Biomedical subjects
I Amado-Boccara
Publications and source records attributed to I Amado-Boccara.
[Depression, cognition and brain imaging].
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Effects of antidepressants on cognitive functions: a review.
The widespread use of antidepressants since the late 1950s and especially the ambulatory treatment of the majority of depressive patients raises the issue of the state of knowledge of the effects of these drugs on cognitive function. This review aims at synthesizing information about differential effects of antidepressants on cognitive function to facilitate good prescription. The first part of this review tries to summarize the main tasks used to explore global reactivity, attention, memory and psychomotor performances. The second part of this work presents the differential cognitive effects of antidepressants with a discrimination between substances which have a sedative impact, antidepressants with no cognitive effect, and drugs which seem to have a positive cognitive action. The differenciation is established for single and repeated administration, for healthy volunteers and depressed subjects. For each substance, the dose, the tasks selected and cognitive effect are discussed and the question of the real benefit of this cognitive impact is raised. The specificity of cognitive effects of antidepressants related to age and to the combination with alcohol are also tackled. Then the discussion raises the difficulty and the biases encountered to perform neuropsychological studies and particularly evaluation of cognitive effects of antidepressants. Finally the conclusion of this review gives some advice to select and prescribe antidepressants according to their cognitive effects.
[Cognitive impact of antidepressants].
This review aims to synthesize informations about the cognitive effects of antidepressants, eg memory, attention and psychomotor functions. The specific cognitive profile of each compound relies on its biochemical action, particularly with its anticholinergic or noradrenergic properties. Some of these treatments can produce sedative or dysmnesic impact while on the other hand others can have no cognitive impact or even produce a stimulating effect. This analysis tends to facilitate a good clinical prescription by summarizing all the different cognitive effects of antidepressants, regarding the type of the population selected (healthy volunteers or depressed patients), their age and the duration of the prescription (acute dose or long-term treatment). Finally general advices are preconized to avoid a decrease in cognitive efficiency when an antidepressant treatment is introduced.
[Effect of psychotropic drugs on vigilance and motor performances].
This review paper deals with the impact of psychotropic drugs on vigilance, awakening and motricity. Antidepressants can be divided into 3 categories, depending on the subject's awakening: sedatives with a strong anticholinergic component, compounds devoid of positive or negative impact on cognition and stimulating antidepressants. The principal effect of lithium is to lengthen the reaction time. Taken acutely, neuroleptics produce alterations of fine motor gestures, but when taken chronically they spare the functioning of cognition. Benzodiazepines act on vigilance in various ways, depending on their half-life and on their plasma peak time after oral administration. The effect of anticonvulsants on cognition is more pronounced with phenytoin and barbiturates than with carbamazepine or valproate sodium. The problems of comparative analysis in this field and the trends in current studies are underlined.
[Evaluation methods of memory in depression].
The aim of this review is the description of the main modifications of memory of depressive subjects. Cognitive alterations concerning long term and working memory, results of tests dealing with learning items or stories with affective contents. Capacities of depressed subjects on the word completion test (implicit memory) are preserved. In a second part these cognitive particularities will be reviewed in integrative models and these theoretical approaches and their limits will be discussed. Finally, as a general conclusion, difficulties encountered in neuropsychological investigations of depressive subjects will be stressed.
[Randomized study of the therapeutic effect of electroconvulsive therapy, uni- or bilateral, on certain cognitive functions in depression, with electroencephalography monitoring. Preliminary results].
Cognitive functions are known to be impaired by ECT. The aim of this study is to differentiate the effects of electroconvulsive therapy on some cognitive functions according to the mode of application of the electrodes. The brief-pulse Thymatron DG apparatus allows to control four electrical parameters and to assess electroencephalographic data. The preliminary sample comprises nine patients suffering of major depressive disorder; they are randomly assigned to the mode of application of the electrodes, bilateral or unilateral to the non dominant hemisphere. Clinical evolution is surveyed by the Montgomery and Asbert Depression Rating Scale. Non mnesic functions are assessed: arousal by CFF (Critical Fusion Frequency), and attentional, motor and decisional abilities by CRT (Choice Reaction Test). Different mnesic function are studied by selective reminding test, cued recall test, block tapping test and picture fragmentation test. After treatment by ECT, verbal mnesic functions assessed by selective reminding test are impaired with the bilateral application. Whereas they are not modified with the unilateral application. The variance of CFF regains a physiological value in the bilateral group, but remains altered in the unilateral.
[Effects of antidepressants on cognitive functions. Review of the literature].
In this review the authors propose to study the impact of antidepressants on attention, memory and motor functions in healthy volunteers and depressed patients on single and long-term administration. After reviewing the principal cognitive functions, we examine the actual investigation means to conclude that the Critical Flicker Fusion Test (CFFT) is one of the most drug-sensitive tests. It permits a categorization in: sedative antidepressants that in single administration lower CFFT; compounds with no effect on CFFT and no deleterious cognitive effect; and finally substances that raise CFFT and may have psychostimulating properties. On single administration amitriptyline is the most sedative antidepressant on attention or motor level. It seems to produce negative effects on memory level. However, experimental trials give contradictory results. Imipramine in single administration also has sedative effects on memory and car driving capacity. However divergent results of experimental trials do not allow any conclusions of a clearcut negative cognitive effect. Memory impairments with imipramine appear at administration levels of 150 mg. Mianserin has a sedative impact on attention and motor level at low doses (10 mg). Among the tricyclics, nortriptyline has a highly dose dependent sedative effect that has been shown on attention tests (Time Reaction:TR, Digit Symbol Substitution Test: DSST). Among non-tricyclic compounds, doxepine lowers attention and motor performances. Maprotiline (75 mg) lowers CFFT and has a dose dependent effect. Trazodone also has a negative impact on attention tests. Finally viloxazine lowers CFFT but does not impair other attention or motor tests on a 100 mg doses. Buspirone, lofepramine, midalcipran and zimelidine are antidepressants with no effect on CFFT and do not have any positive or negative cognitive effect. On the other hand nomifensine, paroxetine and fluoxetine raise CFFT in healthy volunteers on single administration. Improvement of CFFT performances was found in an isolated manner for nomifensine and paroxetine on 30 mg doses with no other memory or motor effects. MAO-Inhibitors do not impair attention or motor function; thus moclobemide has no negative impact on memory, attention or car driving tests. Cognitive impact of antidepressants in depressive patients seems the same with those of healthy volunteers on single administration. In long-term administration antidepressants have different effects in healthy and depressed subjects. In healthy volunteers cognitive effects of most compounds are normalized after the second week of treatment. However, attention and motor performances with amitriptyline are normalized after 3 weeks of treatment. Sedative motor or cognitive effects of imipramine do not exceed 8 days.(ABSTRACT TRUNCATED AT 400 WORDS)
[The concept of mood in psychology].
The concept of mood is complex and difficult to establish. It reflects a moving notion that cannot be easily grasped. It has always been a fundamental concept in the history of philosophy and medicine. The origin of mood relies on the theory of the four humours: blood, phlegma, yellow and black bilious. Mood can be balanced by the equilibrium of these four liquids. Mood is also difficult to define because one's judgment depends on the perception of mood in other people. It is a highly subjective concept which is backed by personal references. Mood can be expressed with different tonalities. Its panel of expressions can likely explain the different definitions and analysis of this notion. The first part of this report tends to clarify the definition of mood regarding emotion, feeling or affect. Emotion is an instantaneous perception of a feeling. Affect corresponds to a freudian notion of drives. In the second part different conceptions of mood in psychology are treated. Some of them have been derived from philosophical conceptions of mood e.g. the cognitive theory and ethological conception. Others are based on the pathological model of manic depressive psychosis e.g. phenomenological and psychoanalytic views of mood theory. Moreover this analysis will attempt to show the interest of psychological tests to confirm mood troubles or to substantiate a clinical diagnosis of mood disorders. The conception of mood in cognitive psychology is derived from the analysis of emotion. Mood is considered as a group of persisting feelings associated with evaluative and cognitive states which influence all the future evaluations, feelings and actions.(ABSTRACT TRUNCATED AT 250 WORDS)
[Cognition disorders in obsessive disorder].
The authors present a critical overview of the multiple studies of cognitive functions of patients with obsessive compulsive disorder. First are mentioned some correlations between neurological diseases and obsessive compulsive disorder. Then, the authors analyse the results obtained by the patients in WAIS, in the tactual perception memory test, in visual memory and orientation and in verbal memory. Verbal behaviour, performances in sensory perception tests, motor performances, attention and, lastly, troubles in information processing are reviewed. With these results, the authors try to develop the relevant theories about the mechanisms in obsessive compulsive disorder: dysfunction of the dominant hemisphere and abnormality of the serotoninergic system.