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  • Authors: J-A, Micoulaud-Franchi; C, Quilès; M, Cermolacce; R, Belzeaux; +3 Authors

    The first objective of this article is to summarize the history of electroconvulsive therapy (ECT) in psychiatry in order to highlight the transition from clinical level of evidence based on phenomenological descriptions to controlled trial establishing causal relationship. The second objective is to apply the criteria of causation for ECT, to focus on the dose-effect relationship criteria, and thus to analyze the conditions of application of these criteria for ECT.A literature review exploring the use of electricity, ECT and electroencephalography (EEG) in psychiatry was conducted. The publications were identified from the Pubmed and GoogleScholar electronic databases. The scientific literature search of international articles was performed in July 2016.In 1784, a Royal commission established in France by King Louis XVI tested Mesmer's claims concerning animal magnetism. By doing that, the commission, including such prominent scientists as the chemist Anton Lavoisier and the scientist and researcher on electricity and therapeutics Benjamin Franklin, played a central role in establishing the criteria needed to assess the level of evidence of electrical therapeutics in psychiatry. Surprisingly, it is possible to identify the classical Bradford Hill criteria of causation in the report of the commission, except the dose-effect relationship criteria. Since then, it has been conducted blinded randomized controlled trials that confirmed the effectiveness of ECT against ECT placebos for the treatment of psychiatric disorders. At present, the dose-effect relationship criteria can be analyzed through an EEG quality assessment of ECT-induced seizures.EEG quality assessment includes several indices: TSLOW (time to onset of seizure activity ≤5Hz, seconds), peak mid-ictal amplitude (mm), regularity (intensity or morphology of the seizure (0-6)), stereotypy (global seizure patterning, 0-3) and post-ictal suppression (0-3). A manual rating sheet is needed to score theses indices. Such manual rating with example of EEG segments recording is proposed in this article. Additional studies are needed to validate this manual, to better establish the dose-response relationship for the ECT, and thus strengthen the position of the EEG as a central element for clinical good practice for ECT.

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  • Authors: A, Joffroy;
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  • Authors: L, Glavtcheva;
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  • Authors: A, Czorny; J L, Roche;

    In infants, two types of pathologies require treatment for osteomeningeal substance losses of the cranial vault: --posttraumatic skull fracture dehiscence, --decompressive craniectomy for neonatal intracranial hematomas. Osseous dehiscence alone does not explain the pathogenesis of the condition, and treatment must take subjacent lesions into account. The progressive nature of these lesions is linked to the considerable brain growth that reaches its maximum during the first year of life. Pressure is also exerted by contingent phenomena: the edema caused by the subjacent brain contusion and hydrocephalus. Treatment principles include: --insertion of a normal vault, with its two tables, opposite a sutured meninges or a membrane that has been replaced by a more or less pedunculated pericranial autoplasty, --creation of contact between the bone defect and healthy dura mater that has conserved its outer osteogenic layer and, if possible, a healthy pedunculated pericranium. The authors propose 180 degrees flap rotations for extensive losses of substance and 90 degrees rotations after synthesis of a fracture. In cases of a frontal lesion or extensive craniectomy, flap exchange procedures are recommended; periosteal flaps are used for covering purposes, respecting the principles above for the donor sites. These techniques have been used for three cases of traumatic osteo-dural tears and 3 craniectomies; short term and especially long term results are satisfactory.

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  • Authors: M, Collard; C, Conraux; M S, Thiébaut; F, Thiébaut;

    pmid: 56

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  • Authors: D, Trono; Y, Kapanci;

    An autopsy study of 218 cases of lymphoproliferative disease was performed to establish the cause of death. It covered 144 cases of malignant nonHodgkin's lymphoma, 23 cases of Hodgkin's disease and 51 cases of myeloma. It was established that infection is by far the most frequent cause (34% of cases) followed by tumor invasion (11.5% of cases), hemorrhage (9% of cases) and other pathologies linked to the basic process (10% of cases). The proportion of patients who die from intercurrent illness is still considerable (62 cases, 28%). Infection is most often pulmonary or systemic; gram-negative bacteria play a predominant role. Toxicity of treatment is obvious in causing neutropenia and thrombocytopenia among other side effects with fatal consequences.

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  • Authors: A, Hedjoudje; S, Torre; S, Bekri; A-M, Guerrot; +3 Authors
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  • Authors: E, Aron; M, Bruneau; F, Laffont; G, Lelord; +1 Authors

    During a preliminary study comparing 5 normal subjects and 5 alcoholics (25 experiments) changes in evoked potentials were found in these patients. There was mainly a reduction in these potentials during the first 100 milleseconds following stimulation. Such a reduction generally means a disorder of the arrival of the influx at the level of the cortex and may be found mainly in peripheral nerve involvement. A complementary study of the H reflex (34 experiments) showed that this reflex was affected in 60% of chronic alcoholics whether or not they had liver cirrhosis. The theory according to which the EEG abnormalities observed may be linked to a metabolic disorder of the amino-acids was not confirmed. The changes of the first 100 milleseconds of the evoked potential associated with the change in Hoffman's reflex are in favour of early peripheral involvement even in alcoholics who do not appear to have any peripheral neuritis. These signs are different from those which are observed in marijuana or psylocybine poisoning where the EEG signs are due to central involvement.

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  • Authors: A, Rougeul; J, Verdeaux;

    pmid: 45382

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  • Authors: M, Sindou; M, Alaywan;

    The authors describe the technique of removal of the orbital rim, the zygomatic arch and the combination of both, i.e., the orbito-zygomatic arch. Then they give the summary of an anatomical study in human cadavers (13 approaches), measuring the field view angle (F.V.A.) of various intra-cranial targets in the vicinity of the skull base after orbital and/or zygomatic removal associated to fronto-temporal craniotomy. Thanks to orbital and/or zygomatic removal, F.V.A. was increased on average, by 75% in the sub-frontal approach, 46% in the pterional approach, and 86% in the sub-temporal approach. Finally the authors illustrate the usefulness of these combined approaches in a series of 24 cases of various difficult lesions located in the vicinity of the skull base, operated on during the last 3 years.

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The following results are related to Neuroinformatics. Are you interested to view more results? Visit OpenAIRE - Explore.
12,476 Research products
  • Authors: J-A, Micoulaud-Franchi; C, Quilès; M, Cermolacce; R, Belzeaux; +3 Authors

    The first objective of this article is to summarize the history of electroconvulsive therapy (ECT) in psychiatry in order to highlight the transition from clinical level of evidence based on phenomenological descriptions to controlled trial establishing causal relationship. The second objective is to apply the criteria of causation for ECT, to focus on the dose-effect relationship criteria, and thus to analyze the conditions of application of these criteria for ECT.A literature review exploring the use of electricity, ECT and electroencephalography (EEG) in psychiatry was conducted. The publications were identified from the Pubmed and GoogleScholar electronic databases. The scientific literature search of international articles was performed in July 2016.In 1784, a Royal commission established in France by King Louis XVI tested Mesmer's claims concerning animal magnetism. By doing that, the commission, including such prominent scientists as the chemist Anton Lavoisier and the scientist and researcher on electricity and therapeutics Benjamin Franklin, played a central role in establishing the criteria needed to assess the level of evidence of electrical therapeutics in psychiatry. Surprisingly, it is possible to identify the classical Bradford Hill criteria of causation in the report of the commission, except the dose-effect relationship criteria. Since then, it has been conducted blinded randomized controlled trials that confirmed the effectiveness of ECT against ECT placebos for the treatment of psychiatric disorders. At present, the dose-effect relationship criteria can be analyzed through an EEG quality assessment of ECT-induced seizures.EEG quality assessment includes several indices: TSLOW (time to onset of seizure activity ≤5Hz, seconds), peak mid-ictal amplitude (mm), regularity (intensity or morphology of the seizure (0-6)), stereotypy (global seizure patterning, 0-3) and post-ictal suppression (0-3). A manual rating sheet is needed to score theses indices. Such manual rating with example of EEG segments recording is proposed in this article. Additional studies are needed to validate this manual, to better establish the dose-response relationship for the ECT, and thus strengthen the position of the EEG as a central element for clinical good practice for ECT.

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  • Authors: A, Joffroy;
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  • Authors: L, Glavtcheva;
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  • Authors: A, Czorny; J L, Roche;

    In infants, two types of pathologies require treatment for osteomeningeal substance losses of the cranial vault: --posttraumatic skull fracture dehiscence, --decompressive craniectomy for neonatal intracranial hematomas. Osseous dehiscence alone does not explain the pathogenesis of the condition, and treatment must take subjacent lesions into account. The progressive nature of these lesions is linked to the considerable brain growth that reaches its maximum during the first year of life. Pressure is also exerted by contingent phenomena: the edema caused by the subjacent brain contusion and hydrocephalus. Treatment principles include: --insertion of a normal vault, with its two tables, opposite a sutured meninges or a membrane that has been replaced by a more or less pedunculated pericranial autoplasty, --creation of contact between the bone defect and healthy dura mater that has conserved its outer osteogenic layer and, if possible, a healthy pedunculated pericranium. The authors propose 180 degrees flap rotations for extensive losses of substance and 90 degrees rotations after synthesis of a fracture. In cases of a frontal lesion or extensive craniectomy, flap exchange procedures are recommended; periosteal flaps are used for covering purposes, respecting the principles above for the donor sites. These techniques have been used for three cases of traumatic osteo-dural tears and 3 craniectomies; short term and especially long term results are satisfactory.

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  • Authors: M, Collard; C, Conraux; M S, Thiébaut; F, Thiébaut;

    pmid: 56

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  • Authors: D, Trono; Y, Kapanci;

    An autopsy study of 218 cases of lymphoproliferative disease was performed to establish the cause of death. It covered 144 cases of malignant nonHodgkin's lymphoma, 23 cases of Hodgkin's disease and 51 cases of myeloma. It was established that infection is by far the most frequent cause (34% of cases) followed by tumor invasion (11.5% of cases), hemorrhage (9% of cases) and other pathologies linked to the basic process (10% of cases). The proportion of patients who die from intercurrent illness is still considerable (62 cases, 28%). Infection is most often pulmonary or systemic; gram-negative bacteria play a predominant role. Toxicity of treatment is obvious in causing neutropenia and thrombocytopenia among other side effects with fatal consequences.

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  • Authors: A, Hedjoudje; S, Torre; S, Bekri; A-M, Guerrot; +3 Authors
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  • Authors: E, Aron; M, Bruneau; F, Laffont; G, Lelord; +1 Authors

    During a preliminary study comparing 5 normal subjects and 5 alcoholics (25 experiments) changes in evoked potentials were found in these patients. There was mainly a reduction in these potentials during the first 100 milleseconds following stimulation. Such a reduction generally means a disorder of the arrival of the influx at the level of the cortex and may be found mainly in peripheral nerve involvement. A complementary study of the H reflex (34 experiments) showed that this reflex was affected in 60% of chronic alcoholics whether or not they had liver cirrhosis. The theory according to which the EEG abnormalities observed may be linked to a metabolic disorder of the amino-acids was not confirmed. The changes of the first 100 milleseconds of the evoked potential associated with the change in Hoffman's reflex are in favour of early peripheral involvement even in alcoholics who do not appear to have any peripheral neuritis. These signs are different from those which are observed in marijuana or psylocybine poisoning where the EEG signs are due to central involvement.

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  • Authors: A, Rougeul; J, Verdeaux;

    pmid: 45382