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Abstract: The regular questioning of psychoanalysis constantly makes us seek answers to the current questions we have to deal with in our clinical practices. This article aims at contributing to our psychoanalytical practices research methods. Lacan based his teachings on the critical reading of Freud by advising us to take his texts into consideration. We think that his method, his “discipline of text commentary”, has its place in today''s research both as far as transmission and innovation are concerned. Moreover, it enables psychoanalysts, who can thus be regarded as readers of the unconscious, to transform knowledge into creativity, by deciphering the powerful mystery of texts and theory. [Copyright &y& Elsevier]

Abstract: Tourette''s syndrome is a neuro-psychiatric disorder which starts in childhood and is characterized by the association of motor and vocal tics of which the frequency, type and location vary in time. The numerous ways of neurotransmission of the physiopathology of this illness have been tested. Several psychiatric comorbidities have been described at length among which the attention deficit hyperactivity disorder and obsessional compulsive disorder are the most frequent. The decision to initiate a treatment must take into account numerous factors and notably the repercussions of the pathology on the social and occupational life of the patient which rest on an individual valuation of the illness. Care must first start with psychoeducation allowing a better understanding of the syndrome by the patients and their family. Medicinal therapeutics then intervenes to treat the weak to severe tics affecting the daily life of the patients. The choice of the molecule will differ according to the severity of the illness, to the age of the patient and to the comorbid associations. Psychotherapies such as behavior therapy and supportive therapy are an alternative to pharmacologic treatment. They can be employed alone and may be sufficient for some patients. They can be also associated with classic therapeutics in order to increase therapeutic effectiveness. Finally, deep cerebral stimulation may constitute a new and interesting way, but it is in its developmental stage and needs to be assessed. This treatment is restricted for the time being to cases resistant to the classical treatments and to patients meeting the requirements of eligibility for such treatment. [Copyright &y& Elsevier]

Cerebral functional exploration using Event related potentials (ERPs) is greatly relevant in clinical psychiatry. Although ERP usefulness as a diagnostic tool is limited due to the complexity of psychiatric diagnosis, which raises theoritical, methodological and ethical problems that cannot be resolved by neurobiologial methods, ERP offers relevant information in 3 different topics:

Le traitement cholinomimétique dans la maladie d’Alzheimer a permis d’étudier la relation entre la modulation de la neurotransmission cholinergique et les aspects cliniques dans de larges essais. Deux de ces thérapies ont des activités pharmacologiques additionnelles, telles que la modulation du récepteur nicotinique pour la galantamine et l’inhibition additionnelle de la butyrylcholinestérase pour la rivastigmine. Comprendre le lien entre cette pharmacologie et les effets cliniques devient alors difficile. La simulation par modèle mathématique de cette pharmacologie complexe peut permettre d’identifier des relations spécifiques entre le mode d’action pharmacologique et les effets sur la neurotransmission cholinergique. Le modèle de synapse virtuelle est basé sur l’intégration de multiples données publiées. Le modèle est validé par la prédiction d’un résultat spécifique concernant la modulation du niveau de la dopamine et la vérification expérimentale dans des tissus striataux. Quelques exemples de cette approche dans la réalité clinique seront présentés. Mots clés : modélisation, synapse, dopamine, Alzheimer Abstract Since the launch of cholinomimetics on the Alzheimer market, large clinical trials have been performed with the aim of linking clinical scales to the pathology and pharmacology of the cholinergic neurotransmission system. However, given the additional mode of action of nicotinic receptor modulation in the case of galantamine, and of butyrylcholinesterase inhibition in the case of rivastigmine, it is of interest to study the link between this additional pharmacology and the specific clinical outcomes. This may be helpful in identifying new targets and optimising the clinical development of new compounds. One of the most appropriate and promising approaches is to use mathematical modelling to describe the complex pharmacology of these agents and their relationships with clinical outcomes. The virtual synapse is based upon the full integration of neuroanatomical and neuropharmacological datasets, to which complete pharmacological information on the drugs is added. Validation of this system is performed by predicting the outcome in a preclinical setting and subsequent testing of this hypothesis. Some examples of this model with regard to the prediction of clinical outcome are presented. Keywords: mathematical modelling, synapse, dopamine, Alzheimer Texte reçu le 29 septembre 2003 ; accepté le 15 décembre 2003 [ABSTRACT FROM AUTHOR]

Pré-requis: Les encéphalopathies épileptiques précoces (EEP) constituent un groupe hétérogène de maladies du développement, dont les points communs sont : - une épilepsie sévère débutant dans les trois premiers mois de vie; - un tracé EEG perturbé, de type « suppression-burst » - un trouble sévère du développement. Les EEP peuvent être en rapport avec des anomalies morphologiques cérébrales (Lissencéphalie, hémimégalencéphalie…), ou des anomalies fonctionnelles, avec une IRM cérébrale normale. Objectifs: À partir de données obtenues chez l’animal, notre projet consiste à étudier tous les gènes impliqués dans la neurotransmission glutamatergique chez les patients EEP. Nous avons débuté une étude multicentrique visant à collecter de manière prospective les nouveaux cas d’EEP avec IRM normale, dont le bilan étiologique est négatif. Notre étude comportera ensuite trois étapes : [1)] Séquençage des gènes impliqués dans les EEP : STXBP1/MUNC18-1 et ARX chez le garçon. [2)] Screening par puce CGH haute densité [3)] Screening par puce dédiée haute-résolution de 2205 exons appartenant à des gènes impliqués dans le métabolisme du glutamate. Les résultats préliminaires seront décrits. [ABSTRACT FROM AUTHOR]