Universiẗat, Diss., 2002--Jena.

Diplomarbeit Hochschule für Angewandte Psychologie Zürich, 2005.

Universiẗat, Diss., 2006--Linz. / Hergestellt on demand.

Thesis (Doctoral)--Göteborg University, 2006. / "1101-718X"--T.p. verso. Includes bibliographical references.

No description available.

Le développement d’altérations cognitives consécutives au cancer et aux traitements anticancéreux associés constitue une problématique croissante pouvant avoir des répercussions sur le fonctionnement psychosocial, le statut fonctionnel, la prise en charge médicale mais également sur la survie des patients. Si ce champ de recherche est en plein essor, de nombreux points nécessitent encore d’être clarifiés que ce soit par rapport au développement d’altérations cognitives, aux facteurs associés mais aussi à leur prise en charge. Ceci est d’autant plus vrai pour les personnes âgées dont l’accumulation de vulnérabilités cognitives liées au cancer et ses traitements, au vieillissement mais aussi à leurs interactions peut complexifier le fonctionnement cognitif attendu chez des patients plus jeunes.Ce travail de thèse a, par conséquent, pour objectif d’améliorer la compréhension du fonctionnement cognitif de patients âgés atteints d’une hémopathie maligne durant les premières semaines d’un traitement par chimiothérapie, d’en évaluer l’impact psychologique et d’identifier les possibilités d’interventions destinées à la prise en charge d’altérations cognitives. Plus spécifiquement, ce travail de thèse, composé de trois chapitres, vise à répondre aux trois objectifs suivants :(a) l’étude des mécanismes cognitifs compensatoires de patients âgés atteints d’une hémopathie maligne durant les premières semaines d’un traitement par chimiothérapie, (b) l’étude de la relation entre le fonctionnement cognitifsubjectif et le sentiment du patient d’être une charge pour son proche aidant principal, et (c) la réalisation d’un état des lieux des interventions destinées à la prise en charge des altérations cognitives en oncologie.Les résultats du premier chapitre de ce travail de thèse soulignent que des patients âgés atteints d’une hémopathie maligne et considérés comme cliniquement « fit » d’après leur hématologue référent présentent, durant les premières semaines d’un traitement par chimiothérapie, des mécanismes cognitifs compensatoires plus faibles que des individus contrôles. Néanmoins, face à un contexte d’évaluation connu, ils peuvent bénéficier des effets cognitifs facilitateurs de la motivation et d’une détresse émotionnelle régulée. Par ailleurs, les résultats du second chapitre de ce travail de thèse démontrent que la présence d’altérations cognitives perçues par le patient participe au développement du sentiment du patient d’être une charge pour son proche aidant principal. Il est à noter que plus d’un patient sur trois éprouvera ce sentiment de manière modérée à sévère et ce dès le début d’un traitement par chimiothérapie. Enfin, le troisième chapitre de ce travail de thèse qui a permis d’identifier des études d’interventions destinées à la prise en charge d’altérations cognitives suggère des résultats plus prometteurs à l’avantage des interventions non-pharmacologiques.Ce travail de thèse souligne l’importance d’évaluer le fonctionnement cognitif des patients âgés et particulièrement celui de patients considérés comme cliniquement « fit » en raison d’un risque de banalisation de leurs difficultés cognitives pouvant être considérées comme minimes et normales pour l’âge et le contexte médical. Il importe également d’évaluer l’impact délétère de la présence d’altérations cognitives, et ce dès les premières semaines d’un traitement par chimiothérapie, de manière à assurer une prise en charge qui se veut la plus précoce et la plus adaptée au patient. / Doctorat en Sciences psychologiques et de l'éducation / info:eu-repo/semantics/nonPublished

Attention-Deficit/Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD) are two neurodevelopmental disorders with distinct diagnostic criteria that often co-occur. Although both ASD and ADHD are associated with structural and functional brain abnormalities when compared to typically developing (TD) populations, it is necessary to disentangle the shared and specific abnormalities between these disorders, potentially underlying similarities and differences in their clinical and neurocognitive profiles. The aim of this thesis was to explore the shared and disorder specific functional and structural brain abnormalities between ASD and ADHD. For this purpose, the neural underpinnings of a group of children with ADHD, a group of children with ASD and a group of TD children aged 8 to 12 years old were compared using different neuroimaging techniques. In Chapter 2, the experimental sample included in this thesis was described using multiple clinical and neurocognitive measures. In the first study (Chapter 3), total and regional brain volumes were compared between groups, using voxel-based morphometry. The results of this study showed larger grey matter volume (GMV) in the left precuneus and decreased GMV in the right thalamus in the ADHD group compared to either the TD or the ASD groups, and increased GMV in the right precentral gyrus in the ASD group compared to either the ADHD or the TD groups. In the second study (Chapter 4), white matter microstructure was compared between groups using diffusion tensor imaging derived indices (fractional anisotropy [FA] and mean diffusivity [MD]). Reduced FA (i.e. reduced diffusion directionality) in the genu of the corpus callosum (CC) was found in the ASD group compared to either children with ADHD or TD children, whereas lower FA in the body of the CC was a shared feature between the ADHD and ASD groups. Finally, in the last study (Chapter 5), inhibition-related brain activation was compared between groups during the execution of an inhibition stop-signal task. In children with ADHD, successful inhibition was associated with right inferior parietal activation, whereas right frontal regions were activated in children with ASD. Between-group comparisons disclosed higher middle frontal activation in the ASD group compared to the ADHD or the TD groups. Taken together, our findings provide further evidence contributing to disentangle the shared and specific brain structural and functional abnormalities between ASD and ADHD. / Doctorat en Sciences psychologiques et de l'éducation / info:eu-repo/semantics/nonPublished

Research over decades has demonstrated that emotions interact with various cognitive functions. In contrast with first-order cognition, studies exploring the influence of emotions on metacognition (i.e. the ability to reflect on and control our own cognitive processes) are still very sparse. The present thesis investigated how several emotional states influence metacognitive performance. We have considered different emotions (such as happiness, anxiety or depression) and different metacognitive measures (such as subjective difficulty, overall confidence or metacognitive efficiency). Altogether, our results provide evidence that emotional states can specifically influence the way individuals evaluate their own decisions, which exist independently of their first-order performance. Furthermore, our findings suggest that different emotions each exert a different impact on metacognition. For instance, inducing a sad mood reduces overall confidence, while induced anxiety leads to a decrease in metacognitive efficiency. However, predicting how an emotion will influence metacognition remains very difficult, as this seems to depend on many parameters. / Doctorat en Sciences psychologiques et de l'éducation / info:eu-repo/semantics/nonPublished

Background: Sepsis is defined as a life-threatening organ dysfunction caused by a dysregulated host response to infection1. One of the most commonly affected organ is the brain, leading to sepsis-associated encephalopathy (SAE). The prevalence of SAE widely varies between studies, between 10 to 75% of septic patients. It is characterized by a diffuse cerebral dysfunction ranging from delirium to coma, in the absence of direct brain damage or another cause of encephalopathy3–5. Despite improvements in critical care, SAE remains associated with increased mortality and cognitive disability. Sepsis is also associated with long term cognitive sequelae such as memory, attentional and executive functions deficits.Methods: Single-center prospective observational study of adult’s patients with sepsis without acute or chronic neuropsychiatric disorders and co-existing causes of encephalopathy between January 1, 2016, and August 30, 2020. During acute phase, we assessed the severity of sepsis, consciousness and arousal using four clinical scales (CAM-ICU, CRS-R, GCS and FOUR) and electroencephalography. Survivors underwent a cognitive assessment before hospital discharge with brief screening tools (MoCA and FAB scores) and a comprehensive neuropsychological assessment at 6 and 12 months after discharge.Results: We enrolled 109 patients, of which 61% had SAE during the first 48-h of the ICU stay. The most frequent clinical manifestation was fluctuation of arousal. Ten of the 52 ICU survivors that could be assessed showed persistent cognitive dysfunction at hospital discharge. Only the presence of SAE was associated with persistent cognitive dysfunction, in the whole cohort as well as in the subgroup of patients not receiving continuous sedation. At 6 months after discharge, 84% of survivors presented diffuse cognitive impairment (memory, attention, and executive functions were impaired), and high depression score. Cognitive deficit at 6 month was associated with cognitive disability at discharge, and severity of illness during ICU stay, but not with SAE. After 12 months, 82% of survivors presented cognitive difficulties in the same cognitive domains as at the 6-month follow-up. Presence of SAE or any other ICU associated variables were not associated with the severity of cognitive impairment. We found an evolution compared to middle-term assessment in broad cognition, but individual cognitive profiles were mixed.Conclusion: SAE occurs in most patients with sepsis, even in the absence of prior or concomitant causes of encephalopathy. Its detection requires testing patients for fluctuation in arousal. Also, long-term cognitive impairment and depression are observed in survivors. Therapeutics interventions to improve cognitive deficits are thus desirable, and it is also crucial to consider psychological health in those patients. / Doctorat en Sciences psychologiques et de l'éducation / info:eu-repo/semantics/nonPublished

Höhergradige Gliome gehören zu den häufigsten malignen Hirntumoren bei Erwachsenen und gehen mit einer sehr schlechten Prognose einher. Die Patientinnen und Patienten leiden häufig unter kognitiven Einschränkungen, welche auch auf einen Integritätsverlust der Weißen Substanz zurückzuführen sind und die Lebensqualität der Betroffenen stark beeinträchtigen. Um in Zukunft eine Behandlung zu gewährleisten, die nicht nur das Überleben verlängert, sondern auch den Erhalt der neurokognitiven Funktionen verbessert, sind zuverlässige Methoden zur Messung von Veränderungen der neurokognitiven Fähigkeiten in einem frühen Stadium erforderlich. Der direkteste Weg zur Objektivierung neurokognitiver Eigenschaften sind neuropsychologische Tests. Wir betrachten das Corpus callosum als eine zuverlässige Struktur zur Identifizierung der Verschlechterung der Integrität der weißen Substanz. Wir stellten die Hypothese auf, dass ein Zusammenhang zwischen einer beeinträchtigten strukturellen Integrität in bestimmten Regionen des Corpus Callosum und neurokognitiven Defiziten bei Patientinnen und Patienten mit höhergradigem Gliom besteht. Wir schlossen 25 Patientinnen und Patienten mit höhergradigem Gliom in unsere Studie ein, die sich präoperativ einer neuropsychologischen Testbatterie und einer MRT mit DTI Sequenzen unterzogen. Die MRT-Daten wurden mit der Software fsl, Oxford, verarbeitet. Neuropsychologische Parameter wurden mit der FA in drei Teilen des Corpus Callosum korreliert: Rostrum bzw. Genu, Truncus und Splenium. Präoperativ korrelierten die meisten neuropsychologischen Parameter signifikant mit der FA von mindestens einem Bereich des Corpus Callosum. Höhere FA-Werte wurden mit besserer Konzentration, Gedächtnis, Schnelligkeit und flüssigem Sprechen in Verbindung gebracht. Verschiedene Tests untersuchten den gleichen neuropsychologischen Parameter und korrelierten dann mit der gleichen Region des Corpus Callosum. So konnten das lexikalische und visuelle Gedächtnis mit dem Genu und Rostrum in Verbindung gebracht werden, exekutive Funktionen und das Arbeitsgedächtnis korrelierten mit dem Truncus und die Verarbeitungsgeschwindigkeit mit dem Splenium. Darüber hinaus stimmte diese Zuordnung mit den Ergebnissen vorangegangener Studien überein. Wir betrachten Veränderungen der mikrostrukturellen Integrität der Corpus Callosum als robustes morphologisches Korrelat für die Untersuchung des neurokognitiven Zustands von Patientinnen und Patienten mit höhergradigem Gliom. / High-grade gliomas are malignant brain tumors in adults and are associated with a very poor prognosis. Patients often suffer from cognitive impairment, which is due to a loss of integrity of the white matter and severely impairs the quality of life of those patients. To ensure a treatment that does not only lengthen survival, but also improves preservation of neurocognitive functions, reliable methods to measure changes in neurocognitive abilities at an early stage are necessary. The most direct way to objectify neurocognitive properties is neuropsychological testing. We take the corpus callosum as a reliable structure to identify decline of white matter integrity. We hypothesized a relation between compromised structural integrity in specific regions of the corpus callosum and neurocognitive deficits in glioma patients. We included 25 patients with high-grade glioma who underwent a neuropsychological test battery and MRI with Diffusion Tensor Imaging preoperatively. MRI data was processed using the software fsl, Oxford. Neuropsychological parameters were correlated with the Fractional Anisotropy (FA) in three parts of the corpus callosum: Rostrum or genu, truncus and splenium. Preoperatively most neuropsychological parameters correlated significantly with FA of at least one of the corpus callosum volumes. Higher FA-values were associated with better focus, memory, speed and fluency of speech. Different tests examined the same neuropsychological parameter and then correlated with the same region of the corpus callosum: Thus, lexical and visual memory could be linked to the genu and rostrum, executive functions and working memory correlated with the truncus and processing speed with the splenium. Furthermore, this correlation was consistent with the results of previous studies. We take changes of the microstructural integrity of corpus callosum as a robust morphological correlate for examination and progress monitoring of the neurocognitive state of glioma patients.