decision making, and the types of hospitalization. Although current evidence needs to be completed with further studies, it is already clear that group and family psychoeducation, cognitive remediation, community-based psychiatric services, and shared therapeutic decision making are essential approaches in the management of patients with psychosis.
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http://dx.doi.org/10.1097/NMD.0000000000001125DOI Listing
April 2020

Peer Role-Play for Training Communication Skills in Medical Students: A Systematic Review.

Simul Healthc 2020 Apr;15(2):106-111

From the Centre de Rééducation Neurologique Mutualiste Propara (A.G.), Parc Euromédecine, Montpellier; Centre Ressource de Réhabilitation Psychosociale (S.C., N.F.), CH Le Vinatier, Université de Lyon, UCBL, Faculté de Médecine Lyon-Sud Charles Mérieux, Oullins; Pôle Est (R.R.), CH Le Vinatier, Bron; Pôle Lyon-Sud de Simulation en Santé - (PL3S) (G.L., B.R.), Université de Lyon, UCBL, Faculté de Médecine Lyon-Sud Charles Mérieux, Oullins; Collège Universitaire de Médecine Générale (P.L.), Université de Montpellier, Montpellier; Service de Médecine Physique et de Réadaptation (A.D.), CHU de Nîmes, Université de Montpellier, Nîmes; CHU Montpellier, Service de Chirurgie Infantile (M.D.), Hôpital Lapeyronie, Montpellier; and SUAL (B.R.), Pôle MOPHA, CH Le Vinatier, Bron, France.

Statement: Peer role-play (PRP) is a simulation-based training method (SBTM) in which medical students alternately play the patient's and clinician's role. This review aimed to assess the effectiveness of PRP for improving the communication skills of medical students. A systematic search was conducted in the MedLine, PsycInfo, and ERIC databases. Studies were qualitatively analyzed according to the Kirkpatrick evaluation level (Kirkpatrick level) and the Medical Education Research Study Quality Instrument.Twenty-two studies were included. Studies assessing the "reaction" of students (Kirkpatrick level 1, n = 15) found that PRP was appreciated, whereas those assessing the effect of PRP on "learning" (Kirkpatrick level 2, n = 12) found that PRP improves communication skills but no more than other SBTMs. No study assessed real-life "attitudes" or "clinical outcomes" (Kirkpatrick levels 3 and 4), whereas 2 studies found that using PRP had a better cost-efficacy ratio than the use of simulated patients. Compared with other SBTMs, PRP improved communication skills similarly in medical students and seemed less expensive.
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http://dx.doi.org/10.1097/SIH.0000000000000412DOI Listing
April 2020

Psychiatric advance directives for people living with schizophrenia, bipolar I disorders, or schizoaffective disorders: Study protocol for a randomized controlled trial - DAiP study.

BMC Psychiatry 2019 12 27;19(1):422. Epub 2019 Dec 27.

School of medicine - La Timone Medical Campus, EA 3279: CEReSS - Health Service Research and Quality of Life Center, Aix-Marseille University, 27 Boulevard Jean Moulin, F-13005, Marseille Cedex 5, France.

Background: Compulsory admission to psychiatric hospital is rising despite serious ethical concerns. Among measures to reduce compulsory admissions, Psychiatric Advance Directives (PAD) are the most promising, with intensive PAD (i.e. facilitated and shared) being the most effective. The aim of the study is to experiment Psychiatric Advance Directives in France.

Methods: A multicentre randomized controlled trial and qualitative approach conducted from January 2019 to January 2021 with intent-to-treat analysis.

Setting: Seven hospitals in three French cities: Lyon, Marseille, and Paris. Research assistants meet each participant at baseline, 6 months and 12 months after inclusion for face-to-face interviews.

Participants: 400 persons with a DSM-5 diagnosis of bipolar I disorder (BP1), schizophrenia (SCZ), or schizoaffective disorders (SCZaff), compulsorily admitted to hospital within the last 12 months, with capacity to consent (MacCAT-CR), over 18 years old, and able to understand French.

Interventions: The experimental group (PAD) (expected n = 200) is invited to fill in a document describing their crisis plan and their wishes in case of loss of mental capacity. Participants meet a facilitator, who is a peer support worker specially trained to help them. They are invited to nominate a healthcare agent, and to share the document with them, as well as with their psychiatrist. The Usual Care (UC) group (expected n = 200) receives routine care.

Main Outcomes And Measures: The primary outcome is the rate of compulsory admissions to hospital during the 12-month follow-up. Secondary outcomes include quality of life (S-QoL18), satisfaction (CSQ8), therapeutic alliance (4-PAS), mental health symptoms (MCSI), awareness of disorders (SUMD), severity of disease (ICG), empowerment (ES), recovery (RAS), and overall costs.

Discussion: Implication of peer support workers in PAD, potential barriers of supported-decision making, methodological issues of evaluating complex interventions, evidence-based policy making, and the importance of qualitative evaluation in the context of constraint are discussed.

Trial Registration: ClinicalTrials.gov identifier: NCT03630822. Registered 14th August 2018.
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http://dx.doi.org/10.1186/s12888-019-2416-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6935101PMC
December 2019

Controversies in Midday Water Potential Regulation and Stomatal Behavior Might Result From the Environment, Genotype, and/or Rootstock: Evidence From Carménère and Syrah Grapevine Varieties.

Front Plant Sci 2019 2;10:1522. Epub 2019 Dec 2.

Facultad de Ciencias Agronómicas, Universidad de Chile, Santiago, Chile.

Controversies exist regarding the iso/anisohydric continuum for classifying plant water-use strategies. Isohydricity has been argued to result from plant-environment interaction rather than it being an intrinsic property of the plant itself. Discrepancies remain regarding the degree of isohydricity (σ) of plants and their threshold for physiological responses and resistance to drought. Thus, the aim of this study was to evaluate the isohydricity of the grapevine varieties Syrah and Carménère under a non-lethal water deficit progression from veraison from two different locations, the Cachapoal Valley (CV) and Maipo Valley (MV), in central Chile and with different rootstock only in Syrah. For this purpose, the midday stem water potential (Ψ) regulation and stomatal responses to drought, leaf traits related to pressure-volume curves, stomatal sensitivity to ABA, cavitation threshold, and photosynthetic responses were assessed. A higher atmospheric water demand was observed in the CV compared to the MV, with lower Ψ values in the former for both varieties. Also, the σ values in Carménère were 1.11 ± 0.14 MPa MPa and 0.68 ± 0.18 MPa MPa in the CV and MV, respectively, and in Syrah they were 1.10 ± 0.07 MPa MPa in the CV and 0.60 ± 0.10 MPa MPa in the MV. Even though similar variations in σ between locations in both varieties were evident, Carménère plants showed a conserved stomatal response to Ψ in both study sites, while those of Syrah resulted in a higher stomatal sensitivity to Ψ in the site of lower σ. Besides the differences in seasonal weather conditions, it is likely that the different rootstock and clonal variability of each season in Syrah were able to induce coordinated changes in σ, Ψ, and osmotic potential at full turgor (π). On the other hand, irrespective of the σ, and given the similarity between the π and Ψ in leaves before drought, it seems that π could be a convenient tool for assessing the Ψ threshold values posing a risk to the plants in order to aid the irrigation decision making in grapevines under controlled water deficit. Finally, water deficits in vineyards might irreversibly compromise the photosynthetic capacity of leaves.
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http://dx.doi.org/10.3389/fpls.2019.01522DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6900739PMC
December 2019

A Transnosographic Self-Assessment of Social Cognitive Impairments (ACSO): First Data.

Front Psychiatry 2019 21;10:847. Epub 2019 Nov 21.

Reference Center for Cognitive Remediation and Psychosocial Rehabilitation (SUR-CL3R), Le Vinatier Hospital, Lyon, France.

Social cognition refers to the mental operations underlying social interactions. Given the major role of social cognitive deficits in the disability associated with severe psychiatric disorders, they therefore constitute a crucial therapeutic target. However, no easily understandable and transnosographic self-assessment scale evaluating the perceived difficulties is available. This study aimed to analyze the psychometric qualities of a new self-administered questionnaire (ACSo) assessing subjective complaints in different domains of social cognition from 89 patients with schizophrenia, schizoaffective disorders, bipolar disorders or autism. The results revealed satisfactory internal validity and test-retest properties allowing the computation of a total score along with four sub scores (attributional biases, social perception and knowledge, emotional perception and theory of mind). Moreover, the ACSo total score was correlated with other subjective assessments traditionally used in cognitive remediation practice but not with objective neuropsychological assessments of social cognition. In summary, the ACSo is of interest to complete the objective evaluation of social cognition processes with a subjective assessment adapted to people with serious mental illness or autism spectrum disorder.
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http://dx.doi.org/10.3389/fpsyt.2019.00847DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6881457PMC
November 2019

Is social cognitive training efficient in autism? A pilot single-case study using the RC2S+ program.

Neurocase 2019 12 15;25(6):217-224. Epub 2019 Sep 15.

University Department of Rehabilitation (SUR-CL3R), Le Vinatier hospital , Lyon , France.

In high-functioning autism, deficits in emotional processing and theory of mind are relevant to understanding the particularities of social functioning. Here we used a multiple baseline and ABA single-case design to assess the efficacy of an individualized social cognitive training program using both pen-and-paper and computerized materials for an 18-year old patient. After the treatment phase, we found significant improvement in both emotional processes and theory of mind. These results provide further significant data showing that therapeutic tools based on digital relational simulation are a promising way for helping people with autism to compensate for their impaired social functioning.
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http://dx.doi.org/10.1080/13554794.2019.1666877DOI Listing
December 2019

Functioning and cognitive characteristics of clozapine users referred to psychosocial rehabilitation centers: A REHABase cohort study.

Psychiatry Res 2019 11 28;281:112543. Epub 2019 Aug 28.

Centre Ressource de Réhabilitation Psychosociale et de Remédiation Cognitive (CRR), Hôpital Le Vinatier, Centre National de la Recherche Scientifique (CNRS) et Université de Lyon, Lyon, France; Centre Référent Lyonnais de Réhabilitation Psychosociale (CL3R), Centre Hospitalier Le Vinatier, Lyon, France.

Objectives: To explore whether clozapine users have specific rehabilitation needs compared to users of other antipsychotics.

Methods: The study was performed using the REHABase collecting data on persons referred to a French network of psychosocial rehabilitation centers. It was restricted to persons with schizophrenia spectrum disorder using antipsychotics. Multivariate analyses were used to compare baseline functioning and cognitive characteristics in clozapine users vs. users of other antipsychotics.

Results: Of the 675 patients identified in the REHABase, one out of ten (n = 70) used clozapine. Compared to users of other antipsychotics, clozapine users had been more frequently hospitalized in psychiatry and presented less frequently with psychoactive substance use. Functional measures did not significantly differ between the two groups. Clozapine users had poorer short-term verbal memory performance than users of other antipsychotics and did not differ on executive performance.

Conclusion: Clozapine users may reach a recovery level comparable to that obtained in persons without treatment-resistant schizophrenia. In order to reduce the negative impact of memory deficits on the recovery process of clozapine users, it is necessary to optimize their psychotropic treatment and to promote their access to cognitive remediation programs addressing their specific needs.
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http://dx.doi.org/10.1016/j.psychres.2019.112543DOI Listing
November 2019

Exploratory case study of monozygotic twins with 22q11.2DS provides further clues to circumscribe neurocognitive markers of psychotic symptoms.

Neuroimage Clin 2019 17;24:101987. Epub 2019 Aug 17.

GénoPsy, Centre de Référence Maladies Rares à Expression Psychiatrique, Centre Hospitalier Le Vinatier, 95 bd Pinel BP300.91, F-69 678 BRON Cedex, France; Equipe EDR-Psy, Institut de Sciences Cognitives Marc Jeannerod, CNRS-UMR5229 & Université Lyon 1 Claude Bernard, 67 bd Pinel, F-69 500 BRON, France. Electronic address:

Variation in facial emotion processing abilities may contribute to variability in penetrance for psychotic symptoms in 22q11.2DS. However, the precise nature of the social cognitive dysfunction (i.e., facial expression perception vs. emotion recognition), the potential additional roles of genetic and environmental variabilities, and consequently the possibility of using this neurocognitive marker in clinical monitoring remain unclear. The present case study aimed at testing the hypothesis that when confounding factors are controlled, the presence of psychotic symptoms in 22q11.2DS is associated, at the individual level, with a neural marker of facial expression perception rather than explicit emotional face recognition. Two monozygotic twins with 22q11.2DS discordant for psychiatric manifestations performed (1) a classical facial emotion labelling task and (2) an implicit neural measurement of facial expression perception using a frequency-tagging approach in electroencephalography (EEG). Analysis of the periodic brain response elicited by a change of facial expression from neutrality indicated that the twin with psychotic symptoms did not detect emotion among neutral faces while the twin without the symptoms did. In contrast, both encountered difficulties labelling facial emotion. The results from this exploratory twin study support the idea that impaired facial expression perception rather than explicit recognition of the emotion expressed might be a neurocognitive endophenotype of psychotic symptoms that could be reliable at a clinical level. Although confirmatory studies should be required, it facilitates further discussion on the etiology of the clinical phenotype in 22q11.2DS.
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http://dx.doi.org/10.1016/j.nicl.2019.101987DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6713843PMC
September 2020

Corpus callosum metrics predict severity of visuospatial and neuromotor dysfunctions in ARID1B mutations with Coffin-Siris syndrome.

Psychiatr Genet 2019 12;29(6):237-242

Faculty of Medicine, University of Paris Descartes (SPC) INSERM UMR 1178/1018-CESP, University of Paris Sud-Paris Saclay, UVSQ Villejuif and Paris Descartes, SPC.

ARID1B mutations in Coffin-Siris syndrome are a cause of intellectual disability (0.5-1%), with various degrees of autism and agenesis of the corpus callosum (10%). Little is known regarding the cognitive and motor consequences of ARID1B mutations in humans and no link has been made between corpus callosum anomalies and visuospatial and neuromotor dysfunctions. We have investigated the visuospatial and neuromotor phenotype in eight patients with ARID1B mutations. A paramedian sagittal section of the brain MRI was selected, and corpus callosum was measured in anteroposterior length, genu and trunk width. Spearman's rank order coefficients were used to explore correlations between visuospatial and social cognitive variables and dimensions of the corpus callosum. A significant correlation between genu width size and visual cognition was observed. Retrocerebellar cysts were associated with corpus callosum anomalies. Here, we show that corpus callosum anomalies caused in ARID1B mutations may be predictive of the visuospatial and motor phenotype in Coffin-Siris syndrome.
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http://dx.doi.org/10.1097/YPG.0000000000000225DOI Listing
December 2019

A reflection upon methods to explore timing in patients with schizophrenia.

Psych J 2019 Mar;8(1):82-89

INSERM U1114, Psychiatric Center, University of Strasbourg, Regional University Hospital of Strasbourg, University of Strasbourg, Strasbourg, France.

Phenomenologists have provided a detailed description of the disorders of the subjective experience associated with minimal-self disorders in patients with schizophrenia. Those patients report a range of distortions of their conscious experiences, including a sense of inner void, confusion between self and others, and, sometimes, a disruption of the sense of time. These reports have been interpreted as distortion of the first-person perspective and a lack of immersion in the world, associated with a breakdown of the temporal structure of consciousness, and especially a disruption of the sense of time continuity. Further, it has been proposed that these disruptions are based on a difficulty to retain past information and to predict future information, that is, the mechanisms that help to relate events with one another and to reach a sense of time continuity. Experimental psychology results seem to converge to similar conclusions, inasmuch as some results in patients with schizophrenia suggest a deficient ability to predict sequences of events at the millisecond level. Several studies have underlined this convergence. Here we reflect on the limits of both the phenomenological and experimental psychology approaches, and of the convergence of their hypotheses. We think that this reflection is necessary to avoid premature conclusions on the mechanisms underlying the impairments in patients, but also to enrich our understanding of schizophrenia.
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http://dx.doi.org/10.1002/pchj.268DOI Listing
March 2019

Neuroimaging Studies of Cognitive Function in Schizophrenia.

Adv Exp Med Biol 2019;1118:117-134

Centre Ressource de Réhabilitation Psychosociale et Remédiation Cognitive, Lyon, France.

Persons suffering from schizophrenia present cognitive impairments that have a major functional impact on their lives. Particularly, executive functions and episodic memory are consistently found to be impaired. Neuroimaging allows the investigation of affected areas of the brain associated with these impairments and, moreover, the detection of brain functioning improvements after cognitive remediation interventions. For instance, executive function impairments have been associated with prefrontal cortex volume and thickness; cognitive control impairments are correlated with an increased activation in the anterior cingulate cortex, and episodic memory impairments are linked to hippocampal reduction. Some findings suggest the presence of brain compensatory mechanisms in schizophrenia, e.g. recruiting broader cortical areas to perform identical tasks. Similarly, neuroimaging studies of cognitive remediation in schizophrenia focus differentially on structural, functional and connectivity changes. Cognitive remediation improvements have been reported in two main areas: the prefrontal and thalamic regions. It has been suggested that those changes imply a functional reorganisation of neural networks, and cognitive remediation interventions might have a neuroprotective effect. Future studies should use multimodal neuroimaging procedures and more complex theoretical models to identify, confirm and clarify these and newer outcomes. This chapter highlights neuroimaging findings in anatomical and functional brain correlates of schizophrenia, as well as its application and potential use for identifying brain changes after cognitive remediation.
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http://dx.doi.org/10.1007/978-3-030-05542-4_6DOI Listing
August 2019

An implicit and reliable neural measure quantifying impaired visual coding of facial expression: evidence from the 22q11.2 deletion syndrome.

Transl Psychiatry 2019 02 4;9(1):67. Epub 2019 Feb 4.

Reference Center for Rare Diseases with Psychiatric Phenotype - GénoPsy, Centre Hospitalier le Vinatier, Marc Jeannerod Institute (CNRS & Claude Bernard Lyon 1 University), Bron, France.

Although various psychiatric disorders present with social-cognitive impairment, a measure assessing social-cognitive processes implicitly and reliably, with high selectivity and with enough signal-to-noise ratio (SNR) for individual evaluation of any population at any age, is lacking. Here we isolate a neural marker quantifying impaired visual coding of facial expression in individuals with 22q11.2 deletion syndrome (22q11DS) using frequency-tagging with electroencephalography (EEG). Twenty-two 22q11DS participants and 22 healthy controls were presented with changes of facial expression displayed at low, moderate, and high intensities every five cycles in a stream of one neutral face repeating 6 times per second (i.e., at a 6 Hz base rate). The brain response to expression changes tagged at the 1.2 Hz (i.e., 6 Hz/5) predefined frequency was isolated over occipito-temporal regions in both groups of participants for moderate- and high-intensity facial expressions. Neural sensitivity to facial expression was reduced by about 36% in 22q11DS, revealing impaired visual coding of emotional facial signals. The significance of the expression-change response was estimated for each single participant thanks to the high SNR of the approach. Further analyses revealed the high reliability of the response and its immunity from other neurocognitive skills. Interestingly, response magnitude was associated with the severity of positive symptoms, pointing to a potential endophenotype for psychosis risk. Overall, the present study reveals an objective, selective, reliable, and behavior-free signature of impaired visual coding of facial expression implicitly quantified from brain activity with high SNR. This novel tool opens avenues for clinical practice, providing a potential early biomarker for later psychosis onset and offering an alternative for individual assessment of social-cognitive functioning in even difficult-to-test participants.
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http://dx.doi.org/10.1038/s41398-019-0411-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6362075PMC
February 2019
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