[Disorders of folate metabolism in the Kearns-Sayre syndrome].
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Biomedical subjects
Publications and source records attributed to D Laplane.
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Two complementary models of brain organization are nowadays offered: one anatomical and functional, the other computational. The first model implies a subdivision of brain functions in order to find the corresponding brain areas. It is easy to show that this cutting up can only be artificial and is influenced by some kind of "folk psychology", thereby raising suspicion on the "top down" method. On the other hand, it seems impossible to do without any psychological and even any subjective reference and work only according to the bottom up way. It must therefore be concluded that our subdivisions of brain functions must always be regarded as provisional as long as the two methods do not exactly overlap. The computational model uses either the conventional method or the parallel distributed processing. It can be shown that the conventional language utilized impoverishes the normal language and even more thought and is therefore unable to yield more than restricted results. It is suggested that the main advantage of parallel distributed processing is precisely to erase the formalization of language and it is then possible to expect from it much more interesting models. Although it seems possible to improve continuously our understanding of the functional conditions required for consciousness to appear, there seems to be theoretical limits to a complete scientific explanation of self awareness.
CT scan and magnetic resonance imaging in patients with bilateral lesions of the lenticular nuclei, especially the pallidum, have demonstrated a relationship between these lesions and obsessive-compulsive behaviours. Typical behaviour may satisfy the DSM III criteria for obsessive-compulsive disorders, but in some patients signs are limited to elementary stereotyped movements or thoughts, either together or separately. The same patient may exhibit several kinds of behaviour. The range of disorders suggests that circuits running through the striatum and pallidum participate in regulatory and unification processes of sensori-motor and mental systems. Neuropsychological and metabolic tests suggest that frontal circuits involving the pallidum are especially important in this process. Similar disorders may be observed in patients with frontal or bilateral lesions of the caudate. Obsessive-compulsive behaviour is often associated with a loss of psychic self-activation, but there are exceptions. This evidence suggests a similarity between obsessions related to demonstrated lesions of the basal ganglia and other diseases displaying obsessive-compulsive behaviour, including Gilles de la Tourette disease and the former obsessive neurosis, currently termed obsessive-compulsive trouble. As after von Economo encephalitis, these pathological and clinical features should be considered in the current interpretation of the mechanisms of obsession-compulsion. It appears to be easier to apply Charcot's intuitions about neuroses to obsessive-compulsive behaviour than to hysteria.
The case, including pathological description, of a 65 year old man is presented. Severe disturbances in respiratory rhythm and consciousness occurring during wakefulness and sleep, progressing by acute exacerbations, developed after the disease had been present for 4 years and resulted in death after three months. Small degenerative lesions of the pontine nucleus, the locus coerulus, the intermedio-lateral column and the substantia nigra were seen.