激活右腹外侧前额叶提高抑郁症患者对社会疼痛的情绪调节能力：一项TMS研究

负性人际交往经历和负性社会事件是抑郁症的重要诱导因素, 而社会功能受损是抑郁症患者的重要特征之一, 患者通常表现出对社会疼痛的情绪失调。为了提高抑郁症患者在负性社交情境中或面对负性社会事件时的情绪调节能力, 本研究采用经颅磁刺激技术(transcranial magnetic stimulation, TMS), 考察抑郁症患者在腹外侧前额叶(the ventrolateral prefrontal cortex, VLPFC)被激活后其情绪调节能力的改变。结果表明, 当右侧VLPFC被TMS激活且患者采用认知重评策略调节情绪时, 实验组患者(n = 64)比对照组患者(n = 63)在社会排斥情境下报告了更弱的负性情绪体验, 这说明激活右侧VLPFC可以有效提高患者对社会疼痛的外显性情绪调节能力。本研究是采用TMS提高抑郁症患者情绪调节能力的首次尝试, 实验发现不但支持了VLPFC与认知重评策略的因果关系, 还为临床改善抑郁症等社会功能障碍患者的情绪调节能力提供了明确的神经治疗靶点。后续研究还需探讨多疗程TMS刺激方案、改变社会疼痛的诱发方式、对比左右侧VLPFC的治疗效果、尝试使用其他的情绪调节策略, 进一步验证本研究的结论, 优化TMS治疗方案。     

The effects of massage velocity on heart rate and heart rate variability in healthy infants: A randomized crossover study

BackgroundInfant massage, in which mothers stroke their infant’s skin slowly and gently, can cause pleasant sensations in the infant that can be affected by the velocity of massage. However, the massage velocity at which infants feel the most pleasant sensations remains unclear.ObjectiveTo investigate the effects of massage velocity on heart rate (HR) and HR variability (HRV) in healthy infants.MethodTwenty-two infant-mother dyads two to seven months of age were recruited. Mothers stroked their infant’s skin at three massage velocities (5.0, 7.5, and 10.0 cm/s) in a randomized order for 15 min. The rhythm of massage velocity was calculated according to the length of three body areas. The massage velocity of the mothers was regulated using a metronome. HR and HRV (high frequency [HF] and low frequency [LF]) were measured at rest and during massage for each velocity. The effects on pleasantness were evaluated using percent change in median baseline value compared with median values for the three massage velocities. Statistical analysis was performed using analysis of variance mixed effect models to exclude “period” and “carryover” effects during massage.ResultsWhen measuring HF, massage (7.5 cm/s) caused a significant increase in pleasantness compared with 10.0 cm/s (p = 0.04). The HR and LF/HF ratio were not significantly changed between velocities.ConclusionResults of this study suggested that a massage velocity of 7.5 cm/s was the most pleasant for infants. Future research should investigate the relationship between an infant massage by optimal velocity and infant development in longitudinal studies.     

背外侧前额叶对主动遗忘负性社会反馈的作用：针对抑郁症的TMS研究

抑郁症患者的负性心境可能源于其抑制功能障碍。患者在主动遗忘负性材料时无法有效调用背外侧前额叶(the dorsolateral prefrontal cortex, DLPFC)等负责抑制控制的额叶脑网络。同时, 患者对社会信息的加工比对非社会信息的加工存在更明显的认知神经障碍, 很难主动遗忘对自己不利的社会反馈信息。为了提高抑郁症患者对负性社会反馈的主动遗忘能力, 本研究采用经颅磁刺激技术(transcranial magnetic stimulation, TMS), 考察抑郁症患者在左侧(n = 32)或右侧DLPFC (n = 30)被激活后其记忆控制能力的改变。结果表明, 当患者的DLPFC被TMS激活时, 他们对社会拒绝的回忆正确率与健康对照组(n = 31)无差异, 且TMS激活右侧DLPFC还改善了患者对他人的社会态度。本研究是采用TMS提高抑郁症患者主动遗忘能力的首次尝试, 研究结果不但支持了DLPFC与记忆控制功能的因果关系, 还为临床治疗抑郁症、创伤后应激障碍、药物成瘾等患者的记忆控制缺陷提供了明确的神经靶点。     

Gender detransition: a case study

Within the last decade, there has been a sharp global rise in the number of young people identifying as transgender. More recently, there appears to be an increase in the numbers of young people detransitioning or returning to identifying with their natal sex after pursuing medical transition. A case is presented of a young woman who pursued a gender transition and returned to identifying as female after almost two years on testosterone. The author considers and critiques the affirmative model of care for gender dysphoric youth in light of this case.     

SC-IAT范式下中学生良心的内隐性

目的:研究探讨了单类内隐联想测验(Single Category Implicit Association Test,SC-IAT)测量中学生良心的可行性,并分析内隐良心和外显良心的关系。方法:采用E-prime3.0软件编制SC-IAT良心测量程序,测量了中学生内隐良心; 采用青少年良心问卷测量了中学生的外显良心,并运用相关技术分析两者之间的关系。结果:SC-IAT实验中,中学生良心的内隐效应显著,且不存在性别、独生与否、学段、家庭结构、家庭所在地等人口统计学指标上的显著差异; 内隐良心与外显良心之间的相关不显著。结论:(1)中学生良心存在积极内隐效应;(2)外显良心和内隐良心相互分离,是两个不同的建构。     

自然数码奇象记忆法记忆复杂数字的神经机制

本研究采用学习-再认范式和复杂数字记忆材料,考察自然数码奇象记忆法相对于机械记忆法在记忆提取上的优势及神经机制。行为结果表明,自然数码奇象记忆法比机械记忆法的再认准确率更高。事件相关电位分析结果显示,再认提取阶段奇象记忆条件下诱发的N400和N700波幅显著更低,这说明奇象记忆提取更容易。在自然数码奇象记忆条件下,正确再认旧数字诱发的前额区、左顶枕叶区及中顶枕叶区N700成分与使用自然数码奇象记忆有关。本研究表明,采用自然数码奇象记忆可以减少或跨越语义加工,从而提高个体对材料的记忆效率。     

Plus de contention ni d’isolement sans contrôle du juge judiciaire

Although of old and common use, the use of isolation and restraint in psychiatry was not regulated until 2016 with the creation of article L. 3222-5-1 of the Public Health Code. However, the Court of Cassation considered that, as a form of care, it was beyond the office of the liberty and custody judge to controle its implementation. Questioned by a plea of unconstitutionality submitted by the Court of Cassation, the Constitutional Council considered, with its decision of 19 June 2020, that these measures constituted a deprivation of liberty requiring judicial review at short notice. The Sages thus declare the provisions of article L. 3222-5-1 unconstitutional, with delayed effect as of December 31, 2020, requiring legislator to rethink and organise the supervision and control of decisions of restraint and isolation.     

Le vaccin,un médicament devenu l’arme absolue promise contre la COVID-19 : une réglementation adaptée ?

As the first vaccines against COVID-19 arrive on the market, the question of the safety of these products arises in the public debate. The major concern is about the possible occurrence of adverse effects, particularly in the context of the use of novel pharmaceutical technologies such as mRNA. It is important to remind both patients and professionals that a vaccine is not only a medicinal product in its own right, but also a special medicinal product: biological and immunological. As a result, its supervision is draconian, and despite the urgency, no requirements have been lowered. The speed of marketing is the result both of adapted clinical trials and optimized evaluation procedures.     

γ节律神经振荡：反映自闭症多感觉整合失调的一项重要生物指标

多感觉整合是对不同感官信息进行选择、联系、统一乃至解释的加工过程, 它需要神经系统不同功能区域的共同投入与相互协调, 以实现多种感觉信息的时间捆绑以及全局性的预测编码。而γ神经振荡因具有反映神经皮层兴奋/抑制的平衡状况, 实现多感官信息的时间同步, 以及通过跨频耦合实现全局性预测编码的特点, 在多感觉整合的加工过程中发挥着重要作用。相比正常个体, 自闭症患者神经系统中的GABA中间神经元存在结构与功能异常, 导致γ神经振荡紊乱, 由此破坏了正常的时间同步以及预测编码加工, 并最终引发多感觉整合失调。基于上述因果关联, 未来研究可结合无创可逆性干预技术, 以γ节律神经振荡为生物反馈指标, 形成科学系统化的临床干预治疗方案。     

创造力产生过程中的神经振荡机制

创造力究竟是怎么产生的, 目前尚未得出一致的结论。神经电生理技术因其高时间分辨率, 可以准确地揭示创造力产生进程中的神经振荡机制, 从而帮助人们更深刻地理解创造力的本质。近年来的研究发现, 单节律alpha神经振荡会随着创造力的增加而增强, 这反映了创造力产生过程中的内部信息加工需求增加、自上而下的抑制控制增强。同时, 多频段神经振荡交叉节律耦合体现了创造性产生过程中额叶、颞叶和顶叶等多脑区之间信息交流的动态变化。未来研究应该以整合理论框架为基础, 结合多层次多方法的研究工具, 引进更生态化的数理计算方法, 并利用计算神经科学建模来预测个体创造力发展趋势, 从而全面深刻地认识创造力的本质。