Biomedical subjects
Publications and source records attributed to J Dalery.
Sleep disorders are common in childhood, and almost always benign. Simple explanations and parental reassurance are generally sufficient for the alleviation or tolerance of the disorder. However, severe forms exist for which a therapeutic support is necessary and often very efficient.
The effects of fenfluramine were studied in a group of 44 children with the autistic syndrome and in 26 non autistic children with behavior abnormalities, mostly hyperkinetic children, as a control group. The mean daily dosage was 0.65 mg/kg/day. There were 75% positive results in the autistic children and 77% in the control group. The clinical improvement appears to be mainly related to the control of the hyperactive behavior in the autistic children. Platelet serotonin levels were studied in both groups, showing a clear cut decrease during fenfluramine therapy with no significant differences between the 2 groups and no correlation between the clinical effects and the magnitude of the decrease.
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Incorporation of methionine into brain proteins has been measured by quantitative autoradiography after desmethylimipramine administration in rats. Acute treatment decreased protein synthesis in three regions: hippocampus, hypothalamus and habenula. After chronic treatment the decrease extended to four other regions: substantia nigra, raphe dorsalis, trigeminal nerve and hypophysis. An opposite effect was observed in the retrosplenial cortex.
Sex education should not be delayed until the time of puberty, when it is already too late, but should commence during early childhood and be part of general education. The parents are the people in the best position to tackle this topic.
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We have presented the case of a 7 year old retarded child with psychotic like behavioral troubles. Biological studies are compatible with typical phenylketonuria. Two times, a low phenylalanine diet was followed by an improvement of the behavioral troubles, and the interruption of the diet by a relapse of these troubles. Biologically, an hyposerotoninergy was recorded by the lowering of the 5 HIAA renewal in CSF after probenecid, partially corrected by the low phenylalanine diet. From this personal case and a review of the literature, the authors discuss the biochemical interpretation of the behavioral troubles in the light of the serotoninergic deficit.
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According with experiments, it appears that hormonal environment plays a major role on anatomical, neuroendocrinological and behavioral sexual differentiation in animals. This environment occurs at a critical period, which is specific for each specie, either during fetal life or soon after birth. Sexually dimorphic behavior appears to be influenced by androgens who act either directly or after chemical modification on specific central receptors. In the absence of androgens during the critical specific period, these central structures and consequent behavior differentiate in a feminine pattern. In the presence of androgens during this period, structures and behavior differentiate in a masculine pattern. But this influence of androgens require a double component, defeminization and masculinization, variable among species, as it is observed in rats and mice when defeminization can not be obtained in primates. In human beings, "nature experiments" such as congenital adrenal hyperplasia in feminine foetuses and abnormalities in testosterone metabolism in masculine foetuses are more difficult to study. Fetal hyperandrogenization is responsible of an anatomical and perhaps behavioral masculinization. Neuroendocrine and behavioral defeminization seems not to occur as ovulatory menstrual cycles are possible with a regular treatment, and as sexual identity is feminine when sex of rearing is feminine even if some aspects of sexual roles are unusual. Moreover, these peculiar behavioral traits and changes in sexual orientation in a masculine way at puberty are difficult to explain : fetal hyperandrogenization seems to play a role, as it is observed in animals and as seem to demonstrate Dr J. Imperato-Mc Ginley's observations, but other factors seem to predominate, such as parental attitude in regard with sexual ambiguity and psychological consequences of the acknowledgment of ambiguous genitalia.
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Transient hyperkinesia was observed in a 16-year-old epileptic and mentally retarded patient after a single intravenous perfusion of diphenylhydantoin (DPH). No clinical signs of DPH intoxication were associated with the movement disorder. Repeated plasma anticonvulsant level determinations never showed toxic concentrations of DPH. Since a few spontaneous episodes of hyperkinesia had been observed before, the DPH intravenous perfusion could have unmasked a preexisting latent movement disorder in our patient. However, neuroradiological investigations failed to demonstrate the existence of any anatomical damage of the basal ganglia, and HVA as well as 5-HIAA levels measured in the CSF with the probenecid technique were within the normal range 2 months after cessation of hyperkinesia. HVA and 5-HIAA levels have also been measured in the CSF during the period with hyperkinesia; the results are discussed with reference to previously published data concerning cerebral monoamine metabolism in drug-treated epileptic patients.
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The existence of a genetic background is well admitted in schizophrenia, but some individuals at genetic risk for that disease could never manifest it at a clinical level. However, several vulnerability models could help us to identify such individuals. According to them, when similar perturbations at a given task are observed both in clinically stable patients with schizophrenia and their nonschizophrenic first degree relatives, this task could be qualify as an indicator of the vulnerability to schizophrenia. In literature, that seems the case for auditory ERP late components in oddball paradigms. Our study was undertaken to replicate literature data. For that purpose, amplitude and latencies of auditory N100, P200, N200 and P300 wave-forms were assessed among 21 clinically, stable schizophrenics, 21 of their biological full siblings and 21 unrelated control subjects matched with the two others groups for several socio-demographic factors. Comparison were performed by non parametric analyses (Kruskal-Wallis one way ANOVA, and post-hoc Mann-Whitney). Compared to controls, delayed latencies and/or reduced amplitudes were observed for several ERP components--mainly with P300--in the sibling group. ERP values from this group did not statistically differ from those of the group with schizophrenia. In conclusion, results from the sibling group suggest that ERP impairments in auditory oddball paradigms may actually represent indicators of the genetic vulnerability to schizophrenia.
Most of existing self-report measures of schizotypal personality assess only few of the nine traits of schizotypal personality disorder according to DSM III-R or DSM IV. Adrian Raine has developed a self-report scale named "Schizotypal Personality Questionnaire, [SPQ]" to evaluate all these traits. The questionnaire was found to have high sampling validity, high internal reliability [0.91] and test-retest reliability [0.82]. However, the SPQ was still not available in French. Therefore, the first purpose of this report was to offer a French translation of this tool with the agreement of A. Raine for both translated version and its back translation. The second purpose of our study was to establish French norms. The preliminary norms presented here were obtained by administering the SPQ to a sample of 134 French students of both gender (mean age: 20.11 +/- 1.53 years; mean educational level: 13.39 +/- 1.04 years). On that sample, the minimal score was 2/74 and the maximal one 54/74 (mean of the sample: 23.60 +/- 12.09). With the original English study, based on a sample of American students, the cut-offs for the top and the bottom ten percents of SPQ scores were respectively of 41/74 and 12/74. Very close preliminary cut-offs were observed in our own study i.e. respectively 40/74 and 9/74. We will confirm them in a larger sample.
Meehl used the term "schizotype" to refer to individuals who possess an underlying vulnerability for schizophrenia. Because of the extremely varying degrees of the schizotype's clinical expression, he recommended assessing schizotypic signs through objective measures rather than clinical judgement. In this way, Chapman et al. have developed symptom-oriented scales based on Meehl's manual, such as the Social Anhedonia (SA) and Physical Anhedonia (PhA) Scales, the Magical Ideation Scale (MIS), the Perceptual Aberration Scale (PAS) and the Impulsive Nonconformity Scale (IN). Whereas Chapman's scales of psychosis proneness are the most internationally used instruments for the assessment of schizotypy, some of them, such as MIS and PAS, were still not available in French. Therefore, the first aim of this report was to offer French translations of the Magical Ideation and the Perceptual Aberration Scales; the agreement of the original authors were obtained for both translated versions and their back translations. The second aim of our study was to establish French norms for each of these scales. The preliminary norms presented here [MIS: 19/30 (for females) and 20/30 (for males); PAS: 18/35 (for both genders)] were obtained by administering both scales to a sample of 134 French students. They are very close to those found by Chapman et al. for University of Wisconsin undergraduate students. We will confirm them with a larger sample of French students.
Since several investigations have shown attentional deficits both in patients with schizophrenia and in subjects at high risk for schizophrenia, these deficits could be valuable vulnerability markers for schizophrenia. The aim of this study was to investigate wether non psychotic relatives of schizophrenic probands have deficits in sustained attention as measured by the Continuous Performance Test, Identical Pairs (CPT-IP) version. The study subjects were 25 schizophrenic probands, 50 of their first-degree relatives and 46 normal controls. For each subject, attention was assessed during 6 experimental conditions (2 standard, 2 slow, 2 easy conditions) of visual stimuli (digit-numbers and shapes). In each of the six conditions, the value of the sensitive index d' in the first-degree relative group was at an intermediate level between the patient and control groups. Moreover, in the standard shape condition, the d' value was significantly lower in the schizophrenic and in the relative groups than in the control group. This deficit was all the more interesting since it was not explained by a deficit in general intellectual abilities or by psychopathology such as anxiety or depression. Furthermore, the schizophrenic patients made more random errors in the standard and in the slow number conditions than both other groups. All groups improved their performance when the stimulus duration increased and when the processing load decreased. As a conclusion, this investigation seems: 1) to confirm the existence of an attentional deficit in the first-degree relatives of patients with schizophrenia; 2) to demonstrate the interest of the CPT-IP to detect this deficit. It must be emphasized that in order to detect the deficit, one only needs to explore the standard shape condition and that under such circumstances, the CPT-IP test has the advantage of being less time consuming than tests used in previous studies.