Biomedical subjects

Martin Lepage

Publications and source records attributed to Martin Lepage.

At least 19 recordsLinked to original sources

PubMed2026

Applications and outcomes of virtual reality in inpatient psychiatry: A systematic review.

BACKGROUND: Virtual reality (VR) has been widely used in outpatient psychiatric services and has demonstrated benefits across several clinical diagnoses, but its use and effects in inpatient settings remain to be explored. This systematic review aimed to examine the use of VR during psychiatric hospitalization, including types of VR applications, barriers and facilitators of implementation, and effects on various outcomes. METHODS: The review was registered in PROSPERO (#CRD42023446524). Following PRISMA guidelines, databases (Ovid, SciVerse, Web of Science, Cochrane Library, ProQuest, and WorldCat) were searched from 1983 to 2025 using keywords related to VR and psychiatric disorders. Studies involving the use of VR with psychiatric inpatients (≥85%) were included. Descriptive statistics and narrative syntheses were used to summarize findings. Study quality was assessed with the Mixed Methods Appraisal Tool. RESULTS: After full-text screening, 37 studies (N = 1,004) met inclusion criteria. VR was used for both assessment and intervention, with cognitive-behavioral therapy/exposure (35%) and assessment (24%) being the most frequently used. VR use in inpatient units appeared feasible, acceptable, and safe for inpatients and clinicians, though findings remain preliminary. Several facilitators (e.g. adequate staff training and supervision) and common barriers (e.g. technical difficulties and limited resources) were identified. The most consistent improvements were observed in clinical symptoms (e.g. anxiety) compared with psychosocial, cognitive, and physiological outcomes. CONCLUSIONS: These findings suggest that inpatient settings represent a promising, yet understudied context for VR-based assessments and interventions. High-quality trials and systematic reporting of implementation are needed in future studies to inform research and clinical practice.

Humans↗

PubMed2006

Associative memory encoding and recognition in schizophrenia: an event-related fMRI study.

BACKGROUND: We used an event-related functional Magnetic Resonance Imaging (fMRI) approach to examine the neural basis of the selective associative memory deficit in schizophrenia. METHODS: Fifteen people with schizophrenia and 18 controls were scanned during a pair and item memory encoding and recognition task. During encoding, subjects studied items and pairs of visual objects. In a subsequent retrieval task, participants performed an item recognition memory test (old/new decisions) and an associative recognition test (intact/rearranged decisions). The fMRI analysis of the recognition data was restricted to correct items only and a random effects model was used. RESULTS: At the behavioral level, both groups performed equally well on item recognition, whereas people with schizophrenia demonstrated lower performance on associative recognition relative to the control group. At the brain level, the comparison between associative and item encoding revealed greater activity in the control group in the left prefrontal cortex and cingulate gyrus relative to the schizophrenia group. During recognition, greater left dorsolateral prefrontal and right inferior prefrontal activations were observed in the control group relative to the schizophrenia group. CONCLUSION: This fMRI study implicates the prefrontal cortex among other brain regions as the basis for the selective associative memory encoding and recognition deficit seen in schizophrenia.

Adult↗

PubMed2006

Episodic memory impairment in Huntington's disease: a meta-analysis.

Memory dysfunction is an important feature in the clinical presentation of Huntington's disease (HD) and may precede the onset of motor symptoms. Although several studies have contributed to the quantitative and qualitative description of memory impairments in HD, the characterization of episodic memory impairments has varied considerably. Whereas most studies report significant impairments on free recall tests, performance on recognition tests has been considerably more variable, ranging from normal to markedly deficient. This absence of a well-established recognition memory deficit has led some investigators to attribute the memory deficits in HD to a retrieval-based episodic memory impairment. We felt that a quantitative review of the literature was needed to better characterize these episodic memory impairments. We conducted a meta-analysis to assess the magnitude of the recognition memory deficit in HD and to examine it in relation to the known deficit in recall. Memory data were provided by 544 symptomatic HD patients, 224 presymptomatic gene-carriers, and 963 control subjects. The overall group comparison between symptomatic patients and controls yielded effect sizes of d=1.95 for free recall and d=1.73 for recognition. We split the symptomatic group into two subgroups based on their mental status (mild and moderate/severe dementia) and both showed significant deficits in recall and recognition memory, though recall was more impaired than recognition in the mild dementia subgroup. Only slight memory impairment was observed in the presymptomatic subjects. The results show that deficits in recognition memory must be accounted for in future models of memory impairment in HD.

Adult↗

PubMed2006

A process-specific functional dissociation of the amygdala in emotional memory.

Converging evidence highlights the important role of the amygdala in the enhanced memory for emotional material. However, it is unknown whether any regional and/or hemispheric specificity exists regarding its involvement in the different memory stages, such as encoding and retrieval. We directly addressed this issue by conducting an event-related functional magnetic resonance imaging study of memory for faces with different emotional expressions, in which both encoding and recognition were scanned. We found significant amygdala activation associated with both successful encoding and retrieval of fearful faces. Critically, a direct comparison between both stages revealed that whereas the right amygdala was involved in emotional memory formation, the retrieval of those memories relied on the left amygdala. Thus, this study demonstrates a hemispheric dissociation of amygdala involvement in different stages of emotional memory in humans.

Adult↗

PubMed2006

Brain imaging and cognitive dysfunctions in Huntington's disease.

Recent decades have seen tremendous growth in our understanding of the cognitive dysfunctions observed in Huntington's disease (HD). Advances in neuroimaging have contributed greatly to this growth. We reviewed the role that structural and functional neuroimaging techniques have played in elucidating the cerebral bases of the cognitive deficits associated with HD. We conducted a computer-based search using PubMed and PsycINFO databases to retrieve studies of patients with HD published between 1965 and December 2004 that reported measures on cognitive tasks and used neuroimaging techniques. Structural neuroimaging has provided important evidence of morphological brain changes in HD. Striatal and cortical atrophy are the most common findings, and they correlate with cognitive deficits in attention, working memory and executive functions. Functional studies have also demonstrated correlations between striatal dysfunction and cognitive performance. Striatal hypoperfusion and decreased glucose utilization correlate with executive dysfunction. Hypometabolism also occurs throughout the cerebral cortex and correlates with performance on recognition memory, language and perceptual tests. Measures of presynaptic and postsynaptic dopamine biochemistry have also correlated with measurements of episodic memory, speed of processing and executive functioning. Aided by the results of numerous neuroimaging studies, it is becoming increasingly clear that cognitive deficits in HD involve abnormal connectivity between the basal ganglia and cortical areas. In the future, neuroimaging techniques may shed the most light on the pathophysiology of HD by defining neurodegenerative disease phenotypes as a valuable tool for knowing when patients become "symptomatic," having been in a gene-positive presymptomatic state, and as a biomarker in following the disease, thereby providing a prospect for improved patient care.

Brain↗

PubMed2005

Associative interference does not affect recognition memory in schizophrenia.

Studies of schizophrenia suggest a specific impairment in binding different parts of a memory event into a cohesive whole, a finding that may account for the reported preferential deficits in associative recognition memory relative to item recognition. As a further test of this hypothesis and to exert greater control over task differences, we used a recognition memory interference test in which participants encoded landscape pictures that had each been divided into three segments. During encoding, subjects were presented with one segment from each of the landscapes. Then, an interference generating task followed consisting of the presentation of the second segment from half of the landscapes. Finally, a forced-choice recognition memory test consisted of the presentation of each encoding picture stimulus concurrently with the related third segment that had never been presented before. Thus, for half of the stimuli, additional related information was encoded and this is known to interfere with recognition memory. However, an impaired ability to bind this related information should reduce the interfering effect of associated stimuli. Thirty-five schizophrenia patients and 37 healthy controls were administered this memory interference task. A significant interaction between groups and recognition conditions was found with a significant interference effect observed for controls (performance dropping from 76% to 62%) but not for patients (performance remaining unchanged from 66% to 68%). These results provide further support for faulty associative memory processing in schizophrenia.

Adult↗

PubMed2005

Cognitive and clinical moderators of recognition memory in schizophrenia: a meta-analysis.

Recognition memory performance in schizophrenia has been shown to vary greatly across studies. To identify the conditions under which recognition memory is significantly impaired, we used a meta-analytic strategy to quantify the moderating effects of several cognitive and clinical variables. Eighty-four studies (from 1965 to July 2003) provided recognition memory data for both a schizophrenia and control group. The overall group comparison for recognition memory yielded a significant mean weighted effect size of d=0.76. Material specificity was the most significant cognitive variable found, with patients exhibiting greater impairment for figural than verbal recognition. A yes-no recognition format and auditory encoding also led to significantly greater effect sizes for recognition memory relative to forced-choice recognition tests and visual encoding, respectively. Furthermore, the effect size for recognition memory as measured by false alarm was smaller than the effect size as measured by hit rate or by d-prime and its related measures. Among clinical variables that were associated with higher effect sizes, chronicity was the most significant, but different trends linking poor performance to negative symptoms and general symptomatology were also observed. Thus, a recognition memory deficit moderated by both cognitive and clinical variables is clearly present in schizophrenia.

Cognition Disorders↗

PubMed2005

A face to remember: emotional expression modulates prefrontal activity during memory formation.

Emotion can exert a modulatory role on episodic memory. Several studies have shown that negative stimuli (e.g., words, pictures) are better remembered than neutral ones. Although facial expressions are powerful emotional stimuli and have been shown to influence perception and attention processes, little is known about their effect on memory. We used functional magnetic resonance imaging (fMRI) in humans to investigate the effects of expression (happy, neutral, and fearful) on prefrontal cortex (PFC) activity during the encoding of faces, using a subsequent memory effect paradigm. Our results show that activity in right PFC predicted memory for faces, regardless of expression, while a homotopic region in the left hemisphere was associated with successful encoding only for faces with an emotional expression. These findings are consistent with the proposed role of right dorsolateral PFC in successful encoding of nonverbal material, but also suggest that left DLPFC may be a site where integration of memory and emotional processes occurs. This study sheds new light on the current controversy regarding the hemispheric lateralization of PFC in memory encoding.

Adult↗

PubMed2005

Quantitative pharmacokinetic analysis of DCE-MRI data without an arterial input function: a reference region model.

Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) can assess tumor perfusion, microvascular vessel wall permeability and extravascular-extracellular volume fraction. Analysis of DCE-MRI data is usually based on indicator dilution theory that requires knowledge of the concentration of the contrast agent in the blood plasma, the arterial input function (AIF). A method is presented that compares the tissues of interest (TOI) curve shape to that of a reference region (RR), thereby eliminating the need for direct AIF measurement. By assigning literature values for Ktrans (the blood perfusion-vessel permeability product) and v(e) (extravascular-extracellular volume fraction) in a reference tissue, it is possible to extract the Ktrans and v(e) values for a TOI without knowledge of the AIF. The operational RR equation for DCE-MRI analysis is derived, and its sensitivity to noise and incorrect assignment of the RR parameters is tested via simulations. The method is robust at noise levels of 10%, returning accurate (+/-20% in the worst case) and precise (+/-15% in the worst case) values. Errors in the TOI Ktrans and v(e) values scale approximately linearly with the errors in the assigned RR Ktrans and v(e) values. The methodology is then applied to a Lewis Lung Carcinoma mouse tumor model. A slowly enhancing TOI yielded Ktrans=0.039+/-0.002 min-1 and v(e)=0.46+/-0.01, while a rapidly enhancing region yielded Ktrans=0.35+/-0.05 min-1 and v(e)=0.31+/-0.01. Parametric Ktrans and v(e) mappings manifested a tumor periphery with elevated Ktrans (>0.30 min-1) and v(e) (>0.30) values. The main advantage of the RR approach is that it allows for quantitative assessment of tissue properties without having to obtain high temporal resolution images to characterize an AIF. This allows for acquiring images with higher spatial resolution and/or SNR, and therefore, increased ability to probe tissue heterogeneity.

Algorithms↗

PubMed2005

Decrease and increase in brain activity during visual perceptual priming: an fMRI study on similar but perceptually different complex visual scenes.

A robust finding among functional neuroimaging studies on visual priming is decreased neural activity in extrastriate and inferior prefrontal cortices for the second presentation of an object relative to its first presentation. This effect can also be observed for different but perceptually similar objects that are alternative exemplars of the initially presented object (e.g. two different pencils). An unanswered question is whether this decrease in activity can be found for the successive presentation of similar complex visual scenes. We used a test in which landscape pictures were divided vertically into three segments. A first segment was presented and followed several stimuli later by a second related segment. Reaction times were faster for the presentation of the second segment relative to the first one. Although perceptually different from the first segment, the presentation of the second segment was nonetheless associated with reduced activity in late stage visual processing areas including parahippocampal/fusiform gyri bilaterally, left middle occipital and temporal gyri, right inferior temporal and superior occipital gyri, and in left inferior frontal gyrus. The observed decreases in activity in these regions replicate results on priming of different exemplars of single objects while further extending these results to similar complex visual scenes. The presentation of the second segment was also associated with increased activity mainly in frontal and parietal regions, two areas known to be associated with memory retrieval. In sum, priming effects can also occur for complex visual scenes that are intrinsically different from each other although similar in their composition.

Adolescent↗

PubMed2005

Neural correlates of memory for items and for associations: an event-related functional magnetic resonance imaging study.

Although results from cognitive psychology, neuropsychology, and behavioral neuroscience clearly suggest that item and associative information in memory rely on partly different brain regions, little is known concerning the differences and similarities that exist between these two types of information as a function of memory stage (i.e., encoding and retrieval). We used event-related functional magnetic resonance imaging to assess neural correlates of item and associative encoding and retrieval of simple images in 18 healthy subjects. During encoding, subjects memorized items and pairs. During retrieval, subjects made item recognition judgments (old vs. new) and associative recognition judgments (intact vs. rearranged). Relative to baseline, item and associative trials activated bilateral medial temporal and prefrontal regions during both encoding and retrieval. Direct contrasts were then performed between item and associative trials for each memory stage. During en- coding, greater prefrontal, hippocampal, and parietal activation was observed for associations, but no significant activation was observed for items at the selected threshold. During recognition, greater activation was observed for associative trials in the left dorsolateral prefrontal cortex and superior parietal lobules bilaterally, whereas item recognition trials showed greater activation of bilateral frontal regions, bilateral anterior medial temporal areas, and the right temporo-parietal junction. Post hoc analyses suggested that the anterior medial temporal activation observed during item recognition was driven mainly by new items, confirming a role for this structure in novelty detection. These results suggest that although some structures such as the medial temporal and prefrontal cortex play a general role in memory, the pattern of activation in these regions can be modulated by the type of information (items or associations) interacting with memory stages.

Adult↗

PubMed2005

Episodic memory-related activation in schizophrenia: meta-analysis.

BACKGROUND: Numerous studies have examined the neural correlates of episodic memory deficits in schizophrenia, yielding both consistencies and discrepancies in the reported patterns of results. AIMS: To identify in schizophrenia the brain regions in which activity is consistently abnormal across imaging studies of memory. METHOD: Data from 18 studies meeting the inclusion criteria were combined using a recently developed quantitative meta-analytic approach. RESULTS: Regions of consistent differential activation between groups were observed in the left inferior prefrontal cortex, medial temporal cortex bilaterally, left cerebellum, and in other prefrontal and temporal lobe regions. Subsequent analyses explored memory encoding and retrieval separately and identified between-group differences in specific prefrontal and medial temporal lobe regions. CONCLUSIONS: Beneath the apparent heterogeneity of published findings on schizophrenia and memory, a consistent and robust pattern of group differences is observed as a function of memory processes.

Brain↗

PubMed2004

Dorsolateral prefrontal cortex involvement in memory post-retrieval monitoring revealed in both item and associative recognition tests.

Post-retrieval monitoring is a process that contributes to episodic memory retrieval by allowing people to evaluate the relevance of retrieved information in relation to the task requirements. Previous studies have suggested that post-retrieval monitoring is supported by the dorsolateral prefrontal cortex (DLPFC). In this study, we used functional magnetic resonance imaging (fMRI) to evaluate involvement of the DLPFC in post-retrieval monitoring in two different recognition tests (item recognition and associative recognition). The item recognition memory test required subjects to make old/new judgments and the associative recognition memory test required them to make intact/rearranged judgments. Because the post-retrieval monitoring demand increases during old (hits) relative to new (correct rejections) item recognition trials, and also during rearranged (correct rejections) relative to intact (hits) associative recognition trials, we evaluated the brain activation associated with the interaction of Memory test (item versus associative) by Recognition trial (hit versus correct rejection). As expected, the DLPFC was activated in this interaction as well as for both old relative to new item recognition trials and rearranged relative to intact associative recognition trials. This study provides strong evidence that DLPFC activation supports post-retrieval monitoring across different types of recognition tasks.

Adult↗

PubMed2004

The interfering effect of related events on recognition memory discriminability: a functional magnetic resonance imaging study.

Retrieval of information from memory often involves the selection of an event among competing related events, a process that frequently gives rise to interference effects. The present study used a forced-choice recognition test to identify neural correlates of the interfering effect of related events on recognition memory discriminability. Participants encoded landscape pictures divided into three segments. One segment was presented during encoding, and a forced-choice recognition task contrasted a studied and a nonstudied segment for each landscape. For half of the landscapes, the third segment was presented between encoding and recognition tasks to induce associative interference by reducing recognition discriminability. A behavioral study with 40 subjects yielded a significant difference in the correct recognition rate between control and interference trials (76% and 64%, respectively, p<0.001). A subsequent event-related fMRI study with 16 subjects yielded significant activations for correct interference recognition trials relative to control trials in left superior parietal regions, which suggests that these regions play a role in the representation of stimuli and associated information. The opposite contrast yielded significant activations in inferior prefrontal regions bilaterally, right dorsolateral prefrontal cortex and right parahippocampal cortex. Since this contrast was conducted using only correctly recognized trials, these findings could reflect an index of memory discriminability or saliency which could influence conscious recollection.

Adult↗

PubMed2004

Differential contribution of left and right prefrontal cortex to associative cued-recall memory: a parametric PET study.

Several brain imaging studies have implicated prefrontal regions bilaterally during cued-recall memory tasks and yet the functional significance of these regions remains poorly understood. Using PET, we examined the neural activity in prefrontal regions of 15 subjects while they performed three cued-recall tasks differing in pre-experimental semantic associations between cues and targets. This manipulation produced varying levels of retrieval performance when one member (a semantic category name) of the triad was used as a cue for the retrieval of the other two members. The percentage of items correctly recalled was 10, 46, and 70 in the low, medium, and high cued-recall conditions, respectively. Linear contrast analyses of the PET data identified brain regions where neural activity varied with the number of items retrieved from memory. A left lateral prefrontal region showed maximal activity during the high cued-recall condition, which likely reflects processes involved in retrieval success and possibly in the generation of memory responses. Three right prefrontal regions (anterior and dorsolateral) showed maximal activity during the low cued-recall condition, which likely reflects processes involved in memory search/monitoring. These findings add further support for a bilateral prefrontal contribution to memory cued-recall tasks and point to differential roles of the two hemispheres.

Adult↗

PubMed2004

Distributed self in episodic memory: neural correlates of successful retrieval of self-encoded positive and negative personality traits.

Words processed with reference to the self are generally better remembered than words processed in semantic terms. An account of this phenomenon, labeled the Self Reference Effect (SRE), is that the self promotes elaboration and organization of encoded information. Although a few neuroimaging studies associated self-referential encoding with activations of the medial prefrontal cortex, no previous study has investigated the neural correlates of remembering emotional words encoded in an SRE paradigm. The main goal of this study was to define with fMRI the neural correlates of the successful retrieval of negative and positive personality traits encoded in a self-referential mode. Functional MRI scans were acquired for 11 subjects as they recognized positive and negative emotional personality traits adjectives encoded in a self-referential condition, a semantic condition and in a phonemic condition. The correct recognition of self-encoded personality traits engaged dorso-medial prefrontal cortex and lateral prefrontal regions, premotor cortex, parietal and occipital cortex, caudate and cerebellum. The specific recognition of self-encoded negative personality traits involved greater neural activation in the right extra-striate region than the recognition of positive personality traits. Our fMRI findings suggest that specific processes may operate at both encoding and retrieval to subserve the SRE. Unlike self-encoding, the retrieval of personality traits is modulated by the valence of the stimuli with greater activation for negative words. Our results indicate that personally relevant words may signal important emotional clues and support the notion of a widely distributed set of brain regions involved in maintaining the concepts of self.

Adult↗

PubMed2003

Prefrontal cortex contribution to associative recognition memory in humans: an event-related functional magnetic resonance imaging study.

The present event-related fMRI study examined in ten healthy participants neural correlates of recognition memory for intact, rearranged, and new pairs of visual stimuli. The correct categorization of both intact and rearranged pairs relative to pairs of new, never presented before stimuli relies on the retrieval of associative information whereas the discrimination of rearranged pairs from intact pairs additionally involves a recall-to-reject process by which subjects retrieve additional information to reach a recognition decision. Relative to new pairs, both intact and rearranged pairs yielded activation in inferior prefrontal cortex bilaterally and left dorsolateral prefrontal cortex. Relative to intact pairs, rearranged pairs were associated with increased activity in left dorsolateral prefrontal cortex. The latter could reflect the neural correlates of a recall-to-reject process, a pivotal process of associative recognition memory.

Adult↗

PubMed2003

Is associative recognition more impaired than item recognition memory in Schizophrenia? A meta-analysis.

Item recognition memory judgment can be based on two processes: item familiarity and/or the conscious recollection of the initial event. On the other hand, associative recognition relies preferably on conscious recollection. Since evidence points to a specific deficit of conscious recollection in schizophrenia, these patients could show greater impairment during associative recognition tasks relative to item recognition tasks. A meta-analysis of 23 studies of recognition memory in schizophrenia was conducted to test this hypothesis. The impairment is indeed 20% greater (p=0.04) for associative recognition relative to item recognition. This study supports the hypothesis of a specific conscious recollection deficit underlying episodic memory impairment in schizophrenia.

Association↗