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Fabien Perrin

Publications and source records attributed to Fabien Perrin.

15 recordsLinked to original sources
PubMed2006

Brain response to one's own name in vegetative state, minimally conscious state, and locked-in syndrome.

BACKGROUND: A major challenge in the management of severely brain-injured patients with altered states of consciousness is to estimate their residual perception of the environment. OBJECTIVE: To investigate the integrity of detection of one's own name in patients in a behaviorally well-documented vegetative state (VS), patients in a minimally conscious state (MCS), and patients with locked-in syndrome. DESIGN: We recorded the auditory evoked potentials to the patient's own name and to 7 other equiprobable first names in 15 brain-damaged patients. RESULTS: A P3 component was observed in response to the patient's name in all patients with locked-in syndrome, in all MCS patients, and in 3 of 5 patients in a VS. P3 latency was significantly (P<.05) delayed for MCS and VS patients compared with healthy volunteers. CONCLUSIONS: These results suggest that partially preserved semantic processing could be observed in noncommunicative brain-damaged patients, notably for the detection of salient stimuli, such as the subject's own name. This function seems delayed in MCS and (if present) in VS patients. More important, a P3 response does not necessarily reflect conscious perception and cannot be used to differentiate VS from MCS patients.

Acoustic Stimulation↗
PubMed2005

Cerebral correlates of delta waves during non-REM sleep revisited.

We aimed at characterizing the neural correlates of delta activity during Non Rapid Eye Movement (NREM) sleep in non-sleep-deprived normal young adults, based on the statistical analysis of a positron emission tomography (PET) sleep data set. One hundred fifteen PET scans were obtained using H(2)(15)O under continuous polygraphic monitoring during stages 2-4 of NREM sleep. Correlations between regional cerebral blood flow (rCBF) and delta power (1.5-4 Hz) spectral density were analyzed using statistical parametric mapping (SPM2). Delta power values obtained at central scalp locations negatively correlated during NREM sleep with rCBF in the ventromedial prefrontal cortex, the basal forebrain, the striatum, the anterior insula, and the precuneus. These regions embrace the set of brain areas in which rCBF decreases during slow wave sleep (SWS) as compared to Rapid Eye Movement (REM) sleep and wakefulness (Maquet, P., Degueldre, C., Delfiore, G., Aerts, J., Peters, J.M., Luxen, A., Franck, G., 1997. Functional neuroanatomy of human slow wave sleep. J. Neurosci. 17, 2807-S2812), supporting the notion that delta activity is a valuable prominent feature of NREM sleep. A strong association was observed between rCBF in the ventromedial prefrontal regions and delta power, in agreement with electrophysiological studies. In contrast to the results of a previous PET study investigating the brain correlates of delta activity (Hofle, N., Paus, T., Reutens, D., Fiset, P., Gotman, J., Evans, A.C., Jones, B.E., 1997. Regional cerebral blood flow changes as a function of delta and spindle activity during slow wave sleep in humans. J. Neurosci. 17, 4800-4808), in which waking scans were mixed with NREM sleep scans, no correlation was found with thalamus activity. This latter result stresses the importance of an extra-thalamic delta rhythm among the synchronous NREM sleep oscillations. Consequently, this rCBF distribution might preferentially reflect a particular modulation of the cellular processes involved in the generation of cortical delta waves during NREM sleep.

Adult↗
PubMed2005

Neural mechanisms involved in the detection of our first name: a combined ERPs and PET study.

In everyday social interactions, hearing our own first name captures our attention and gives rise to a sense of self-awareness, since it is one of the most socially self related stimulus. In the present study, we combined ERPs and PET scan methods to explore the cerebral mechanisms underlying the detection of our own name. While categorical analyses of PET data failed to reveal significant results, we found that the amplitude of the P3 component, elicited when hearing one's own name, correlates with regional cerebral blood changes in right superior temporal sulcus, precuneus and medial prefrontal cortex. Additionally, the latter was more correlated to the P3 obtained for the subject's name compared to that obtained for other first names. These results suggest that the medial prefrontal cortex plays the most prominent role in self-processing.

Adult↗
PubMed2005

Human cognition during REM sleep and the activity profile within frontal and parietal cortices: a reappraisal of functional neuroimaging data.

In this chapter, we aimed at further characterizing the functional neuroanatomy of the human rapid eye movement (REM) sleep at the population level. We carried out a meta-analysis of a large dataset of positron emission tomography (PET) scans acquired during wakefulness, slow wave sleep and REM sleep, and focused especially on the brain areas in which the activity diminishes during REM sleep. Results show that quiescent regions are confined to the inferior and middle frontal cortex and to the inferior parietal lobule. Providing a plausible explanation for some of the features of dream reports, these findings may help in refining the concepts, which try to account for human cognition during REM sleep. In particular, we discuss the significance of these results to explain the alteration in executive processes, episodic memory retrieval and self representation during REM sleep dreaming as well as the incorporation of external stimuli into the dream narrative.

Cognition↗
PubMed2005

The locked-in syndrome : what is it like to be conscious but paralyzed and voiceless?

The locked-in syndrome (pseudocoma) describes patients who are awake and conscious but selectively deefferented, i.e., have no means of producing speech, limb or facial movements. Acute ventral pontine lesions are its most common cause. People with such brainstem lesions often remain comatose for some days or weeks, needing artificial respiration and then gradually wake up, but remaining paralyzed and voiceless, superficially resembling patients in a vegetative state or akinetic mutism. In acute locked-in syndrome (LIS), eye-coded communication and evaluation of cognitive and emotional functioning is very limited because vigilance is fluctuating and eye movements may be inconsistent, very small, and easily exhausted. It has been shown that more than half of the time it is the family and not the physician who first realized that the patient was aware. Distressingly, recent studies reported that the diagnosis of LIS on average takes over 2.5 months. In some cases it took 4-6 years before aware and sensitive patients, locked in an immobile body, were recognized as being conscious. Once a LIS patient becomes medically stable, and given appropriate medical care, life expectancy increases to several decades. Even if the chances of good motor recovery are very limited, existing eye-controlled, computer-based communication technology currently allow the patient to control his environment, use a word processor coupled to a speech synthesizer, and access the worldwide net. Healthy individuals and medical professionals sometimes assume that the quality of life of an LIS patient is so poor that it is not worth living. On the contrary, chronic LIS patients typically self-report meaningful quality of life and their demand for euthanasia is surprisingly infrequent. Biased clinicians might provide less aggressive medical treatment and influence the family in inappropriate ways. It is important to stress that only the medically stabilized, informed LIS patient is competent to consent to or refuse life-sustaining treatment. Patients suffering from LIS should not be denied the right to die - and to die with dignity - but also, and more importantly, they should not be denied the right to live - and to live with dignity and the best possible revalidation, and pain and symptom management. In our opinion, there is an urgent need for a renewed ethical and medicolegal framework for our care of locked-in patients.

Consciousness↗
PubMed2005

Residual cognitive function in comatose, vegetative and minimally conscious states.

PURPOSE OF REVIEW: The clinical evaluation of cognition in non-communicative severely brain-damaged patients is inherently difficult. In addition to novel behavioural 'consciousness-scales', the role of para-clinical markers of consciousness, such as event related potentials and functional neuroimaging is reviewed. RECENT FINDINGS: New behavioural scales for vegetative and minimally conscious patients have been shown to reduce diagnostic error but regrettably remain underused in clinical routine. Electrophysiological studies have confirmed their role in estimating outcome and possibly cognition. Several recent functional neuroimaging studies have shown residual cortical function in undeniably vegetative patients. This cortical activation, however, seems limited to primary 'low-level' areas and does not imply 'higher-order' integration, considered necessary for conscious perception. Minimally conscious patients show large-scale high-order cerebral activation, apparently dependent upon the emotional relevance of the stimulation. SUMMARY: Careful clinical assessment of putative 'conscious behaviour' in vegetative and minimally conscious patients is the first requirement for their proper diagnosis and management. Complementary functional neuroimaging and electrophysiological studies will have a major impact on future clinical decision making and may guide selective therapeutic options. At present, more experimental evidence and the elucidation of methodological and ethical controversies are awaited prior to their routine clinical use.

Cognition↗
PubMed2004

Are spatial memories strengthened in the human hippocampus during slow wave sleep?

In rats, the firing sequences observed in hippocampal ensembles during spatial learning are replayed during subsequent sleep, suggesting a role for posttraining sleep periods in the offline processing of spatial memories. Here, using regional cerebral blood flow measurements, we show that, in humans, hippocampal areas that are activated during route learning in a virtual town are likewise activated during subsequent slow wave sleep. Most importantly, we found that the amount of hippocampal activity expressed during slow wave sleep positively correlates with the improvement of performance in route retrieval on the next day. These findings suggest that learning-dependent modulation in hippocampal activity during human sleep reflects the offline processing of recent episodic and spatial memory traces, which eventually leads to the plastic changes underlying the subsequent improvement in performance.

Adult↗
PubMed2004

Nonvisual responses to light exposure in the human brain during the circadian night.

The brain processes light information to visually represent the environment but also to detect changes in ambient light level. The latter information induces non-image-forming responses and exerts powerful effects on physiology such as synchronization of the circadian clock and suppression of melatonin. In rodents, irradiance information is transduced from a discrete subset of photosensitive retinal ganglion cells via the retinohypothalamic tract to various hypothalamic and brainstem regulatory structures including the hypothalamic suprachiasmatic nuclei, the master circadian pacemaker. In humans, light also acutely modulates alertness, but the cerebral correlates of this effect are unknown. We assessed regional cerebral blood flow in 13 subjects attending to auditory and visual stimuli in near darkness following light exposures (>8000 lux) of different durations (0.5, 17, 16.5, and 0 min) during the biological night. The bright broadband polychromatic light suppressed melatonin and enhanced alertness. Functional imaging revealed that a large-scale occipito-parietal attention network, including the right intraparietal sulcus, was more active in proportion to the duration of light exposures preceding the scans. Activity in the hypothalamus decreased in proportion to previous illumination. These findings have important implications for understanding the effects of light on human behavior.

Acoustic Stimulation↗
PubMed2003

Olfactory short-term memory and related amygdala recordings in patients with temporal lobe epilepsy.

Olfactory short-term recognition memory was assessed with a delayed odour-matching task in 38 patients with unilateral temporal lobe epilepsy (TLE) and stereotactic electroencephalography (SEEG) recordings taken prior to surgical treatment. The amygdala SEEG activity associated with odorant stimulation was examined in 18 patients. Because the invasive SEEG procedure is only performed in a clinical framework, electrophysiological data obtained from these patients could not be analysed in comparison with data obtained from control subjects. Behavioural results (hits, false alarms, discrimination, bias scores) showed global impairment of odour recognition memory in patients when compared with controls. We also found lower discrimination and higher false alarm scores in left than in right TLE patients, and higher false alarm scores in male than in female patients. The hemisphere effect is discussed in terms of psychosocial trait differences between patients. Electrophysiological recordings collected from the amygdala demonstrated that odorant stimulation was associated with chemosensory evoked potentials (CSEPs). Analysis revealed that CSEPs obtained for target odorants had lower peak amplitudes and latencies than those obtained in response to sample odorants. The reduced peak amplitudes suggest a mechanism of repetition suppression--a process assumed to reflect neural activity related to high-level cognitive processes such as attention, memory and decision making. Latency modulations appear rather to be linked to early stages of information processing and may therefore reflect a facilitation process due to selective attention.

Adult↗
PubMed2003

Modulation of the N400 potential during auditory phonological/semantic interaction.

The processing of phonological and semantic word attributes has been commonly explored with electrophysiological methods using simple contexts where competition between features is eliminated. Conversely, the interaction between phonological and semantic attributes has not been systematically examined. We therefore recorded an event-related electrophysiological marker of word discordance, the N400, in response to sequences of auditory word pairs containing semantic incongruences, phonological discordances, or a mixture of the two. N400 enhancement to semantically unrelated words was systematically observed, whether the subjects heard the sequences passively (no instruction) or actively (semantic judgement task), and even in contexts where the task did not concern semantic attributes. In contrast, the N400 effect to phonologically unrelated (non-rhyming) words was exclusively obtained in the active situation (phonological judgment), while it disappeared in passive conditions and during semantic/phonological interference. This suggests that the detection of semantic incongruences is a more robust and automatized mechanism than that of phonological ones, and tends to occlude this latter when both features are in competition. Our data also provide new elements supporting the persistence of the semantic N400 during 'shallow' word processing tasks, i.e. tasks that discourage analysis of semantic aspects of the words.

Acoustic Stimulation↗
PubMed2003

Event-related potentials during forced awakening: a tool for the study of acute sleep inertia.

Sleep propensity and sleep inertia were assessed in 43 patients with excessive daytime sleepiness (EDS) and 21 sleep-deprived controls, using a forced awakening test under continuous electroencephalographic (EEG) recording. Event-related potentials (ERPs) were first obtained in waking, while participants performed a target detection auditory task. Subjects were then allowed to take a nap with lights off and sleep latency was calculated. After 3 min of continuous sleep, frequent and rare tones were suddenly presented again (and ERPs recorded) in a forced awakening condition, which was repeated a second time if patients fell asleep. ERPs in pre-nap wakefulness did not differ in patients and controls. On forced awakening, almost half (48%) of EDS patients retained morphologically normal ERPs, but showed a significant delay of P300 relative to waking. In the other half of the patients (and none of the controls), the N200/P300 complex to targets was replaced on forced awakening by high-amplitude negative waves ('sleep negativities'). Single subject analysis showed that 65% of patients had abnormal responses during forced awakening (significant P3 delay or sleep negativities), while only three of them (7%) had abnormal ERPs on wakefulness. The presence of sleep negativities was associated with shorter sleep latencies and increased target detection errors on forced awakening. Sleep negativities were more prevalent in narcolepsy and idiopathic hypersomnia than in EDS associated to psychiatric disorders. By combining sleep latency and ERP measures, the forced awakening test provided a robust and relatively rapid tool (45-60 min) to evaluate both sleep propensity and sleep inertia within a single recording session. The test allows each subject to act as his/her own control, thus increasing sensitivity. In the present series, it proved to be much more discriminative than waking ERPs alone to demonstrate specific abnormalities in patients complaining of excessive daytime sleepiness.

Adult↗
PubMed2002

Detection of verbal discordances during sleep.

We used an electrophysiological marker of linguistic discordance, the N400 wave, to investigate how linguistic and pseudo-linguistic stimuli are categorised during sleep as compared to waking. During wakefulness, signs of discordance detection were, as expected, greater for pseudo-words than for real but semantically incongruous words, relative to congruous words. In sleep stage 2 all signs of hierarchic process of discordance disappeared. A new hierarchic process reappeared in paradoxical sleep, which differed from that of waking, responses to pseudo-words being similar to those to congruous words. Linguistic absurdity appears to be accepted in a different manner during paradoxical sleep than during waking, and this might explain why absurd contents are so naturally incorporated into otherwise plausible dream stories.

Acoustic Stimulation↗
PubMed2002

Sleep and motor skill learning.

The improvement of a perceptual or motor skill continues after training has ended. The central question is whether this improvement is just a function of time or whether sleep, a certain circadian phase, or their interaction (sleep occurring in a particular circadian phase) is favorable to the reprocessing of recent memory traces. In this issue of Neuron, provide behavioral evidence that most of the improvement of a motor skill depends on nocturnal sleep.

Cerebral Cortex↗
PubMed2002

Semantic analysis of auditory input during sleep: studies with event related potentials.

This review summarises the results of event-related potentials studies exploring the extent to which the human brain can extract semantic information from external stimuli during sleep. The persistence of a differential response to the subject's own name, relative to any other proper name, during stage 2 (S2) and paradoxical (REM) sleep (PS) suggests that the brain remains able to discriminate an intrinsically relevant word during these sleep stages. The similarities and the differences between these sleep cognitive responses and the waking P300 are stressed, and the functional significance of this component discussed especially in relation with consciousness and memory of the stimulus. Recent studies of the 'N400' potential evoked by semantically incongruous words, have shown that this component may be also elicited during S2 and PS, indicating preserved detection of semantic discordance during these sleep stages. However, linguistic incongruity appears to be processed in a different manner during PS than during waking, since words devoid of meaning (pseudo-words), which are detected as anomalous and evoke N400 during waking, yielded responses similar to those of congruous words in PS. All these data support the view that some semantic analysis of auditory stimuli remains possible in the human sleeping brain, and warrant further studies to elucidate the extent and limits of these capabilities.

Acoustic Stimulation↗