En neuro-oncologie pédiatrique, les études neurocognitives et neuropsychologiques sur les tumeurs hémisphériques (sus-tentorielles) sont plus rares que celles sur les tumeurs de la fosse postérieure (sous-tentorielles), bénignes (notamment l’astrocytome pilocytique du cervelet) ou malignes (en particulier, le médulloblastome qui est la tumeur maligne la plus fréquente chez l’enfant). A l’heure actuelle il n’existe pas, à notre connaissance, de séries publiées de cas d’enfants traités pour tumeur frontale, bénigne ou maligne et même les descriptions isolées d’un seul cas restent rares (Daigneault, S & al, 1997 ; Anderson, S.W, 2000). Il existe des séries de cas de tumeur frontale chez l’adulte (Roca & al, 2010 ; Yong-Gao & al, 2012). Il existe par contre une littérature importante porte sur le devenir et les séquelles des enfants traités pour une tumeur de la fosse postérieure. En effet, les progrès thérapeutiques ont amélioré les taux de survie, et plusieurs équipes ont examinés l’impact de différents facteurs (essentiellement mais pas exclusivement médicaux : topographie lésionnelle, âge d’apparition de la tumeur, nature des traitements et complications, etc., mais aussi niveau d’éducation des parents, etc.) sur les séquelles motrices et cognitives, le devenir et la qualité de vie de ces enfants et adolescents. Entre septembre 2010 et septembre 2011, 21 patients âgés entre 8 ans 3 mois et 27 ans 10 mois au moment de l’évaluation neuropsychologique ont été inclus dans cette étude. L’évaluation neuropsychologique, réalisée en deux temps, incluait des tests (tests papier-crayon et épreuves écologiques) évaluant l’efficience intellectuelle, des fonctions exécutives, d’attention, et de théorie de l’esprit. 44 patients contrôles ont été appariés en âge, sexe et NSC (niveau socio-économique) au groupe de patients. Au niveau statistique d’importantes différences sont relevées, notamment, dans les épreuves de reconnaissance d’expressions faciales émotionnelles. Il s’agit de la 1ère étude qui évalue les fonctions cognitives et affectives dans un groupe de patients ayant été traités dans l’enfance pour une tumeur frontale bénigne ou maligne. / Frontal lesions in children and adolescents have been mainly explored in traumatic brain injury (TBI). Other frontal lobe pathologies such as frontal lobe epilepsy (FLE), frontal focal lobe lesion, such as brain tumours or frontal focal lobe pathologies, can explain sequelae after frontal lobe pathologies. In the literature only two cases studies exist on benign frontal lobe tumour in children. To our knowledge there is no study group of frontal lobe tumours in children. Between September 2010 and September 2011, we observed 21 patients treated for benign/malign tumours. We examined 22 young patients aged between 8.3 years and 27.10 years old, all treated for benign or malign frontal tumour in Gustave Roussy’s Institute (in case of malign tumour) or Necker Enfants-Malades (in case of malign tumour). Treatment of this patients depended on benign or malign tumour. A total of 44 controls subjects were enrolled in study. All children and adolescents had neuropsychological tests, such as executive function tests (planning, mental flexibility, attention, working memory tasks) and measure or theory of mind tests such as face recognition test (TOM). All children were seen twice. Main differences are observed in facial recognition test between patients with malign and benign tumours and control subjects. IQ in not affected when tumours are benign, and most children obtain normal performances in executive tests. This is a first study with comprehensive neuropsychological assessment of children and adolescents with frontal lobe tumours. Findings have to be compared with classical studies of frontal lobe lesions in adults. Results suggest that many children treated for frontal lobe tumours do not present the classical dysexecutive syndrome and major behavioural changes as described in adults. However most of them present deficits in facial recognition of emotions and gesture imitations deficits.

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京都大学 / 0048 / 新制・課程博士 / 博士(医学) / 甲第19366号 / 医博第4043号 / 新制||医||1011(附属図書館) / 32380 / 新制||医||1011 / 京都大学大学院医学研究科医学専攻 / (主査)教授 渡邉 大, 教授 福田 和彦, 教授 村井 俊哉 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

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Frontal Alpha Asymmetry (FAA) has been associated with individual differences such as various aspects of personality. However, the nature of the relationship between FAA and personality traits is not yet fully understood. The present study further investigated this relationship by exploring the correlation between resting-state FAA and the Big Five personality traits: openness, agreeableness, conscientiousness, extraversion, and neuroticism. 15 healthy participants completed resting-state EEG recordings three times and the Big Five Personality Inventory (BFI) twice. The results showed only one statistically significant correlation among the 20 correlations examined, between the F4-F3 resting-state FAA and openness scores. Besides, the direction of the relationship was the opposite of what would be expected. The small sample size of this study may have contributed to results, indicating the need for future research with larger samples. Nonetheless, the current findings add to the existing literature and suggest that the relationship between resting-state FAA and personality traits may be more complex than previously thought.

The current paper examined the relationship between frontal alpha asymmetry (FAA) and threatening face stimuli. Participants were presented with threatening faces, and this was compared to non-threatening (neutral) faces, on the assumption that the threatening faces would trigger a withdrawal motivation and a corresponding decrease in state FAA scores. The EEG data used in the present analysis was taken from an earlier study at the University of Skövde, consisting of twenty-eight participants with no reported current ongoing neurological or psychiatric illnesses, or epilepsy. Based on the paired samples t-test there was no significant statistical difference between participants’ FAA scores in the threatening and non-threatening conditions. The relatively small sample of the present study may be a contributing factor. Furthermore, threatening face images may elicit weaker responses than non-facial images such as threatening images of domestic violence or natural disasters. In the future, the field of FAA may benefit from investigating the connection between FAA and non-facial threatening and non-threatening images, instead of faces.

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Individuals with Traumatic Brain Injury (TBI) exhibit impaired performance on social cognition and theory of mind (ToM) measures, like the Video Social Inference Test (VSIT). The frontal lobe, being the primary region involved in higher level cognitive functions mediates the neural mechanisms involved in social cognition and ToM abilities, according to studies on brain and behaviour. The goal of this study was to examine if individuals with TBI who did not damage their frontal lobe would perform differently on the VSIT than individuals with TBI who did. This study was a secondary analysis of documented imaging data and VSIT scores obtained from 51 adults with moderate-to-severe TBI (23 females). A comparison was made between scores obtained on the VSIT between participants with and without frontal lobe lesions. The results indicated that there was no significant difference between the two groups, in other words, site of lesion in participants with TBI did not predict performance on the VSIT. The results suggest that while the VSIT may yield critical information about social cognition, it is not sensitive to individual site of lesion. There is evidence that aspects of social cognition are impaired in this clinical population, however, most research in this area is obstructed by the complex nature of TBI neuropathology in addition to small heterogenous samples involved in studies. Further research in this area is required in order to reveal and enhance our understanding of social cognition deficits following TBI. Keywords: social cognition, traumatic brain injury, theory of mind, frontal lobe lesions, video social inference test / Thesis / Master of Science (MSc)

Background: Postpartum Depression (PPD) affects up to one in five mothers. While psychotherapy can effectively reduce symptoms of PPD, it is unclear how PPD treatment affects maternal psychophysiology. Determining physiological changes in response to cognitive behavioural therapy (CBT) could provide insights into the mechanisms underlying effective treatment and/or help predict treatment outcomes. This study examined if treating PPD with CBT led to changes in frontal cortical activity and heart rate variability, two markers of maternal emotion regulatory capacity. Methods: Community-dwelling mothers with PPD (Edinburgh Postnatal Depression Scores ≥10) were randomized to receive nine weeks of group CBT delivered by recovered peers (i.e., those who had previously recovered from PPD) (n=26) or be put on a waitlist to receive the intervention nine weeks later (n=24). Electroencephalographic (frontal alpha asymmetry), electrocardiographic (heart rate variability), and clinical (depression, anxiety) data were collected at baseline and nine weeks later. Results: Participants in both the immediate treatment and waitlist control groups reported moderate levels of depression and anxiety at baseline. After treatment, mothers in the treatment group showed greater improvements in depression (p<0.01, Cohen d=1.22), and anxiety (p<0.005, Cohen d = 1.48), and high-frequency heart rate variability (p<0.05, Cohen d=0.70), but not frontal alpha asymmetry, compared to the waitlist control group. Conclusion: Group CBT for PPD can improve symptoms of depression and anxiety and parasympathetic nervous system function. Future research should attempt to replicate and extend these findings using larger samples, additional biomarkers, and longer periods of follow up. Examining how evidence-based treatments for PPD affect maternal psychophysiology can improve our understanding and potentially predict treatment effects. / Thesis / Master of Science (MSc) / Postpartum depression affects up to one in five mothers in the first year after delivery. When treated promptly with talking therapies (i.e., psychotherapy) such as cognitive behavioural therapy (CBT), many experience significant improvements in their symptoms. However, the changes occurring in the brain and the remainder of the nervous system occurring in response to psychotherapy is not well known. It is important that this is understood so that we can develop more effective treatments and better predict who will respond to different types of treatments. In particular, the role of the frontal lobe of the brain, and the body’s parasympathetic system is poorly understood in the context of PPD. This thesis aimed to examine the impact of CBT on women’s frontal lobe functioning using a measure called frontal alpha asymmetry (FAA) measured via electroencephalography (EEG), and parasympathetic nervous system-based heart rate variability (HRV) using electrocardiography (ECG). In this study, we compared mothers with PPD treated with CBT to those who did not receive this treatment. We found that HRV responded in mothers who received CBT compared to women who were in the control group. No significant changes were found for FAA after treatment. These results suggest that HRV may be explored further as a valid treatment outcome for CBT when provided to women with PPD.