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Khadidja B, Benyoucef Z, Sebti S, Hamzi L, Boulekhsaim F, Boukabous H, Khalfa S, Zarroug M, Griballah Z, Toukal S, Khoudri S. PO-1133: Concurrent chemoradiotherapy with or without brachytherapy; a retrospective clinical study. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01150-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Verger A, Rousseau PF, Malbos E, Chawki MB, Nicolas F, Lançon C, Khalfa S, Guedj E. Involvement of the cerebellum in EMDR efficiency: a metabolic connectivity PET study in PTSD. Eur J Psychotraumatol 2020; 11:1767986. [PMID: 33029312 PMCID: PMC7473141 DOI: 10.1080/20008198.2020.1767986] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND We recently reported an improvement of precuneus PET metabolism after EMDR therapy in military participants suffering from PTSD. OBJECTIVE The aim of the present study was to investigate the metabolic changes of precuneus connectivity in these participants after such treatment. METHOD Fifteen participants with PTSD performed a brain 18F-FDG-PET sensitized by virtual reality exposure to war scenes, before and after EMDR treatment. Inter-regional correlation analysis was performed to study metabolic changes of precuneus connectivity through SPMT maps at whole-brain level (p < 0.005 for the voxel, p < 0.05 for the cluster). RESULTS A decrease of connectivity was observed after EMDR between the precuneus and two significant bilateral clusters of the cerebellum (bilateral Crus I and VI cerebellar lobules, Tmax voxel of 5.8 and 5.3, and cluster size of 343 and 314 voxels, respectively). Moreover, higher cerebellar metabolism before treatment was associated with reduced clinical PTSD scores after EMDR (p = 0.03). CONCLUSIONS The posterior cerebellum and its metabolic connectivity with the precuneus are involved in the clinical efficiency of EMDR in PTSD.
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Affiliation(s)
- A Verger
- Department of Nuclear Medicine & Nancyclotep Imaging Platform, CHRU Nancy, Lorraine University, Nancy, France.,Iadi, Inserm, Umr 1254, Lorraine University, Nancy, France
| | - P F Rousseau
- Laboratoire de Neurosciences Sensorielles et Cognitives, Aix-Marseille Université CNRS, Marseille, France
| | - E Malbos
- Department of Psychiatry, La Conception University Hospital, Marseille, France.,Service de Psychiatrie, Hôpital d'Instruction des Armées Sainte-Anne, Toulon, France
| | - M B Chawki
- Department of Nuclear Medicine & Nancyclotep Imaging Platform, CHRU Nancy, Lorraine University, Nancy, France
| | - F Nicolas
- CNRS, Ecole Centrale de Marseille, UMR 7249, Institut Fresnel, Aix-Marseille Université, Marseille, France
| | - C Lançon
- Department of Psychiatry, La Conception University Hospital, Marseille, France
| | - S Khalfa
- Laboratoire de Neurosciences Sensorielles et Cognitives, Aix-Marseille Université CNRS, Marseille, France
| | - E Guedj
- Service de Psychiatrie, Hôpital d'Instruction des Armées Sainte-Anne, Toulon, France.,Department of Nuclear Medicine, Assistance Publique Hôpitaux de Marseille, Timone University Hospital, Marseille, France.,CERIMED, Aix-Marseille University, Marseille, France
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Rousseau PF, Malbos E, Verger A, Nicolas F, Lançon C, Khalfa S, Guedj E. Increase of precuneus metabolism correlates with reduction of PTSD symptoms after EMDR therapy in military veterans: an 18F-FDG PET study during virtual reality exposure to war. Eur J Nucl Med Mol Imaging 2019; 46:1817-1821. [PMID: 31152209 DOI: 10.1007/s00259-019-04360-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Accepted: 05/13/2019] [Indexed: 12/29/2022]
Abstract
PURPOSE The prevalence of posttraumatic stress disorder (PTSD) is higher among veterans, and can lead to disastrous consequences such as suicide. Eye movement desensitization and reprocessing (EMDR) is recommended in first-line psychotherapies for PTSD. Virtual reality exposure (VRE) coupled with 18F-FDG PET imaging can highlight the activated brain regions during stress exposure. The objective of this study is to identify, after EMDR therapy, the regions of brain metabolism that evolve during the stress exposure of a war scene with symptomatic remission in a group of military veterans suffering from PTSD, and to secondarily search for predictive metabolic features. METHODS We recruited 15 military veterans suffering from PTSD who performed an 18F-FDG PET sensitized by the exposure to a virtual war scene, before (T0) and after (T1) EMDR therapy. Statistical parametric mapping was used to compare brain metabolism before and after treatment and to study correlations between metabolism and evolution scores on PTSD clinical scales (PTSD Checklist Scale, PCLS; Clinician-Administered PTSD Scale, CAPS). RESULTS The metabolic activity of the precuneus was increased after EMDR therapy (p < 0.005 uncorrected, k > 180) and correlated with clinical improvement with the CAPS scale (r = -0.73 and p < 0.001). Moreover, the precuneus metabolic value before therapy predicted the clinical improvement on the PCLS scale (T1-T0) after EMDR (r = -0.667 and p < 0.006). CONCLUSION The clinical improvement in military patients with PTSD after EMDR is related to increased precuneus metabolism upon VR stress exposure.
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Affiliation(s)
- P F Rousseau
- Laboratoire de Neurosciences Sensorielles et Cognitives, Aix-Marseille Université CNRS, Marseille, France
| | - E Malbos
- Department of Psychiatry, La Conception University Hospital, Marseille, France
| | - A Verger
- Department of Nuclear Medicine & Nancyclotep Imaging Platform, CHRU Nancy, Lorraine University, Nancy, France
- IADI, INSERM, UMR 1254, Lorraine University, Nancy, France
| | - F Nicolas
- Service de Psychiatrie, Hôpital d'Instruction des Armées Sainte-Anne, Toulon, France
| | - C Lançon
- Department of Psychiatry, La Conception University Hospital, Marseille, France
| | - S Khalfa
- Laboratoire de Neurosciences Sensorielles et Cognitives, Aix-Marseille Université CNRS, Marseille, France
| | - Eric Guedj
- CNRS, Ecole Centrale de Marseille, UMR 7249, Institut Fresnel, Aix-Marseille Université, Marseille, France.
- Department of Nuclear Medicine, Assistance Publique Hôpitaux de Marseille, Timone University Hospital, Marseille, France.
- CERIMED, Aix-Marseille University, Marseille, France.
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Rousseau P, El Khoury-Malhame M, Reynaud E, Zendjidjian X, Samuelian J, Khalfa S. Neurobiological correlates of EMDR therapy effect in PTSD. European Journal of Trauma & Dissociation 2019. [DOI: 10.1016/j.ejtd.2018.07.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Cancel A, Comte M, Truillet R, Boukezzi S, Rousseau PF, Zendjidjian XY, Sage T, Lazerges PE, Guedj E, Khalfa S, Azorin JM, Blin O, Fakra E. Childhood neglect predicts disorganization in schizophrenia through grey matter decrease in dorsolateral prefrontal cortex. Acta Psychiatr Scand 2015; 132:244-56. [PMID: 26038817 DOI: 10.1111/acps.12455] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/15/2015] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Psychosocial trauma during childhood is associated with schizophrenia vulnerability. The pattern of grey matter decrease is similar to brain alterations seen in schizophrenia. Our objective was to explore the links between childhood trauma, brain morphology and schizophrenia symptoms. METHOD Twenty-one patients with schizophrenia stabilized with atypical antipsychotic monotherapy and 30 healthy control subjects completed the study. Anatomical MRI images were analysed using optimized voxel-based morphometry (VBM). Childhood trauma was assessed with the Childhood Trauma Questionnaire, and symptoms were rated on the Scale for the Assessment of Negative Symptoms (SANS) and Scale for the Assessment of Positive Symptoms (SAPS) (disorganization, positive and negative symptoms). In the schizophrenia group, we used structural equation modelling in a path analysis. RESULTS Total grey matter volume was negatively associated with emotional neglect (EN) in patients with schizophrenia. Whole-brain VBM analyses of grey matter in the schizophrenia group revealed a specific inversed association between EN and the right dorsolateral prefrontal cortex (DLPFC). Path analyses identified a well-fitted model in which EN predicted grey matter density in DLPFC, which in turn predicted the disorganization score. CONCLUSION Our findings suggest that EN during childhood could have an impact on psychopathology in schizophrenia, which would be mediated by developmental effects on brain regions such as the DLPFC.
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Affiliation(s)
- A Cancel
- Timone Institute of Neuroscience, UMR 7289, CNRS and Aix-Marseille University, Marseille, France.,Department of Psychiatry, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - M Comte
- Timone Institute of Neuroscience, UMR 7289, CNRS and Aix-Marseille University, Marseille, France
| | - R Truillet
- Public Assistance for Marseille Hospitals (APHM) Unit for Clinical Pharmacology and Therapeutic Evaluation (CIC-UPCET), CHU Timone Hospital, Marseille, France
| | - S Boukezzi
- Timone Institute of Neuroscience, UMR 7289, CNRS and Aix-Marseille University, Marseille, France
| | - P-F Rousseau
- Timone Institute of Neuroscience, UMR 7289, CNRS and Aix-Marseille University, Marseille, France.,Psychiatry Unit, Saint Anne Military Training Hospital, Toulon, France
| | - X Y Zendjidjian
- Department of Psychiatry, La Conception University Hospital, Marseille, France
| | - T Sage
- Clinic of Mental Health, L'escale, Orpea-Clinéa, Saint-Victoret, France
| | - P-E Lazerges
- Department of Psychiatry, Sainte Marguerite University Hospital, Marseille, France
| | - E Guedj
- Timone Institute of Neuroscience, UMR 7289, CNRS and Aix-Marseille University, Marseille, France.,Biophysics and Nuclear Medicine Department, Timone Hospital, Marseille, France
| | - S Khalfa
- Timone Institute of Neuroscience, UMR 7289, CNRS and Aix-Marseille University, Marseille, France
| | - J-M Azorin
- Timone Institute of Neuroscience, UMR 7289, CNRS and Aix-Marseille University, Marseille, France.,Department of Psychiatry, Sainte Marguerite University Hospital, Marseille, France
| | - O Blin
- Timone Institute of Neuroscience, UMR 7289, CNRS and Aix-Marseille University, Marseille, France.,Public Assistance for Marseille Hospitals (APHM) Unit for Clinical Pharmacology and Therapeutic Evaluation (CIC-UPCET), CHU Timone Hospital, Marseille, France
| | - E Fakra
- Timone Institute of Neuroscience, UMR 7289, CNRS and Aix-Marseille University, Marseille, France.,Department of Psychiatry, University Hospital of Saint-Etienne, Saint-Etienne, France
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Cancel A, Comte M, Rousseau P, Boukezzi S, Guedj E, Khalfa S, Fakra E. Impact des évènements traumatiques précoces sur la morphologie cérébrale dans la schizophrénie : une étude en Voxel-Based Morphometry. Eur Psychiatry 2013. [DOI: 10.1016/j.eurpsy.2013.09.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
IntroductionL’étude des facteurs de vulnérabilité à la schizophrénie est un enjeu majeur de la psychiatrie actuelle [3]. Nous avons donc réalisé une étude dans l’objectif d’expliciter les liens existant entre traumatismes subis dans l’enfance et anomalies anatomiques observées dans la schizophrénie.
Patients et méthodeAu total 26 sujets schizophrènes stabilisés par rispéridone ou aripiprazole depuis au moins 6 semaines et 31 volontaires sains appariés ont été inclus. La sévérité des traumatismes infantiles a été évaluée avec la Childhood Trauma Questionnaire (CTQ). L’analyse en Voxel-Based Morphometry (VBM) a été réalisée à partir d’IRM anatomiques haute résolution en veillant à la qualité du prétraitement [1] et après correction pour les comparaisons multiples.RésultatsEn cohérence avec notre hypothèse principale, il a été retrouvé une corrélation négative entre la négligence émotionnelle dans l’enfance et le volume total de matière grise chez les schizophrènes (Δ = −0,50 ; p = 0,003 après ajustement sur l’âge, le sexe et le niveau éducatif). La même tendance est retrouvée non significative chez les volontaires sains. Outre cet effet global, il existe une corrélation négative entre la négligence émotionnelle et la densité de matière grise des schizophrènes dans le cortex cingulaire antérieur dorsal gauche (Z-score = 3,9 ; pFWE = 0,046) et le cortex préfrontal dorsolatéral droit (Z-score = 4,19 ; pFWE = 0,002). La comparaison de la densité de matière grise entre sujets schizophrènes et volontaires sains révèle des diminutions de densités centrées sur la partie antérieure des insula et le gyrus temporal supérieur gauche.
ConclusionCe résultat original démontre l’impact des interactions précoces, auxquelles les schizophrènes semblent particulièrement sensibles, sur la morphologie cérébrale. Les régions retrouvées, cortex cingulaire antérieur dorsal et cortex préfrontal dorsolatéral, sont particulièrement impliquées dans les troubles cognitifs et la dimension de désorganisation de la schizophrénie [2].
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Rousseau P, Boukezzi S, Cancel A, Comte M, Guedj E, Fakra E, Clervoy P, Khalfa S. Conditionnement et extinction à la peur dans l’état de stress post-traumatique, étude des mécanismes centraux en IRM fonctionnelle. Eur Psychiatry 2013. [DOI: 10.1016/j.eurpsy.2013.09.070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
IntroductionLa réponse normale ou pathologique à la peur peut être étudiée par un protocole de conditionnement à la peur et à son extinction. Nous avons étudié les mécanismes cérébraux centraux de réponses à la peur à l’aide du modèle pathologique que constitue l’État de Stress Post-Traumatique (ESPT), par un protocole de conditionnement à la peur et à son extinction en IRM fonctionnelle (IRMf). Notre hypothèse est que si ce mécanisme de conditionnement/extinction est central dans l’ESPT, alors après disparition des symptômes, les anomalies fonctionnelles des structures impliquées dans ce mécanisme (amygdale et cortex préfrontal médian) disparaîtront.
MéthodesCinquante-deux sujets, 22 témoins sains et 30 patients atteints d’ESPT sont inclus. Les patients effectuaient le protocole de conditionnement à la peur et à son extinction avant puis après traitement et disparition des symptômes. Le contraste d’intérêt était la différence de signal BOLD après moins avant traitement chez les sujets ESPT.RésultatsLes patients présentent un retard dans l’extinction d’une peur conditionnée (p < 0,001). Une augmentation du signal BOLD après disparition des symptômes chez les patients ESPT est retrouvée dans des clusters centrés sur le noyau médiodorsal du thalamus, les gyrus frontaux inférieurs et supérieurs gauche (p < 0,005 et k > 5).
Discussion et conclusionTémoignant d’une dérégulation des réponses à la peur, l’ESPT se caractérise par un déficit dans l’extinction d’une peur conditionnée. Le traitement de l’ESPT restaure la fonction du thalamus et du cortex préfrontal dorsolatéral gauche. Le circuit neuronal sous-jacent aux mécanismes de stress ferait donc intervenir le noyau médiodorsal du thalamus gauche, inhibé chez les malades, qui ne jouerait plus son rôle dans l’encodage et le rappel des informations en lien avec le cortex préfrontal dorsolatéral gauche. Ces structures seraient donc essentielles pour permettre une « extinction » des événements traumatisants, c’est-à-dire une intégration de nos émotions négatives.
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Boukezzi S, Rousseau P, Cancel A, Comte M, Khalfa S. Évolution de la densité de matière grise à disparition des symptômes dans l’état de stress post-traumatique. Étude en IRM à haute résolution : Voxel Based Morphometry (VBM). Eur Psychiatry 2013. [DOI: 10.1016/j.eurpsy.2013.09.067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
IntroductionUne controverse existe concernant la nature et l’origine des réductions de densité de matière grise (dMG) dans l’État de Stress Post-Traumatique (ESPT). Ces atrophies pourraient être des facteurs de vulnérabilité pour le développement de l’ESPT [2] ou bien être la conséquence des symptômes liés au traumatisme [1]. Le but de cette étude a été d’étudier la question. Notre hypothèse est que les principales atrophies décrites dans la littérature évolueront avec l’amélioration des symptômes une semaine et 6 mois après une thérapie de désensibilisation et de retraitement de l’information par les mouvements oculaires (EMDR).
Patients et méthodesNous avons étudié l’évolution des symptômes et la dMG chez 9 sujets atteints d’ESPT et chez 17 sujets témoins avant, une semaine et 6 mois après thérapie. Cette étude a été réalisée avec une technique d’IRM à haute résolution : la Voxel Based Morphometry (VBM).RésultatsAvant thérapie, les patients atteints d’ESPT présentaient des atrophies au niveau de 4 régions incluant le lobe frontal (Aire de Brodmann [BA] 32 droite, BA 10 droite, BA 9 gauche, BA 11 droite), le lobe pariétal (BA 43 droite, BA 40 droite), le lobe temporal (BA 42 droite, BA 38 droite) et le cervelet postérieur gauche. L’intensité des symptômes a diminué une semaine et 6 mois après thérapie. Pour BA 38, nous avons observé une augmentation de la dMG une semaine et 6 mois après traitement, mais pas pour les autres régions.
Discussion et conclusionLes atrophies trouvées dans cette étude sont en accord avec la littérature et expliqueraient notamment les déficits concernant les processus de peur et la régulation des émotions [3]. Certaines structures semblent constituer des facteurs de risque et leurs atrophies pourraient préexister avant la venue de l’événement traumatique alors que d’autres atrophies pourraient être la conséquence de cet événement.
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Khalfa S, Elkhoury M, Guedj E, Reynaud E, Roques J, Samuelian JC. Cerebral mechanisms involved in post-traumatic stress disorder (PTSD) and its treatment by Eye Movement Desensitization and Reprocessing (EMDR). Encephale 2012. [DOI: 10.1016/j.encep.2012.07.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Khalfa S, Elkhoury M, Guedj E, Reynaud E, Roques J, Samuelian JC. Mécanismes cérébraux impliqués dans l’état de stress post-traumatique (ESPT) et son traitement par EMDR (Eye Movement Desensization and Reprocessing). Encephale 2012. [DOI: 10.1016/j.encep.2012.07.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Khalfa S, Dubal S, Veuillet E, Perez-Diaz F, Jouvent R, Collet L. Psychometric normalization of a hyperacusis questionnaire. ORL J Otorhinolaryngol Relat Spec 2002; 64:436-42. [PMID: 12499770 DOI: 10.1159/000067570] [Citation(s) in RCA: 259] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Clinical hyperacusis consists of a marked intolerance to ordinary environmental sounds, while hearing thresholds are quite often normal. Hyperacusis appears to be a subjective phenomenon, which is not easily defined or quantified by objective measurements. In order to create a tool suitable to quantify and evaluate various hyperacusis symptoms, a questionnaire screening several aspects of auditory symptomatology has been constructed. Two hundred and one subjects (who were either hyperacusic or not), randomly selected from the general population, were tested. A principal component analysis performed on the correlation matrix of the 14 items of the questionnaire isolated three dimensions: attentional, social, and emotional. The three dimensions had satisfactory internal consistency reliability. The mean +/- SD total score was 15 +/- 6.7 out of 42 (maximum of hyperacusis) and a score greater than 28 seems to represent a strong auditory hypersensitivity. This new psychometric tool should further be tested on hyperacusic patients to verify its relevance in pathology and define the involvement of the three dimensions statistically obtained on the hyperacusis symptomatology.
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Affiliation(s)
- S Khalfa
- Neurosciences and Sensory Systems, Lyon, France.
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Khalfa S, Bougeard R, Morand N, Veuillet E, Isnard J, Guenot M, Ryvlin P, Fischer C, Collet L. Evidence of peripheral auditory activity modulation by the auditory cortex in humans. Neuroscience 2001; 104:347-58. [PMID: 11377839 DOI: 10.1016/s0306-4522(01)00072-0] [Citation(s) in RCA: 60] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
At the auditory periphery, the medial olivocochlear system is assumed to be involved in complex sound processing and may be influenced by feedback from higher auditory nuclei. Indeed, the descending auditory pathway includes fibers coming from the auditory cortex that are anatomically well positioned to influence the superior olivary complex, and thus the medial efferent system. The aim of the present study was to verify the hypothesis of an implied influence of the auditory cortex on the peripheral auditory system. In three rare cases of patients presenting with intractable temporal lobe epilepsy, Heschl's gyrus (i.e. the temporal superior gyrus) was surgically removed in the right hemisphere in two patients and in the left hemisphere in a third patient, in order to minimize epilepsy attacks, as preoperative stereoencephalography had shown the epileptic focus or tumor to be situated in those locations. In all three cases, several weeks after the operation the medial olivocochlear system was clearly less functional on both sides, but especially on the side contralateral to the resection. In healthy controls, no such pattern was obtained. In four other epileptic patients, who were operated unilaterally at the anterior temporal pole, amygdala and hippocampus with the temporal gyrus partially spared, efferent suppression grew stronger in the ear ipsilateral to surgery. These results revealed that, in humans, the primary and secondary auditory cortex play a role in modulating auditory periphery activity through direct or indirect efferent fibers. In accordance with previous findings, this descending influence may improve the auditory afferent message by adapting the hearing function according to cortical analysis of the ascending input.
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Affiliation(s)
- S Khalfa
- Université de Montréal, Département de Psychologie, CP 6128 Succursale Centre-ville, QC, H3C 3J7, Montréal, Canada.
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Abstract
Difficulty in filtering relevant auditory information in background noise is one of the features of autism. Auditory filtering processes can be investigated at the peripheral level as they are hypothesized to involve active cochlear mechanisms which are regulated by the efferent activity of the medial olivocochlear (MOC) system. The aim of the present work was therefore to assess these peripheral auditory processes in 22 children and adolescents with autism compared with age- and gender-matched normal controls. Active cochlear mechanisms were evaluated with transiently evoked otoacoustic emissions (TEOAEs) and MOC system efficiency was assessed via TEOAEs which are decreased when stimulating the contralateral ear with noise. The MOC system evaluation was performed on 18 of the 22 children. In both studies, results were analysed according to age (from 4 to 10 years and from 11 to 20 years). The main result concerns the asymmetry of the efferent system which differs in individuals with autism. Several neural processes might be hypothesized as involved in the results obtained as the MOC system which originates in the brainstem received regulating controls from upper brain structures including auditory cortex. Lateralization abnormalities at the auditory periphery may reflect indirectly a problem at a higher level of auditory processing. A second important result shows a decrease in TEOAE amplitude with age, in patients, that may correspond to a decrease in hearing sensitivity.
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Affiliation(s)
- S Khalfa
- Neurosciences et Systèmes Sensoriels, UPRESA CNRS 5020, Pavillon U, Hôpital Ed. Herriot, Place d'Arsonval 69003 Lyon, France.
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Veuillet E, Khalfa S, Collet L. Clinical relevance of medial efferent auditory pathways. Scand Audiol Suppl 2000; 51:53-62. [PMID: 10803914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
Evoked otoacoustic emissions have been shown to be suppressed by sounds applied in the contralateral ear and this effect can be largely explained by the involvement of medial olivocochlear efferent fibers. Thus, EOAE recording during contralateral stimulation provides a non-invasive means of investigating auditory efferent system functioning in humans. The question remains, however, as to whether this test provides a tool, which could be useful in a variety of clinical applications. This review describes current clinical applications for this test, showing that it may prove useful for improving identification of retrocochlear pathologies. Some new areas are also identified. Methodological topics are discussed and suggestions for maximizing the value of this test are proposed.
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MESH Headings
- Adult
- Audiometry, Pure-Tone/methods
- Audiometry, Speech/methods
- Auditory Diseases, Central/complications
- Auditory Diseases, Central/diagnosis
- Auditory Pathways/pathology
- Child
- Cochlear Nucleus/pathology
- Evoked Potentials, Auditory/physiology
- Female
- Hearing Loss, Sensorineural/diagnosis
- Hearing Loss, Sensorineural/etiology
- Humans
- Hyperacusis/etiology
- Male
- Middle Aged
- Neuroma, Acoustic/complications
- Neuroma, Acoustic/pathology
- Neuroma, Acoustic/surgery
- Neurons, Efferent/pathology
- Olivary Nucleus/pathology
- Tinnitus/etiology
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Affiliation(s)
- E Veuillet
- UPRESA CNRS 5020 Neurosciences et Systèmes Sensoriels, Hôpital Edouard Herriot Pavillon U, Lyon, France
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Morand N, Khalfa S, Ravazzani P, Tognola G, Grandori F, Durrant JD, Collet L, Veuillet E. Frequency and temporal analysis of contralateral acoustic stimulation on evoked otoacoustic emissions in humans. Hear Res 2000; 145:52-8. [PMID: 10867276 DOI: 10.1016/s0378-5955(00)00069-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Previous studies have shown that the effect of contralateral acoustic stimulation (CAS) on ipsilateral evoked otoacoustic emissions (EOAE) depends somewhat upon the spectrum of the eliciting stimulus. The latency of the EOAE, however, is itself frequency-dependent. Consequently, two general ways of analyzing the effects of CAS may be considered: by frequency band or by temporal segment. In this study, we analyzed the effects of CAS both ways in the same subjects, essentially simultaneously. The frequency analysis of the EOAE derived from the wavelet transform (WT). The WT is known to provide a robust approach to the analysis of non-stationary signals and was anticipated to avoid possible time-frequency confounds of the cochlear mechanical system. For comparison, a more basic analysis - using a temporal moving window - was employed. The results largely support earlier findings and confirm that in humans the greatest suppression of EOAEs by CAS is obtained for lower frequency and/or longer latency EOAE components. Despite expectations for the WT analysis, the more basic, temporal, analysis tended to yield the clearer results.
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Affiliation(s)
- N Morand
- Laboratory Neurosciences et Systèmes, UMR CNRS 5020, Hôpital Edouard Herriot, Lyon, France.
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Abstract
In order to gain further information on the characteristics and physiological correlates of tone decay in humans, the tone decay test was administered to 58 normal-hearing subjects, successively in the left and right ears and in absence and presence of a contralateral noise. The results revealed that tone decay was greater in the right than in the left ear and was increased by contralateral noise. The contralateral effect of this noise on cochlear biomechanisms was then estimated by measuring contralaterally induced variations in the amplitude of click-evoked otoacoustic emissions in the same subjects. In the right ear, the increase in tone decay and the decrease in otoacoustic emission amplitude--both induced by contralateral noise--were positively correlated (r = .315, p = .016). Furthermore, the contralateral changes in otoacoustic emission amplitude were found to be on average larger in the right than in the left ear, this asymmetry being correlated with that observed for the tone decay. These findings are discussed in relation to previous results on simple and induced loudness adaptation in the vicinity of threshold, on contralateral attenuation of otoacoustic emissions and on the influence of the auditory efferents on cochlear biomechanisms.
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Affiliation(s)
- S Khalfa
- Université Claude Bernard, Lyon, France.
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Abstract
The auditory sensory end organ is under the control of the central nervous system via efferent projections. Contralateral suppression of otoacoustic emissions (acoustic signatures of the cochlear biomechanical activity) provides a non-invasive approach to assess olivocochlear efferent activity in humans. Using this approach, the present study compared professional musicians with musically-inexperienced subjects. The results revealed stronger bilateral cochlear suppression, suggesting larger efferent influences in both ears, in musicians. Furthermore, in indicating no difference in left/right asymmetry of efferent-mediated suppression between the two groups, the present findings suggest that the observed differences in olivocochlear activity reflect bilaterally-enhanced activity of the cortical auditory structures in musicians rather than differences in cerebral hemispheric asymmetry between the two groups.
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Affiliation(s)
- X Perrot
- Université Claude Bernard Lyon I, Centre National de la Recherche Scientifique UPRESA 5020, Hôpital Edouard Herriot, France
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Dubai S, Khalfa S, Collet L, Pierson A, Jouvent R. 438 Attentional processing in anhedonia: An effort-dependent trait? Int J Psychophysiol 1998. [DOI: 10.1016/s0167-8760(98)90437-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Abstract
It is well established that in humans many differences between right- and left-handers, anatomical, physiological and functional, exist. Left- and mixed-handedness is associated with greater bihemispheric representation of cognitive functions than in right-handers. Several studies indicate a left-right asymmetry in the function of hearing pathways between cochlea and auditory cortex, and furthermore, that this asymmetry is associated with handedness. Our investigation focuses on the medial olivo-cochlear system, which has been demonstrated to be more effective in the right than left ear in right-handers. The aim of the study was to investigate this auditory efferent system asymmetry according to handedness, gender, eyedness, footedness and the presence of spontaneous otoacoustic emissions. The medial efferent system has been found to be more effective in the right than left ear in right-handers, while functioning symmetrically in left-handers. Furthermore, the olivo-cochlear system, assumed to be involved in basic language processing, shows an asymmetrical pattern of functioning influenced by handedness as well as by hemispheric language representation. Reverse medial efferent system asymmetry was observed in left-handers compared to that in right-handers, on condition that only left-handed males were considered, or that the left-handers were also left-eyed, or that spontaneous otoacoustic emissions were present in the left ear of the left-handers, or when only left-handers without mixed-handers were considered.
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Affiliation(s)
- S Khalfa
- CNRS UPRESA 5020, Perception et Mécanismes Auditifs, Pavillon U, Hôpital Edouard Herriot, 3, Place d'Arsonval, 69003 Lyon, France.
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Abstract
Previous studies indicate a left-right asymmetry in the function of peripheral auditory system. Contralateral acoustic suppression of TEOAEs (transient evoked otoacoustic emissions) enables assessment of medial olivocochlear efferent system functioning, and has demonstrated that this system is more effective in the right than in the left ear. Moreover, TEOAE amplitudes are lower in the left than in the right ear. The aim of the present experiment was to verify firstly the absence of a relationship between medial efferent system asymmetry and TEOAE amplitude asymmetry, and secondly to study TEOAE input/output function slopes. There was no link between the asymmetries in TEOAE amplitude and in the medial efferent system functioning. Further, as previously shown, the medial olivocochlear system increased the TEOAE input/output function slopes. These TEOAE input/output function slopes seem to be consistent factors in peripheral asymmetry since the slope is lower in the right than in the left ear. Moreover, the lower the TEOAE amplitudes, the greater the TEOAE slopes. The slope asymmetry of the two ears could correspond to earlier saturation or a lower augmentation ability of the TEOAE response in the right ear, where the TEOAE amplitude is higher. This asymmetry in growth slopes reinforces the notion of peripheral auditory lateralization.
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Affiliation(s)
- S Khalfa
- CNRS UPRESA 5020, Neurosciences et Systèmes Sensoriels, Hôpital Edouard Herriot, Lyon, France.
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Khalfa S, Morlet T, Veuillet E, Perrot X, Collet L. [Peripheral auditory lateralization]. Ann Otolaryngol Chir Cervicofac 1998; 115:156-60. [PMID: 9765718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
Neuropsychological studies have demonstrated that language perception is lateralized at the hemispheric level. There is also much evidence for a peripheral lateralization of the auditory system in humans. Spontaneous otoacoustic emissions are more frequent in the right than in the left ear. The medial olivo-cochlear system is also more functional in the right than in the left ear in normal subjects. The study of specific samples shows that this asymmetry is found in professional musicians which have more functional efferent system in both ears. A link is hypothesized between peripheral and central laterality because of a dysfunctional peripheral asymmetry in pathological cases which show hemispheric lateralization disorders. Consequences of those pathological data will be discussed.
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Affiliation(s)
- S Khalfa
- CNRS UPRESA 5020, Département d'ORL, Hôpital Edouard Herriot, Lyon
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Abstract
The present study aimed to confirm and extend the finding, suggested by the results of a previous study, of different auditory neural efferent functioning in musicians compared with non-musicians. The activity of the medial olivocochlear bundle (MOCB), an auditory efferent subsystem, was measured through the contralaterally induced attenuation of the amplitude of evoked otoacoustic emissions (EOAEs) in two groups, one of musicians and one of non-musicians, paired for age and sex. The results indicated a statistically significant difference between the two groups, with the musicians showing greater amplitude reduction upon contralateral noise stimulation than non-musicians (U-test, U = 204, p < 0.025, n = 32). These results indicate greater MOCB activity in musicians than in non-musicians. The possible origins and implications of this finding are discussed.
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Affiliation(s)
- C Micheyl
- Laboratoire Perception et Mécanismes Auditifs, CNRS UPRESA 5020, Hôpital E, Herriot, Lyon, France
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Abstract
Auditory system hemispheric asymmetry in language processing is well-established, and there are many indications of lateralization as of the peripheral auditory system i.e., as of the cochlea. The left ear is more susceptible to noise damage; tinnitus is more predominant there, while spontaneous otoacoustic emissions (SOAEs) are more often found in the right ear. The present study addressed the following two questions: Does this right-ear SOAE prevalence exist as early as preterm birth? Is there any functional asymmetry in the medial olivo-cochlear (MOC) efferent system, known to modulate outer hair cell contractions? The study involved 483 preterm neonates (gestional age: 24-37 weeks) and 70 right-handed adults (age: 18-31 years). In each ear, SOAEs and evoked otoacoustic emissions (EOAEs) were recorded and analysed, and, for the adults, functional MOC system assessment was made. Results showed SOAEs and EOAE amplitude to be right-predominant and in adults a right MOC functional predominance. These results indicate peripheral auditory system lateralisation, and an early origin thereof. The MOC system being thought to play a protective role, its physiological lateralisation may be relevant to the left prevalence of tinnitus and of auditory fatigue.
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Affiliation(s)
- S Khalfa
- Department of Otolaryngology, Perception and Auditory Mechanisms, CNRS UPRESA 5020, Lyon, France
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Abstract
The aim of this study was to investigate the human peripheral auditory system in either ear to allow comparison of right and left medial olivocochlear inhibition during contralateral ear stimulation with a broad band noise. The efferent system showed a statistically significant greater right-side activity among 44 young subjects. This laterality appeared to be related to the presence of spontaneous otoacoustic emission but not to gender. This efferent asymmetry and the parallel spontaneous otoacoustic emission asymmetry could explain the lateralization of auditory sensitivity, temporary threshold shift and tinnitus.
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Affiliation(s)
- S Khalfa
- URA CNRS 1447: Perception et mécanismes auditifs, Université Claude Bernard, Hôpital Edouard Herriot, Lyon, France
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Khalfa S, Ardjoun H. [Epidemiology of viral hepatitis in Algeria]. Med Trop (Mars) 1984; 44:247-252. [PMID: 6438432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Viral hepatitis is endemoepidemic in Algeria. Recent serologic and epidemiological surveys have specified the importance of A, B and non A non B viruses respectively and brought out some details. -- Hepatitis A is very common: 96% of individuals have anti-HAV antibodies. Patients come into contact with the virus before the age of 10. No symptoms are found in 95% of cases. Icteric hepatitis occurs in infants. -- Hepatitis B infection includes 40 to 50% of icteric hepatitis in adults. Clinical and biological symptoms are similar to those described in the literature. The prevalence of HBs Ag carriers is within the range of 1,8 to 2,8%, but reach high level in Eastern and Saharian Regions of Algeria. It increases with age and low socio-economic status. In hospital environment, laboratory technicians and room servants is the most frequently contaminated personnel. -- Non A non B hepatitis is so far the least known in Algeria. In 1981, an epidemic of water-borne non A non B hepatitis was reported.
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