En situation de perception audiovisuelle de la parole, comme lors des conversations face-àface,nous pouvons tirer partie des informations visuelles fournies par les mouvements orofaciauxdu locuteur. Ceci améliore l’intelligibilité du discours. L'objectif de ce travail était dedéterminer si ce « bénéfice audiovisuel » permet de mieux identifier les phonèmes quin’existent pas dans notre langue. Nos résultats révèlent que l’utilisation de l’informationvisuelle permet de surmonter les difficultés posées par la surdité phonologique dont noussommes victimes lors d'une présentation auditive seule (Etude 1). Une étude EEG indique quel’apport des informations visuelles au processus d’identification de phonèmes non natifspourrait être dû à une modulation précoce des traitements effectués par le cortex auditifprimaire (Etude 2). En présentation audiovisuelle les phonèmes non natifs donnent lieu à uneP50, ce qui n’est pas observé pour les phonèmes natifs. Il semblerait également quel'expérience linguistique affecte l'utilisation des informations visuelles puisque des bilinguesprécoces semblent moins aptes à exploiter ces indices pour distinguer des phonèmes qui neleur sont pas familiers (Etude 3). Enfin, l’étude de l’identification de consonnes plosivesnatives avec une tâche de dévoilement progressif nous a permis d’évaluer la contributionconjointe et séparée des informations auditives et visuelles (Etude 4). Nous avons observé quel’apport de la modalité visuelle n’est pas systématique et que la prédictibilité de l’identité duphonème dépend de la saillance visuelle des mouvements articulatoires du locuteur. / During audiovisual speech perception, like in face-to-face conversations, we can takeadvantage of the visual information conveyed by the speaker's oro-facial gestures. Thisenhances the intelligibility of the utterance. The aim of this work was to determine whetherthis “audiovisual benefit” can improve the identification of phonemes that do not exist in ourmother tongue. Our results revealed that the visual information contributes to overcome thephonological deafness phenomenon we experience in an audio only situation (Study 1). AnERP study indicates that this benefit could be due to the modulation of early processing in theprimary auditory cortex (Study 2). The audiovisual presentation of non native phonemesgenerates a P50 that is not observed for native phonemes. The linguistic background affectsthe way we use visual information. Early bilinguals take less advantage of the visual cuesduring the processing of unfamiliar phonemes (Study 3). We examined the identificationprocesses of native plosive consonants with a gating paradigm to evaluate the differentialcontribution of auditory and visual cues across time (Study 4). We observed that theaudiovisual benefit is not systematic. Phoneme predictability depends on the visual saliencyof the articulatory movements of the speaker.

INTRODUÇÃO: A diabetes mellitus tipo 2 (DM) é uma doença metabólica caracterizada pela presença de hiperglicemia crônica. Estudos prévios demonstraram que pacientes com pré-diabetes (PDM) têm uma história natural de progressão para DM. A neuropatia diabética é a complicação mais comum da DM e avanços recentes na neurofisiologia clínica trouxeram um refinamento das técnicas de avaliação. Entre estas estão à resposta cutânea simpática (SSR) e o teste sensorial quantitativo (QST). Biomarcadores como Enolase Neurônio-Específica (NSE) e a Proteína S100-Beta (S100B) vem sendo descritos por muitos autores como associados a danos em células do sistema nervoso. OBJETIVO: O objetivo deste estudo é avaliar parâmetros neurofisiológicos e compará-los com achados clínicos e bioquímicos (S100B e NSE) em pacientes com DM, PDM e controles saudáveis. MÉTODOS: Pacientes dos ambulatórios de Neurologia e Endocrinologia foram randomizados em um estudo transversal. Os participantes foram submetidos a uma bateria de testes clínicos e neurofisiológicos que englobaram condução nervosa, Onda-F, SSR e QST. Níveis séricos de NSE e S100B foram quantificados através de ensaio ELISA (Enzyme-linked immunosorbent assay). RESULTADOS: A avaliação clínica e os estudos de condução nervosa e Onda-F foram similares nos grupos estudados. Já os limiares QST calor (QSTc) e QST dor (QSTd) foram significativamente elevados nos pacientes PDM e DM com relação aos controles (P<0.05 para todas as comparações). No entanto, estes parâmetros não foram capazes de distinguir pacientes DM vs. PDM (P >0.1 para todas as comparações). O SSR foi capaz de diferenciar o grupo DM do controle (P <0,01) embora não tenha mostrado diferença entre os grupos PDM e controle (P = 0,6). Não houve diferença entre os níveis de S100B (P = 0.6) e NSE (P = 0.2) entre os grupos DM, PDM e controles. CONCLUSÃO: O QST e SSR são testes úteis para a avaliação de pacientes com diferentes graus de tolerância a glicose. Este estudo não encontrou diferenças entre os biomarcadores NSE e S100B em indivíduos com DM e PDM. / BACKGROUND: Type 2 diabetes mellitus (DM) is a metabolic disease characterized by the presence of chronic hyperglycemia. Previous studies demonstrated that patients with prediabetes states (PDM) have a natural history of progression to DM. Neuropathy is the most common and disabling complication of diabetes and recent advances in neurophysiology have enabled a refinement of neurophysiological diagnostic techniques such as sympathetic skin response (SSR) and quantitative sensory testing (QST). Biomarkers like Neuron-specific Enolase (NSE) and S100- Beta Protein (S100B) has been described for many authors as associated with damage at nervous system cells and are related with severity of injury as well as clinical outcomes. OBJECTIVE: The aim of this study is to evaluate neurophysiological findings and compare them with clinical and biochemical findings (S100B and NSE) in patients with DM, PDM and healthy controls. METHODS: Patients at the outpatient Neurology and Endocrinology service were randomized in a cross-sectional study. Participants underwent a battery of clinical and neurophysiological tests that encompassed nerve conduction studies, F-wave, SSR and QST. ELISA (enzyme-linked immunosorbent assay) were perform to quantify serum levels of NSE and S100B. RESULTS: There were no difference regarding clinical evaluation, nerve conduction studies and F-wave were between groups. The QST thresholds of warm (QSTw) and QST pain (QSTp) were significantly elevated in patients with PDM and DM compared to controls (P <0.05 for all comparisons). However, these parameters were not able to distinguish among DM and PDM (P > 0.1 for all comparisons). The SSR was able to differentiate DM from control group (P <0.01) but did not show difference between PDM and control groups (P = 0.6). There was no difference on levels of S100B (P = 0.6) and NSE (P = 0.2) between the DM, PDM and control groups. CONCLUSION: The QST and SSR are useful tests to evaluating patients with different degrees of glucose tolerance. This study found no differences between biomarkers NSE and S100B in subjects with DM and PDM.

INTRODUÇÃO: A diabetes mellitus tipo 2 (DM) é uma doença metabólica caracterizada pela presença de hiperglicemia crônica. Estudos prévios demonstraram que pacientes com pré-diabetes (PDM) têm uma história natural de progressão para DM. A neuropatia diabética é a complicação mais comum da DM e avanços recentes na neurofisiologia clínica trouxeram um refinamento das técnicas de avaliação. Entre estas estão à resposta cutânea simpática (SSR) e o teste sensorial quantitativo (QST). Biomarcadores como Enolase Neurônio-Específica (NSE) e a Proteína S100-Beta (S100B) vem sendo descritos por muitos autores como associados a danos em células do sistema nervoso. OBJETIVO: O objetivo deste estudo é avaliar parâmetros neurofisiológicos e compará-los com achados clínicos e bioquímicos (S100B e NSE) em pacientes com DM, PDM e controles saudáveis. MÉTODOS: Pacientes dos ambulatórios de Neurologia e Endocrinologia foram randomizados em um estudo transversal. Os participantes foram submetidos a uma bateria de testes clínicos e neurofisiológicos que englobaram condução nervosa, Onda-F, SSR e QST. Níveis séricos de NSE e S100B foram quantificados através de ensaio ELISA (Enzyme-linked immunosorbent assay). RESULTADOS: A avaliação clínica e os estudos de condução nervosa e Onda-F foram similares nos grupos estudados. Já os limiares QST calor (QSTc) e QST dor (QSTd) foram significativamente elevados nos pacientes PDM e DM com relação aos controles (P<0.05 para todas as comparações). No entanto, estes parâmetros não foram capazes de distinguir pacientes DM vs. PDM (P >0.1 para todas as comparações). O SSR foi capaz de diferenciar o grupo DM do controle (P <0,01) embora não tenha mostrado diferença entre os grupos PDM e controle (P = 0,6). Não houve diferença entre os níveis de S100B (P = 0.6) e NSE (P = 0.2) entre os grupos DM, PDM e controles. CONCLUSÃO: O QST e SSR são testes úteis para a avaliação de pacientes com diferentes graus de tolerância a glicose. Este estudo não encontrou diferenças entre os biomarcadores NSE e S100B em indivíduos com DM e PDM. / BACKGROUND: Type 2 diabetes mellitus (DM) is a metabolic disease characterized by the presence of chronic hyperglycemia. Previous studies demonstrated that patients with prediabetes states (PDM) have a natural history of progression to DM. Neuropathy is the most common and disabling complication of diabetes and recent advances in neurophysiology have enabled a refinement of neurophysiological diagnostic techniques such as sympathetic skin response (SSR) and quantitative sensory testing (QST). Biomarkers like Neuron-specific Enolase (NSE) and S100- Beta Protein (S100B) has been described for many authors as associated with damage at nervous system cells and are related with severity of injury as well as clinical outcomes. OBJECTIVE: The aim of this study is to evaluate neurophysiological findings and compare them with clinical and biochemical findings (S100B and NSE) in patients with DM, PDM and healthy controls. METHODS: Patients at the outpatient Neurology and Endocrinology service were randomized in a cross-sectional study. Participants underwent a battery of clinical and neurophysiological tests that encompassed nerve conduction studies, F-wave, SSR and QST. ELISA (enzyme-linked immunosorbent assay) were perform to quantify serum levels of NSE and S100B. RESULTS: There were no difference regarding clinical evaluation, nerve conduction studies and F-wave were between groups. The QST thresholds of warm (QSTw) and QST pain (QSTp) were significantly elevated in patients with PDM and DM compared to controls (P <0.05 for all comparisons). However, these parameters were not able to distinguish among DM and PDM (P > 0.1 for all comparisons). The SSR was able to differentiate DM from control group (P <0.01) but did not show difference between PDM and control groups (P = 0.6). There was no difference on levels of S100B (P = 0.6) and NSE (P = 0.2) between the DM, PDM and control groups. CONCLUSION: The QST and SSR are useful tests to evaluating patients with different degrees of glucose tolerance. This study found no differences between biomarkers NSE and S100B in subjects with DM and PDM.

L’évolution du Syndrome Douloureux Régional Complexe (SDRC) peut aboutir à un état de douleur chronique invalidant et difficile à traiter. Parmi les stratégies thérapeutiques utilisables, la kétamine, administrée sur 5 jours à des doses infra-anesthésiques, a une place de choix. Cependant, il s'agit d'un traitement invasif et dont le mécanisme d'action antalgique n'est pas connu. Notre travail a porté sur deux aspects du traitement du SDRC par la kétamine: la prédiction de l’efficacité thérapeutique et la compréhension des mécanismes d'action. Dans un premier temps, chez 105 patients SDRC, nous avons évalué l'intérêt de la scintigraphie osseuse au Technétium 99 réalisée avant le traitement pour prédire l’efficacité thérapeutique de la kétamine. Cette efficacité était corrélée à l’augmentation relative de l'activité inflammatoire et du remodelage osseux objectivée par scintigraphie. Dans une deuxième étude, portant sur l’évaluation de l’excitabilité corticale par stimulation magnétique transcrânienne et incluant 19 patients SDRC, nous avons observé que la kétamine réprimait fortement et de façon bilatérale la facilitation intracorticale, paramètre de transmission glutamatergique, et en revanche restaurait l’inhibition intracorticale correspondant au côté douloureux, paramètre gabaergique qui était très altéré avant le traitement. L'effet antalgique de la kétamine était corrélé à cette restauration d'inhibition ainsi qu'à la réduction de la facilitation correspondant au côté sain. Ainsi, la kétamine semble jouer un rôle dans la balance d'influences gabaergiques et glutamatergiques transcalleuses. Ce travail a permis de caractériser de nouveaux mécanismes physiopathologiques ainsi qu’une nouvelle justification de l’efficacité thérapeutique de la kétamine dans le SDRC. / Regional Complex Pain Syndrome (CRPS) can result in a chronic pain condition that is disabling and difficult to treat. Among the therapeutic strategies that can be used, ketamine, administered over 5 days at infra-anesthetic doses, has a place of choice. However, it is an invasive treatment and the mechanism of analgesic action is not known. Our work focused on two aspects of the treatment of CRPS by ketamine: predicting therapeutic efficacy and understanding mechanisms of action. Initially, in 105 CRPS patients, we assessed the benefit of pre-treatment Technetium 99 bone scintigraphy to predict the therapeutic efficacy of ketamine. This efficacy was correlated with the relative increase in inflammatory activity and bone remodeling detected by scintigraphy. In a second study, evaluating cortical excitability by transcranial magnetic stimulation and including 19 CRPS patients, we observed that ketamine strongly and bilaterally repressed intracortical facilitation, a glutamatergic transmission parameter, and on the other hand restored the intracortical inhibition corresponding to the pain side, a gabaergic parameter which was very altered before the treatment. The analgesic effect of ketamine was correlated with this restoration of inhibition as well as the reduction of the facilitation corresponding to the healthy side. Thus, ketamine seems to play a role in the balance of gabaergic and glutamatergic transcallosal influences. This work allowed new physiopathological mechanisms to be characterized as well as a new justification of the therapeutic efficacy of the ketamine in the CRPS.

INTRODUÇÃO: A diabetes mellitus tipo 2 (DM) é uma doença metabólica caracterizada pela presença de hiperglicemia crônica. Estudos prévios demonstraram que pacientes com pré-diabetes (PDM) têm uma história natural de progressão para DM. A neuropatia diabética é a complicação mais comum da DM e avanços recentes na neurofisiologia clínica trouxeram um refinamento das técnicas de avaliação. Entre estas estão à resposta cutânea simpática (SSR) e o teste sensorial quantitativo (QST). Biomarcadores como Enolase Neurônio-Específica (NSE) e a Proteína S100-Beta (S100B) vem sendo descritos por muitos autores como associados a danos em células do sistema nervoso. OBJETIVO: O objetivo deste estudo é avaliar parâmetros neurofisiológicos e compará-los com achados clínicos e bioquímicos (S100B e NSE) em pacientes com DM, PDM e controles saudáveis. MÉTODOS: Pacientes dos ambulatórios de Neurologia e Endocrinologia foram randomizados em um estudo transversal. Os participantes foram submetidos a uma bateria de testes clínicos e neurofisiológicos que englobaram condução nervosa, Onda-F, SSR e QST. Níveis séricos de NSE e S100B foram quantificados através de ensaio ELISA (Enzyme-linked immunosorbent assay). RESULTADOS: A avaliação clínica e os estudos de condução nervosa e Onda-F foram similares nos grupos estudados. Já os limiares QST calor (QSTc) e QST dor (QSTd) foram significativamente elevados nos pacientes PDM e DM com relação aos controles (P<0.05 para todas as comparações). No entanto, estes parâmetros não foram capazes de distinguir pacientes DM vs. PDM (P >0.1 para todas as comparações). O SSR foi capaz de diferenciar o grupo DM do controle (P <0,01) embora não tenha mostrado diferença entre os grupos PDM e controle (P = 0,6). Não houve diferença entre os níveis de S100B (P = 0.6) e NSE (P = 0.2) entre os grupos DM, PDM e controles. CONCLUSÃO: O QST e SSR são testes úteis para a avaliação de pacientes com diferentes graus de tolerância a glicose. Este estudo não encontrou diferenças entre os biomarcadores NSE e S100B em indivíduos com DM e PDM. / BACKGROUND: Type 2 diabetes mellitus (DM) is a metabolic disease characterized by the presence of chronic hyperglycemia. Previous studies demonstrated that patients with prediabetes states (PDM) have a natural history of progression to DM. Neuropathy is the most common and disabling complication of diabetes and recent advances in neurophysiology have enabled a refinement of neurophysiological diagnostic techniques such as sympathetic skin response (SSR) and quantitative sensory testing (QST). Biomarkers like Neuron-specific Enolase (NSE) and S100- Beta Protein (S100B) has been described for many authors as associated with damage at nervous system cells and are related with severity of injury as well as clinical outcomes. OBJECTIVE: The aim of this study is to evaluate neurophysiological findings and compare them with clinical and biochemical findings (S100B and NSE) in patients with DM, PDM and healthy controls. METHODS: Patients at the outpatient Neurology and Endocrinology service were randomized in a cross-sectional study. Participants underwent a battery of clinical and neurophysiological tests that encompassed nerve conduction studies, F-wave, SSR and QST. ELISA (enzyme-linked immunosorbent assay) were perform to quantify serum levels of NSE and S100B. RESULTS: There were no difference regarding clinical evaluation, nerve conduction studies and F-wave were between groups. The QST thresholds of warm (QSTw) and QST pain (QSTp) were significantly elevated in patients with PDM and DM compared to controls (P <0.05 for all comparisons). However, these parameters were not able to distinguish among DM and PDM (P > 0.1 for all comparisons). The SSR was able to differentiate DM from control group (P <0.01) but did not show difference between PDM and control groups (P = 0.6). There was no difference on levels of S100B (P = 0.6) and NSE (P = 0.2) between the DM, PDM and control groups. CONCLUSION: The QST and SSR are useful tests to evaluating patients with different degrees of glucose tolerance. This study found no differences between biomarkers NSE and S100B in subjects with DM and PDM.

A ocorrência de potenciais de ação e neurotransmissores, componentes principais do sistema nervoso animal, em plantas, bactérias e fungos mostra a universalidade dos princípios de sinalização e transmissão de informações na forma de sinais químicos e elétricos em todos os organismos. Esses tópicos de estudo, juntamente com inteligência em plantas e transporte vesicular de auxina, constituem as linhas de pesquisa principais da recém-criada Neurobiologia Vegetal. Entre os neurotransmissores encontrados em plantas, a acetilcolina atua, entre outras situações, no crescimento e desenvolvimento controlado pelo fitocromo e na permeabilidade iônica de membranas. Nesse contexto, foi sugerido que a acetilcolina pode desempenhar um papel importante na regulação do movimento estomático, tendo efeito estimulatório na abertura dos estômatos além de poder atuar na sinalização entre raiz e parte aérea. Dessa forma, foi proposto identificar a presença deste neurotransmissor em plantas de milho hidratadas e submetidas a estresse hídrico, com o objetivo de correlacionar a presença de acetilcolina com as respostas estomáticas de tais plantas. Além disso, foi objetivo do trabalho avaliar parâmetros fisiológicos como potencial hídrico, condutância estomática, transpiração e fotossíntese líquida e suas possíveis relações com a acetilcolina em três folhas das plantas hidratadas e estressadas. Para tanto, foi montado um experimento em blocos casualizados em esquema fatorial (2x3). Os fatores foram: água, nos níveis de hidratação e estresse, e idade das folhas nos níveis folha 4 (mais velha), folha 5 (idade intermediária) e folha 7 (mais jovem). As plantas foram divididas em 20 blocos, contendo uma planta hidratada e uma sob estresse cada e as análises fisiológicas feitas nas três folhas. As plantas foram colocadas em câmara de crescimento tipo BOD com controle de iluminação e temperatura. Após análises fisiológicas, as folhas foram utilizadas para extração e determinação de acetilcolina. Os extratos purificados e secos foram submetidos à pirólise e cromatografia gasosa e as substâncias identificadas por espectrometria de massas. Não foi detectada acetilcolina nas plantas, apesar de estudos anteriores demonstrarem sua ocorrência em folhas e sementes de milho. Hipóteses foram levantadas para explicar tal fato. Quanto as variáveis fisiológicas, o déficit hídrico reduziu em aproximadamente 59% a transpiração, em 65% a condutância estomática e em 59% a fotossíntese das plantas. Condutância estomática e transpiração, condutância e fotossíntese, e transpiração e fotossíntese apresentaram intensa correlação. Já o potencial hídrico teve baixa correlação com essas variáveis. Quanto ao fator idade, folhas 7 apresentaram maiores valores de fotossíntese, condutância e transpiração que as folhas 4 e 5. / The occurrence of action potential and neurotransmitters, the major components of animal nervous system, in plants, bacteria and fungi, shows the universality of signaling principles and information transmission in the way of chemical and electrical signals in all organisms. These study topics, along with plant intelligence and vesicular-based auxin transport, constitute the major research lines of the newly created Plant Neurobiology. Among the neurotransmitters found in plants, the acetylcholine plays a role in phytochromecontrolled growth and development and in membrane ion permeability. In this context, it was suggested that acetylcholine can play an important role in the regulation of stomatal movements, having stimulatory effect in the stomatal opening. In addition it can play a role in root-to-shoot signaling process. Therefore, it was proposed to identify the presence of this neurotransmitter in maize plants hydrated and under water stress, with the aim of correlating the presence of acetylcholine with the stomatal responses of such plants. Moreover, another aim of the study was to evaluate physiological parameters like water potential, stomatal conductance, transpiration rate and net photosynthetic rate and their possible relationship with the acetylcholine in three leaves of hydrated and stressed plants. Therefore, an experiment was set up in randomized block design in 2x3 factorial. The factors were: water, in the levels of hydration and stress, and leaves age in the levels leaf 4 (older), leaf 5 (intermediary age) and leaf 7 (younger). The plants were divided in 20 blocks, and each one has had one hydrated plant and one stressed plant and the physiological analysis was made in three leaves. The plants were placed in B.O.D. growth chamber under controlled conditions of light and temperature. After the physiological analysis, the leaves were used to extraction and determination of acetylcholine. The dried and purified extracts were subjected to pyrolysis and gas chromatography and the substances identified by mass spectrometry. The acetylcholine was not detected in plants, although earlier studies have had demonstrated its occurrence in maize leaves and seeds. Hypotheses were elaborated to explain such fact. Regarding the physiological variables, water stress reduced the plants transpiration rate in 59%, stomatal conductance in 65% and net photosynthesis in 59%. Stomatal conductance, transpiration and photosynthesis were strongly related. On the other hand, the water potential showed weak correlation with that variable. As for the age factor, leaves 7 had higher photosynthetic rates, conductance and transpiration than the leaves 4 and 5.

INTRODUÇÃO: A técnica de eletromiografia de fibra única (EMGFU), mediante análise do jitter, é o método neurofisiológico mais sensível para a confirmação do distúrbio da junção neuromuscular na miastenia gravis (MG). Os registros são tradicionalmente obtidos com agulha de fibra única, de alto custo e reutilizável. Por causa da necessidade atual do uso de material descartável, a agulha concêntrica vem sendo utilizada em substituição à agulha de fibra única. A técnica utilizada é semelhante, porém os potencias de ação para a análise do jitter são obtidos com eletrodo de agulha concêntrica (Eletromiografia de fibra única - jitter com agulha concêntrica, EMGFU-JAC). Contudo, os estudos são escassos e as metodologias utilizadas são heterogêneas com a utilização dessa agulha. OBJETIVOS: Este estudo tem por objetivo mensurar os valores de jitter obtidos com agulha concêntrica, no músculo Orbicularis Oculi, em sujeitos saudáveis e em pacientes com MG autoimune adquirida e avaliar a validade do método nas formas generalizada e ocular da doença. MÉTODOS: Foram estudados 20 sujeitos saudáveis, 20 pacientes com miastenia gravis forma generalizada (grupo MGG) e 13 com a forma ocular da doença (grupo MGO). A EMGFU-JAC foi realizada em todos os participantes, idealmente com 20 medidas de jitter em cada estudo. O jitter foi expresso como a média das diferenças consecutivas (MCD). Em todos os pacientes do estudo foram realizados o teste de estimulação repetitiva e dosagem sérica de anticorpo antirreceptor de acetilcolina (ac-AChR) no momento da análise do jitter. Nos pacientes soronegativos para ac-AChR, foi pesquisado o anticorpo antimúsculo específico tirosina-quinase (ac-MuSK). Foram definidos o limite superior da normalidade (LSN) para a média do MCD de cada estudo e para valores individuais de MCD. Os critérios de anormalidade foram: (1) média do MCD acima do LSN; ou (2) mais de 10% dos valores individuais de MCD acima do LSN. A definição do LSN para valores individuais de MCD baseou-se no conceito de que dois entre 20 valores de MCD acima do LSN são aceitáveis em um músculo saudável, para a técnica de contração voluntária. Portanto, estimou-se o LSN para o 18o valor mais alto de MCD (18o par). Para análise da acurácia do método, foram construídas duas curvas ROC (Receiver Operating Characteristic) para as variáveis média do MCD e 18o par, no grupo de pacientes (MGG e MGO) versus controle. RESULTADOS: No grupo controle a média das médias do MCD foi (19,0 ± 2,4)us e a média do 18o valor mais alto de cada estudo foi (24,5 ± 3,6)us. Esses valores obtidos apresentaram distribuição Gaussiana e o LSN foi definido como a média desses valores + 2 DP. O LSN para a média do MCD foi 24us, e 32?s para valores individuais de MCD. No grupo MGG, a análise do jitter foi anormal em todos os 20 pacientes por ambos os critérios de anormalidade, exceto em um paciente que apresentou anormalidade por apenas um dos critérios. No grupo MGO, apenas um dos 13 pacientes não preencheu os critérios de anormalidade. No grupo de pacientes, a positividade da EMGFU-JAC foi maior do que o teste de estimulação repetitiva e dosagens de anticorpos. Nas curvas ROC para as variáveis médias do MCD e 18o par, o valor de melhor sensibilidade (93,9%), sem resultados falsos positivos, foi 24,7us e 33,1us, respectivamente. CONCLUSÕES: A EMGFU-JAC apresenta alta sensibilidade e especificidade na identificação de distúrbio da transmissão neuromuscular em pacientes com MG. A utilização da agulha concêntrica é válida para a análise do jitter, como alternativa à agulha de fibra única / INTRODUCTION: Single fiber electromyography (SFEMG) technique, through jitter analysis, is the most sensitive neurophysiological method for confirmation of neuromuscular junction disorder in myasthenia gravis (MG). Records are traditionally obtained with single fiber needle, which is reusable and has a high-cost. Due to the current need of using disposable material, concentric needle has been used to replace single fiber needle. The technique is similar, but the action potential for jitter analysis is obtained with concentric needle electrode (SFEMG - concentric needle jitter, SFEMG-CNJ). However, studies are scarce and methodologies used are heterogeneous with the use of this needle. OBJECTIVES: This study aims to measure jitter values obtained with concentric needle in the Orbicularis Occuli muscle in healthy subjects and in patients with autoimmune acquired MG and to assess the validity of the method in generalized and ocular forms of the disease. METHODS: 20 healthy subjects, 20 patients with generalized myasthenia gravis (GMG group) and 13 with the ocular form of the disease (OMG group) were studied. SFEMG-CNJ was performed on all participants, ideally with 20 jitter values in each study. Jitter was expressed as the mean consecutive difference (MCD). Repetitive nerve stimulation and serum acetylcholine receptor antibody (AChR-ab) were performed in all patients in the study, by the time of jitter analysis. Tyrosine kinase specific antibody muscle antibodies (MuSK-ab) were performed in AChR-ab negative patients. The upper limit of normality (ULN) for the mean MCD and for individual jitter values were defined. The abnormality criteria were: (1) mean MCD above ULN; or (2) more than 10% of individual jitter values above ULN. The definition of ULN for individual jitter values was based on the concept that two out of 20 jitter values above ULN are acceptable in a healthy muscle for voluntary contraction technique. Therefore, the ULN for the 18th highest jitter value (18 pair) was estimated. To analyze the method\'s accuracy, two ROC curves (Receiver Operating Characteristic) for the mean MCD and 18th pair in the group of patients (MGG and MGO) versus control were constructed. RESULTS: In the control group the mean of MCD means was (19.0 ± 2.4)us and the mean of the 18 highest value of each study was (24.5 ± 3.6)us. These values showed Gaussian distribution and the ULN was set as the mean of these values + 2 SD. The ULN for the mean MCD was 24us, and 32us for individual values of MCD. In GMG group, jitter analyses were abnormal in all 20 patients based on both abnormality criteria, except in one patient, who had abnormalities in only one of the criteria. In OMG group, only one patient from 13 met neither of the abnormality criteria. In patients, the positivity of SFEMG-CNJ was higher than repetitive nerve stimulation test and antibody detection. The ROC curve threshold showing the best sensitivity (93.9%) with no false positive results was 24.7Us for the mean MCD and 33.1us for individual pairs, respectively. CONCLUSIONS: SFEMG-CNJ has high sensitivity and specificity in identifying neuromuscular transmission disorder in patients with MG. The use of concentric needle is valid for jitter analysis as an alternative to single fiber needle

Nous proposons que c’est le manque d’individualisation qui fait défaut aux méthodes actuelles destinées à traiter l’alcoolo-dépendance qui ne s’avèrent que modérément efficaces, si l’on en juge par la proportion importante de rechutes sous traitement. Les théories contemporaines dominantes postulent que les addictions et leur maintien pourraient être expliqués par le déséquilibre entre deux grands systèmes neuraux et les mécanismes cognitifs qui y sont associés: un système impulsif, dépendant des régions méso-cortico-limbiques, à la base des mécanismes de récompense, de renforcement et de la formation d’habitudes, et un système réflexif, dépendant du cortex préfrontal, indispensable aux comportements de prise de décision, à l’anticipation des conséquences des comportements et au contrôle inhibiteur. Nous avons dans ce travail développé des outils électrophysiologiques de diagnostic de deux troubles cognitifs clés associés au dysfonctionnement de ces deux systèmes :les biais attentionnels et les troubles de l’inhibition. Nous avons pré-testé ces tâches combinées à l’enregistrement des potentiels évoqués dans des populations d’étudiants binge drinkers et de gros consommateurs d’alcool. Nous avons ensuite testé leur valeur prédictive de la rechute dans une population de patients dépendants en fin de cure de désintoxication. Nous pensons avoir dégagé l’existence de deux marqueurs neurophysiologiques pouvant prédire à trois mois la rechute ou l’abstinence du patient alcoolo-dépendant :il s’agit (1) d’un facteur de rechute, indexé par une P3d plus ample suggérant un besoin accru de ressources neurales pour inhiber correctement un comportement, et (2) d’un facteur de protection, indexé par une composante P3 moins ample en réponses aux stimulations liées à l’alcool, suggérant qu’un investissement motivationnel moindre des stimuli « alcool » peut protéger d’une rechute. La réplication et la confirmation de nos résultats ainsi que l’amélioration de nos outils pourraient mener à l’utilisation des marqueurs mis en évidence en pratique clinique afin d’orienter de façon personnalisée la prise en charge des patients.<p><p> / Doctorat en Sciences Psychologiques et de l'éducation / info:eu-repo/semantics/nonPublished

Détection précoce de crises<p>d’épilepsie à l’aide d’une<p>modélisation du comportement<p>oscillatoire neuronal / Doctorat en Sciences de l'ingénieur / info:eu-repo/semantics/nonPublished

Breathing is an automatic process that we hardly pay any attention to in our daily life. As a social species, we interact using body movement, speech and emotion and these actions require modification of the respiratory pattern. While we understood how the respiratory rhythm is generated, we do not have clear evidence on how higher cortical signals modulate the respiratory pattern. The deep cortical structures in the human brain are inaccessible under normal circumstances, and deep brain stimulation electrode recordings offer an opportunity to understand the neurophysiological interactions ofdeeper brain structures. In this thesis, I investigated deep brain stimulation recordings from implanted electrodes in chronic neuropathic pain subjects in the right and left anterior cingulate cortices, the ventral posterior lateral nucleus of the thalamus and periventricular gray region. The objectives of this research were to elucidate the feed-forward mechanisms of volitional breathing, cortical autonomic regulation, and to investigate whether any of the investigated nuclei haveany carbon dioxide-sensitive neurons which may encode respiratory sensation. The results show lateralisation of the cortical autonomic control whereby the left anterior cingulate exhibits increases in beta band activity (30 to 90 Hz) with cognition and vocalisation tasks. Meanwhile, right anterior cingulate activity increases with hyperoxia. Respiration using various carbon dioxide concentrations shows a constant rise in the alpha band (8 to 14 Hz) activity in the PVG which suggests a sensitive, nonspecific neuronal activity related to systemic carbon dioxide levels.