Hemispheric language asymmetry in first episode psychosis and schizotypy : the role of cannabis consumption and cognitive disorganization

Cannabis use has been related to an elevated psychosis risk and attenuated cognitive functioning. Cannabis-related cognitive impairments are also observed in populations along the psychosis dimension. We here investigated whether a potential behavioural marker of the psychosis dimension (attenuated functional hemispheric asymmetry) is even further attenuated in individuals using cannabis (CU) versus those not using cannabis (nCU). We tested 29 patients with first episode psychosis (FEP; 11 CU) and 90 healthy controls (38 CU) on lateralized lexical decisions assessing left hemisphere language dominance. In patients, psychotic symptoms were assessed (PANSS). In controls, self-reported schizotypy was assessed (O-LIFE questionnaire). Results indicated that nCU FEP patients had a relative reduced hemispheric asymmetry, as did controls with increasing cognitive disorganisation scores, in particular when belonging to the group of nCU controls. Positive, disorganised and negative PANSS scores in patients and negative and positive schizotypy in controls were unrelated to hemispheric asymmetry. These findings suggest that cannabis use balances rather than exacerbates uncommon hemispheric laterality patterns. Moreover, in healthy populations, the potential stabilisation of typical hemispheric asymmetry in CU might be most relevant to individuals with elevated cognitive disorganisation. We discuss the potential beneficial and harmful effects of cannabis use along the psychosis dimension together with propositions for future studies that should account for the mediating role of additional substances (e.g. nicotine), cannabis composition (e.g. cannabidiol content), and individual differences (e.g. physical health, or absence of significant polysubstance use).

Personality traits, behavioral and psychological symptoms and cognitive decline in patients at an early stage of Alzheimer's disease

The aim of this doctoral thesis was to study personality characteristics of patients at an early stage of Alzheimer's disease (AD), and more specifically to describe personality and its changes over time, and to explore its possible links with psychological and symptoms (BPS) and cognitive level. The results were compared to those of a group of participants without cognitive disorder through three empirical studies. In the first study, the findings showed significant personality changes that follow a specific trend in the clinical group. The profil of personality changes showed an increase in Neuroticism and a decrease in Extraversion, Openess to experiences, and Conscientiousness over time. The second study highlighted that personality and BPS occur early in the cours of AD. Recognizing them as possible precoce signs of neurodegeneration may prove to be a key factor for early detection and intervention. In the third study, a significant association between personality changes and cognitive status was observed in the patients with incipient AD. Thus, changes in Neuroticism and Conscientiousness were linked with cognitive deterioration, whereas decreased Openness to experiences and Conscientiousness over time predicted loss of independence in daily functioning. Other well-known factors such as age, education level or civil status were taken into account to predict cognitive decline. The three studies suggested five important implications: (1) cost-effective screening should take into account premorbid and specific personality changes; (2) psycho-educative interventions should provide information on the possible personality changes and BPS that may occur at the beginning of the disease; (3) using personality traits alongside other variables in the future studies on prevention might help to better understand AD's etiology; (4) individual treatment plans (psychotherapeutic, social, and pharmacological) might be adapted to the specific changes in personality profiles; (5) more researches are needed to study the impact of social-cultural and lifestyle variables on the development of AD.

Du principe de continuit�� de l'exploitation en comptabilit�� : contribution �� la formalisation de la d��marche cognitive du r��viseur aux comptes dans la validation de ce principe �� l'aide d'un syst��me abductif de mod��lisation de croyance bas�� sur un processus stochastique

R��sum�� : J'ai souvent vu des experts ��tre d'avis contraires. Je n'en ai jamais vu aucun avoir tort. Auguste Detoeuf Propos d'O.L. Brenton, confiseur, Editions du Tambourinaire, 1948. En choisissant volontairement une probl��matique comptable typiquement empirique, ce travail s'est attel�� �� tenter de d��montrer la possibilit�� de produire des enseignements purement comptables (ie �� l'int��rieur du sch��me de repr��sentation de la Comptabilit��) en s'interdisant l'emprunt syst��matique de theories cl��-en-main �� l'��conomie -sauf quant cela s'av��re r��ellement n��cessaire et l��gitime, comme dans l'utilisation du CAPM au chapitre pr��c��dent. Encore une fois, rappelons que cette th��se n'est pas un r��quisitoire contre l'approche ��conomique en tant que telle, mais un plaidoyer visant �� mitiger une telle approche en Comptabilit��. En relation avec le positionnement ��pist��mologique effectu�� au premier chapitre, il a ��t�� cherch�� �� mettre en valeur l'apport et la place de la Comptabilit�� dans l'��conomie par le positionnement de la Comptabilit�� en tant que discipline pourvoyeuse de mesures de repr��sentation de l'activit�� ��conomique. Il nous para��t clair que si l'activit�� ��conomique, en tant que s��miosph��re comptable directe, dicte les observations comptables, la mesure de ces derni��res doit, tant que faire se peut, tenter de s'affranchir de toute d��pendance �� la discipline ��conomique et aux th��ories-m��thodes qui lui sont li��es, en adoptant un mode op��ratoire orthogonal, rationnel et syst��matique dans le cadre d'axiomes lui appartenant en propre. Cette prise de position entra��ne la d��finition d'un nouveau cadre ��pist��mologique par rapport �� l'approche positive de la Comptabilit��. Cette derni��re peut se d��crire comme l'expression philosophique de l'investissement de la recherche comptable par une r��flexion m��thodique propre �� la recherche ��conomique. Afin d'��tre au moins partiellement valid��, ce nouveau cadre -que nous voyons d��riv�� du constructivisme -devrait faire montre de sa capacit�� �� traiter de mani��re satisfaisante une probl��matique classique de comptabilit�� empirico-positive. Cette probl��matique sp��cifique a ��t�� choisie sous la forme de traitement-validation du principe de continuit�� de l'exploitation. Le principe de continuit�� de l'exploitation postule (��nonciation d'une hypoth��se) et ��tablit (v��rification de l'hypoth��se) que l'entreprise produit ses ��tats financiers dans la perspective d'une poursuite normale de ses activit��s. Il y a rupture du principe de continuit�� de l'exploitation (qui devra alors ��tre ��cart��e au profit du principe de liquidation ou de cession) dans le cas de cessation d'activit��, totale ou partielle, volontaire ou involontaire, ou la constatation de faits de nature �� compromettre la continuit�� de l'exploitation. Ces faits concernent la situation financi��re, ��conomique et sociale de l'entreprise et repr��sentent l'ensemble des ��v��nements objectifs 33, survenus ou pouvant survenir, susceptibles d'affecter la poursuite de l'activit�� dans un avenir pr��visible. A l'instar de tous les principes comptables, le principe de continuit�� de l'exploitation proc��de d'une consid��ration purement th��orique. Sa v��rification requiert toutefois une analyse concr��te, portant r��ellement et de mani��re mesurable �� cons��quence, raison pour laquelle il repr��sente un th��me de recherche fort appr��ci�� en comptabilit�� positive, tant il peut (faussement) se confondre avec les ��tudes relatives �� la banqueroute et la faillite des entreprises. Dans la pratique, certaines de ces ��tudes, bas��es sur des analyses multivari��es discriminantes (VIDA), sont devenues pour l'auditeur de v��ritables outils de travail de par leur simplicit�� d'utilisation et d'interpr��tation. �� travers la probl��matique de ce travail de th��se, il a ��t�� tent�� de s'acquitter de nombreux objectifs pouvant ��tre regroup��s en deux ensembles : celui des objectifs li��s �� la d��marche m��thodologique et celui relevant de la mesure-calibration. Ces deux groupes-objectifs ont permis dans une derni��re ��tape la construction d'un mod��le se voulant une cons��quence logique des choix et hypoth��ses retenus.

Conduite automobile et troubles cognitifs: comment anticiper [Driving and cognitive impairment: how best to anticipate?].

Driving requires integrating multiple motor, sensory, and cognitive skills. As people age, cognition becomes increasingly vulnerable due to impairment and dementia. Older drivers suffering from dementia, even at an early stage, have been shown to be significantly more likely to develop unsafe driving. Primary care physicians have the difficult task to assess these persons' driving capacity. This paper briefly describes the consequences of altered cognition on driving capacity and proposes an algorithm to address this challenge.

Stability of cognitive performance in children with mild intellectual disability.

AIM: Longitudinal studies that have examined cognitive performance in children with intellectual disability more than twice over the course of their development are scarce. We assessed population and individual stability of cognitive performance in a clinical sample of children with borderline to mild non-syndromic intellectual disability. METHOD: Thirty-six children (28 males, eight females; age range 3-19y) with borderline to mild intellectual disability (Full-scale IQ [FSIQ] 50-85) of unknown origin were examined in a retrospective clinical case series using linear mixed models including at least three assessments with standardized intelligence tests. RESULTS: Average cognitive performance remained remarkably stable over time (high population stability, drop of only 0.38 IQ points per year, standard error=0.39, p=0.325) whereas individual stability was at best moderate (intraclass correlation of 0.58), indicating that about 60% of the residual variation in FSIQ scores can be attributed to between-child variability. Neither sex nor socio-economic status had a statistically significant impact on FSIQ. INTERPRETATION: Although intellectual disability during childhood is a relatively stable phenomenon, individual stability of IQ is only moderate, likely to be caused by test-to-test reliability (e.g. level of child's cooperation, motivation, and attention). Therefore, clinical decisions and predictions should not rely on single IQ assessments, but should also consider adaptive functioning and previous developmental history.

Cognitive Predictors and Risk Factors of PTSD Following Stillbirth: A Short-Term Longitudinal Study.

This short-term longitudinal study investigated cognitive predictors and risk factors of posttraumatic stress disorder (PTSD) in mothers following stillbirth. After a stillbirth at ≥ 24 weeks gestational age, 65 women completed structured clinical interviews and questionnaires assessing PTSD symptoms, cognitive predictors (appraisals, dysfunctional strategies), and risk factors (perceived social support, trauma history, obstetric history) at 3 and 6 months. PTSD symptoms decreased between 3 and 6 months (Cohen's d ranged .34-.52). Regression analyses also revealed a specific positive relationship between Rumination and concurrent frequency of PTSD symptoms (β = .45). Negative Self-View and Negative World-View related positively and Self-Blame related negatively to concurrent number of PTSD symptoms (β = .48, .44, -.45, respectively). Suppression and Distraction predicted a decrease and Numbing predicted an increase in time-lagged number of PTSD symptoms (β = -.33, -.28, .30, respectively). Risk factors for PTSD symptoms were younger age (β = -.25), lower income (β = -.29), fewer previous pregnancies (β = -.31), and poorer perceived social support (β = -.26). Interventions addressing negative appraisals, dysfunctional strategies, and social support are recommended for mothers with PTSD following stillbirth. Knowledge of cognitive predictors and risk factors of PTSD may inform the development of a screening instrument.

Copy number variations and cognitive phenotypes in unselected populations

IMPORTANCE: The association of copy number variations (CNVs), differing numbers of copies of genetic sequence at locations in the genome, with phenotypes such as intellectual disability has been almost exclusively evaluated using clinically ascertained cohorts. The contribution of these genetic variants to cognitive phenotypes in the general population remains unclear. OBJECTIVE: To investigate the clinical features conferred by CNVs associated with known syndromes in adult carriers without clinical preselection and to assess the genome-wide consequences of rare CNVs (frequency ≤0.05%; size ≥250 kilobase pairs [kb]) on carriers' educational attainment and intellectual disability prevalence in the general population. DESIGN, SETTING, AND PARTICIPANTS: The population biobank of Estonia contains 52,000 participants enrolled from 2002 through 2010. General practitioners examined participants and filled out a questionnaire of health- and lifestyle-related questions, as well as reported diagnoses. Copy number variant analysis was conducted on a random sample of 7877 individuals and genotype-phenotype associations with education and disease traits were evaluated. Our results were replicated on a high-functioning group of 993 Estonians and 3 geographically distinct populations in the United Kingdom, the United States, and Italy. MAIN OUTCOMES AND MEASURES: Phenotypes of genomic disorders in the general population, prevalence of autosomal CNVs, and association of these variants with educational attainment (from less than primary school through scientific degree) and prevalence of intellectual disability. RESULTS: Of the 7877 in the Estonian cohort, we identified 56 carriers of CNVs associated with known syndromes. Their phenotypes, including cognitive and psychiatric problems, epilepsy, neuropathies, obesity, and congenital malformations are similar to those described for carriers of identical rearrangements ascertained in clinical cohorts. A genome-wide evaluation of rare autosomal CNVs (frequency, ≤0.05%; ≥250 kb) identified 831 carriers (10.5%) of the screened general population. Eleven of 216 (5.1%) carriers of a deletion of at least 250 kb (odds ratio [OR], 3.16; 95% CI, 1.51-5.98; P = 1.5e-03) and 6 of 102 (5.9%) carriers of a duplication of at least 1 Mb (OR, 3.67; 95% CI, 1.29-8.54; P = .008) had an intellectual disability compared with 114 of 6819 (1.7%) in the Estonian cohort. The mean education attainment was 3.81 (P = 1.06e-04) among 248 (≥250 kb) deletion carriers and 3.69 (P = 5.024e-05) among 115 duplication carriers (≥1 Mb). Of the deletion carriers, 33.5% did not graduate from high school (OR, 1.48; 95% CI, 1.12-1.95; P = .005) and 39.1% of duplication carriers did not graduate high school (OR, 1.89; 95% CI, 1.27-2.8; P = 1.6e-03). Evidence for an association between rare CNVs and lower educational attainment was supported by analyses of cohorts of adults from Italy and the United States and adolescents from the United Kingdom. CONCLUSIONS AND RELEVANCE: Known pathogenic CNVs in unselected, but assumed to be healthy, adult populations may be associated with unrecognized clinical sequelae. Additionally, individually rare but collectively common intermediate-size CNVs may be negatively associated with educational attainment. Replication of these findings in additional population groups is warranted given the potential implications of this observation for genomics research, clinical care, and public health.

Commentary on "The Cognitive-Emotional Brain: From Interactions to Integration" by Luiz Pessoa - "On theory integration: Toward developing affective components within cognitive architectures"

In The Cognitive-Emotional Brain, Pessoa (2013) suggests that cognition and emotion should not be considered separately. We agree with this and argue that cognitive architectures can provide steady ground for this kind of theory integration and for investigating interactions among underlying cognitive processes. We briefly explore how affective components can be implemented and how neuroimaging measures can help validate models and influence theory development.