23 results on '"Adam-Darque A"'
Search Results
2. Anatomical and functional predictors of disorientation after first-ever brain damage
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Adam-Darque, Alexandra, Ptak, Radek, Schneider, Stephan, and Schnider, Armin
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- 2023
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3. Distinct outcome processing in deterministic and probabilistic reversal learning
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Habiby Alaoui, Selim, Adam-Darqué, Alexandra, Ptak, Radek, and Schnider, Armin
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- 2021
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4. Music enhances structural maturation of emotional processing neural pathways in very preterm infants
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Sa de Almeida, Joana, Lordier, Lara, Zollinger, Benjamin, Kunz, Nicolas, Bastiani, Matteo, Gui, Laura, Adam-Darque, Alexandra, Borradori-Tolsa, Cristina, Lazeyras, François, and Hüppi, Petra S.
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- 2020
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5. Shedding light on excessive crying in babies
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Adam-Darque, Alexandra, Freitas, Lorena, Grouiller, Frédéric, Sauser, Julien, Lazeyras, François, Van De Ville, Dimitri, Pollien, Philippe, Garcia-Rodenas, Clara L., Bergonzelli, Gabriela, Hüppi, Petra S., and Ha-Vinh Leuchter, Russia
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- 2021
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6. Early vocal contact and music in the NICU: new insights into preventive interventions
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Filippa, Manuela, Lordier, Lara, De Almeida, Joana Sa, Monaci, Maria Grazia, Adam-Darque, Alexandra, Grandjean, Didier, Kuhn, Pierre, and Hüppi, Petra S.
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- 2020
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7. Preterm infants show an atypical processing of the mother's voice
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Benis, D., primary, Filippa, M., additional, Adam-Darque, A., additional, Hüppi, P., additional, and Grandjean, D., additional
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- 2023
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8. Preterm infants show an atypical processing of the mother’s voice
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Manuela Filippa, Damien Benis, Alexandra Adam-Darque, Didier Grandjean, and Petra S. Huppi
- Abstract
To understand the consequences of prematurity on language perception it is fundamental to determine how atypical early sensory experience affects brain development. To date the neural oscillatory correlates in the time-frequency domain of voice processing as a function of atypical early sensory experience, as after premature birth, remain elusive. At term equivalent age, ten preterm and ten full-term newborns underwent high-density EEG recordings during mother or stranger speech presentation, presented in the forward (naturalistic) or backward order. A general group effect terms > preterms for the naturalistic mother’s voice is evident in the theta frequency band in the left temporal area, where only full-term newborns showed an increased activity for the mother’s voice, whereas preterm infants showed significant activation for stranger naturalistic speech. Similarly, a significant group contrast in the low and high theta in the right temporal regions indicates higher activations for the stranger’s speech in preterms. Finally, only full-term newborns presented a late gamma band increase for the maternal naturalistic speech, indicating a more mature brain response.The current study based on neural time-frequency patterns, demonstrates that preterm infants lack selective brain responses to mother’s naturalistic voice typical for full-term newborns, whereas preterms are selectively responsive to stranger voices in both temporal hemispheres.
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- 2022
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9. Preterm infants show an atypical processing of the mother’s voice
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Filippa, Manuela, primary, Benis, Damien, additional, Adam-Darque, Alexandra, additional, Grandjean, Didier, additional, and Huppi, Petra S., additional
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- 2022
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10. Distinct outcome processing in deterministic and probabilistic reversal learning
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Selim Habiby Alaoui, Armin Schnider, Radek Ptak, and Alexandra Adam-Darque
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Brain activity and meditation ,Cognitive Neuroscience ,Experimental and Cognitive Psychology ,Context (language use) ,Reversal Learning ,Stimulus (physiology) ,Electroencephalography ,behavioral disciplines and activities ,050105 experimental psychology ,Task (project management) ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,0501 psychology and cognitive sciences ,Association (psychology) ,Evoked Potentials ,Anterior cingulate cortex ,medicine.diagnostic_test ,05 social sciences ,Brain ,ddc:616.8 ,Frontal Lobe ,Neuropsychology and Physiological Psychology ,medicine.anatomical_structure ,Orbitofrontal cortex ,Psychology ,030217 neurology & neurosurgery ,Cognitive psychology - Abstract
Anticipations that fail to happen are important drivers of behavioral adaptation. Their processing appears to depend on the context. In a deterministic environment, where a stimulus unequivocally predicts the outcome, processing of absent outcomes involves the posterior orbitofrontal cortex (OFC). Failure has been linked to reality confusion with confabulations and disorientation. In a probabilistic environment, absent outcomes appear to be processed by the anterior cingulate cortex (ACC) rather than the OFC. Failure has been associated with poor decision making and schizophrenia. These data suggest different mechanisms depending on the context. Here, healthy human subjects made two formally similar reversal learning tasks, but one with deterministic, the other with probabilistic instructions. Brain activity was monitored using high-density electroencephalography. We found that in the deterministic task, negative outcomes, which unequivocally call for a behavioral switch, induced a distinct frontal potential at 200-300 msec. Computational modeling indicated a strong association of evoked potentials with prediction error, surprise, and behavioral adaptation. In the probabilistic task, where behavioral adaptation follows the cumulated processing of outcomes, negative outcomes evoked potentials that were associated with prediction error and surprise, but had a weak link with subsequent behavior. Outcome processing in the probabilistic task induced stronger activation than the deterministic task of an extended network including the ACC, OFC and striatum at 300-400 msec. In both tasks, negative outcomes were processed differently from positive outcomes at 400-600 msec, possibly reflecting updating of the outcome record. We conclude that the brain disposes of at least two distinct systems processing outcomes with unequivocal or ambiguous behavioral significance. These systems differ along behavioral, clinical, electrophysiological and anatomical dimensions.
- Published
- 2020
11. Music enhances structural maturation of emotional processing neural pathways in very preterm infants
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Benjamin Zollinger, Petra Susan Hüppi, Lara Lordier, Laura Gui, François Lazeyras, Alexandra Adam-Darque, Nicolas Kunz, Matteo Bastiani, Joana Sa de Almeida, and Cristina Borradori-Tolsa
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Male ,Emotions ,Infant, Premature, Diseases ,Audiology ,distortion correction ,0302 clinical medicine ,Neural Pathways ,Medicine ,Infant, Very Low Birth Weight ,Human brain development ,CIBM-AIT ,Sensory stimulation therapy ,ddc:618 ,05 social sciences ,Extreme capsule ,Magnetic Resonance Imaging ,White Matter ,medicine.anatomical_structure ,Diffusion tensor imaging ,Neurology ,Auditory Perception ,Female ,fractional anisotropy ,Infant, Premature ,Tractography ,medicine.medical_specialty ,External capsule ,white-matter changes ,low-birth-weight ,Cognitive Neuroscience ,Uncinate fasciculus ,ddc:616.0757 ,Emotional processing ,050105 experimental psychology ,Music intervention ,lcsh:RC321-571 ,White matter ,03 medical and health sciences ,Neuroimaging ,Neuroplasticity ,mr-images ,impaired recognition ,Humans ,0501 psychology and cognitive sciences ,human brain ,lcsh:Neurosciences. Biological psychiatry. Neuropsychiatry ,human fetal ,business.industry ,Infant, Newborn ,Infant ,Preterm birth ,probabilistic diffusion tractography ,central-nervous-system ,business ,030217 neurology & neurosurgery ,Music - Abstract
Prematurity disrupts brain maturation by exposing the developing brain to different noxious stimuli present in the neonatal intensive care unit (NICU) and depriving it from meaningful sensory inputs during a critical period of brain development, leading to later neurodevelopmental impairments. Musicotherapy in the NICU environment has been proposed to promote sensory stimulation, relevant for activity-dependent brain plasticity, but its impact on brain structural maturation is unknown. Neuroimaging studies have demonstrated that music listening triggers neural substrates implied in socio-emotional processing and, thus, it might influence networks formed early in development and known to be affected by prematurity. Using multi-modal MRI, we aimed to evaluate the impact of a specially composed music intervention during NICU stay on preterm infant's brain structure maturation. 30 preterm newborns (out of which 15 were exposed to music during NICU stay and 15 without music intervention) and 15 full-term newborns underwent an MRI examination at term-equivalent age, comprising diffusion tensor imaging (DTI), used to evaluate white matter maturation using both region-of-interest and seed-based tractography approaches, as well as a T2-weighted image, used to perform amygdala volumetric analysis. Overall, WM microstructural maturity measured through DTI metrics was reduced in preterm infants receiving the standard-of-care in comparison to full-term newborns, whereas preterm infants exposed to the music intervention demonstrated significantly improved white matter maturation in acoustic radiations, external capsule/ claustrum/extreme capsule and uncinate fasciculus, as well as larger amygdala volumes, in comparison to preterm infants with standard-of-care. These results suggest a structural maturational effect of the proposed music intervention on premature infants' auditory and emotional processing neural pathways during a key period of brain development.
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- 2020
12. Shedding light on excessive crying in babies
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Adam-Darque, Alexandra, primary, Freitas, Lorena, additional, Grouiller, Frédéric, additional, Sauser, Julien, additional, Lazeyras, François, additional, Van De Ville, Dimitri, additional, Pollien, Philippe, additional, Garcia-Rodenas, Clara L., additional, Bergonzelli, Gabriela, additional, Hüppi, Petra S., additional, and Ha-Vinh Leuchter, Russia, additional
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- 2020
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13. Neural Correlates of Voice Perception in Newborns and the Influence of Preterm Birth
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Adam-Darque, Alexandra, primary, Pittet, Marie P, additional, Grouiller, Frédéric, additional, Rihs, Tonia A, additional, Leuchter, Russia Ha-Vinh, additional, Lazeyras, François, additional, Michel, Christoph M, additional, and Hüppi, Petra S, additional
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- 2020
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14. fMRI-based Neuronal Response to New Odorants in the Newborn Brain
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Philippe Pollien, Russia Ha-Vinh Leuchter, Frédéric Grouiller, Alexandra Adam-Darque, Petra Susan Hüppi, François Lazeyras, and Lana Vasung
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Male ,0301 basic medicine ,Olfactory system ,Cognitive Neuroscience ,Central nervous system ,Gestational Age ,Olfaction ,Biology ,ddc:616.0757 ,Brain mapping ,03 medical and health sciences ,Cellular and Molecular Neuroscience ,0302 clinical medicine ,Stimulus modality ,Piriform cortex ,Image Processing, Computer-Assisted ,medicine ,Humans ,Brain Mapping ,ddc:618 ,medicine.diagnostic_test ,Infant, Newborn ,Brain ,Olfactory Pathways ,Olfactory Perception ,Magnetic Resonance Imaging ,Oxygen ,Smell ,030104 developmental biology ,medicine.anatomical_structure ,Odorants ,Female ,Orbitofrontal cortex ,Functional magnetic resonance imaging ,Neuroscience ,psychological phenomena and processes ,030217 neurology & neurosurgery - Abstract
The sense of smell is one of the oldest and the most primitive senses mammals possess, it helps to evaluate the surrounding environment. From birth, smell is an important sensory modality, highly relevant for neonatal behavioral adaptation. Even though human newborns seem to be able to perceive and react to olfactory stimuli, there is still a lack of knowledge about the ontogeny of smell and the underlying central processing involved in odor perception in newborns. Brain networks involved in chemosensory perception of odorants are well described in adults, however in newborns there is no evidence that central olfaction is functional given the largely unmyelinated neonatal central nervous system. To examine this question, we used functional magnetic resonance imaging (fMRI) in the newborn to characterize cortical response to olfactory and trigeminal odorants. Here we show that brain response to odors can be measured and localized using functional MRI in newborns. Furthermore, we found that the developing brain, only few days after birth, processes new artificial odorants in similar cortical areas than adults, including piriform cortex, orbitofrontal cortex and insula. Our work provides evidence that human olfaction at birth relies on brain functions that involve all levels of the cortical olfactory system.
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- 2017
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15. Neural correlates of voice perception in newborns and the influence of preterm birth
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Russia Ha-Vinh Leuchter, Frédéric Grouiller, Tonia A. Rihs, Alexandra Adam-Darque, Marie P. Pittet, François Lazeyras, Christoph M. Michel, and Petra Susan Hüppi
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Male ,medicine.medical_specialty ,Cognitive Neuroscience ,media_common.quotation_subject ,Electroencephalography ,Stimulus (physiology) ,Audiology ,ddc:616.0757 ,Cellular and Molecular Neuroscience ,Perception ,Medicine ,Humans ,Oddball paradigm ,media_common ,Neural correlates of consciousness ,Brain Mapping ,ddc:618 ,medicine.diagnostic_test ,business.industry ,Novelty ,Infant, Newborn ,Brain ,Recognition, Psychology ,Magnetic Resonance Imaging ,ddc:616.8 ,ddc:128.37 ,Cerebral activity ,Auditory Perception ,Voice ,Premature Birth ,Female ,business ,Functional magnetic resonance imaging ,Infant, Premature - Abstract
Maternal voice is a highly relevant stimulus for newborns. Adult voice processing occurs in specific brain regions. Voice-specific brain areas in newborns and the relevance of an early vocal exposure on these networks have not been defined. This study investigates voice perception in newborns and the impact of prematurity on the cerebral processes. Functional magnetic resonance imaging (fMRI) and high-density electroencephalography (EEG) were used to explore the brain responses to maternal and stranger female voices in full-term newborns and preterm infants at term-equivalent age (TEA). fMRI results and the EEG oddball paradigm showed enhanced processing for voices in preterms at TEA than in full-term infants. Preterm infants showed additional cortical regions involved in voice processing in fMRI and a late mismatch response for maternal voice, considered as a first trace of a recognition process based on memory representation. Full-term newborns showed increased cerebral activity to the stranger voice. Results from fMRI, oddball, and standard auditory EEG paradigms highlighted important change detection responses to novelty after birth. These findings suggest that the main components of the adult voice-processing networks emerge early in development. Moreover, an early postnatal exposure to voices in premature infants might enhance their capacity to process voices.
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- 2020
16. Early vocal contact and music in the NICU: new insights into preventive interventions
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Joana Sa de Almeida, Petra Susan Hüppi, Didier Maurice Grandjean, Maria Grazia Monaci, Pierre Kuhn, Manuela Filippa, Lara Lordier, Alexandra Adam-Darque, Institut des Neurosciences Cellulaires et Intégratives (INCI), and Université de Strasbourg (UNISTRA)-Centre National de la Recherche Scientifique (CNRS)
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Brain development ,Auditory Pathways ,media_common.quotation_subject ,Psychological intervention ,Developmental psychology ,Scientific evidence ,03 medical and health sciences ,0302 clinical medicine ,Child Development ,Neuroimaging ,Hearing ,Orientation (mental) ,030225 pediatrics ,Perception ,Intensive Care Units, Neonatal ,Humans ,Music Therapy ,ComputingMilieux_MISCELLANEOUS ,media_common ,Neuronal Plasticity ,Age Factors ,Infant, Newborn ,Infant ,Acoustic Stimulation ,Pediatrics, Perinatology and Child Health ,Infant Behavior ,Preventive intervention ,Auditory Perception ,Intensive Care, Neonatal ,Voice ,Psychology ,030217 neurology & neurosurgery ,Period (music) ,Infant, Premature ,[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology - Abstract
It is now clearly established that the environment and the sensory stimuli, particularly during the perinatal period, have an impact on infant's development. During the last trimester of gestation, activity-dependent plasticity shapes the fetal brain, and prematurity has been shown to alter the typical developmental trajectories. In this delicate period, preventive interventions aiming at modulating these developmental trajectories through activity-inducing interventions are currently underway to be tested. The purpose of this review paper is to describe the potentialities of early vocal contact and music on the preterm infant's brain development, and their potential beneficial effect on early development. Scientific evidence supports a behavioral orientation of the newborn to organized sounds, such as those of voice and music, and recent neuroimaging studies further confirm full cerebral processing of music as multisensory stimuli. However, the impact of long-term effects of music exposure and early vocal contact on preterm infants' long-term neurodevelopment needs be further investigated. To conclude, it is necessary to establish the neuroscientific bases of the early perception and the long-term effects of music and early vocal contact on the premature newborns' development. Scientific projects are currently on the way to fill this gap in knowledge.
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- 2020
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17. Early vocal contact and music in the NICU: new insights into preventive interventions
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Filippa, Manuela, Rebenaque-Martinez, Lara, Alves Sa De Almeida, Joana Rita, Monaci, Maria Grazia, Adam-Darque, Alexandra, Grandjean, Didier Maurice, Kuhn, Pierre, and Hüppi, Petra Susan
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ddc:128.37 ,ddc:618 ,ddc:150 ,ddc:616.8 - Abstract
It is now clearly established that the environment and the sensory stimuli, particularly during the perinatal period, have an impact on infant's development. During the last trimester of gestation, activity-dependent plasticity shapes the fetal brain, and prematurity has been shown to alter the typical developmental trajectories. In this delicate period, preventive interventions aiming at modulating these developmental trajectories through activity-inducing interventions are currently underway to be tested. The purpose of this review paper is to describe the potentialities of early vocal contact and music on the preterm infant's brain development, and their potential beneficial effect on early development. Scientific evidence supports a behavioral orientation of the newborn to organized sounds, such as those of voice and music, and recent neuroimaging studies further confirm full cerebral processing of music as multisensory stimuli. However, the impact of long-term effects of music exposure and early vocal contact on preterm infants' long-term neurodevelopment needs be further investigated. To conclude, it is necessary to establish the neuroscientific bases of the early perception and the long-term effects of music and early vocal contact on the premature newborns' development. Scientific projects are currently on the way to fill this gap in knowledge.
- Published
- 2019
18. Absence of an early hippocampal encoding signal after medial temporal lesions: No consequence for the spacing effect
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Aurélie L. Manuel, Armin Schnider, Louis Nahum, Radek Ptak, Alexandra Adam-Darque, and Domilė Tautvydaitė
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Adult ,Male ,Cognitive Neuroscience ,Hippocampus ,Neuropsychological Tests ,Hippocampal formation ,Signal ,050105 experimental psychology ,Temporal lobe ,03 medical and health sciences ,0302 clinical medicine ,Continuous recognition task ,Humans ,Learning ,Medicine ,Medial temporal ,Lobe ,0501 psychology and cognitive sciences ,Evoked Potentials ,Aged ,Aged, 80 and over ,business.industry ,Spacing effect ,05 social sciences ,Electroencephalography ,Recognition, Psychology ,Biomarker ,Evoked potentials ,Middle Aged ,Magnetic Resonance Imaging ,Temporal Lobe ,ddc:616.8 ,Stroke ,Memory, Short-Term ,Unilateral left ,Case-Control Studies ,Female ,Depth electrode ,business ,Neuroscience ,psychological phenomena and processes ,030217 neurology & neurosurgery - Abstract
Immediately repeated meaningful pictures in a continuous recognition task induce a positive frontal potential at about 200-300 ms, which appears to emanate from the medial temporal lobe (MTL) centered on the hippocampus, as concluded from inverse solutions, coherence measurements, and depth electrode recordings in humans. In this study, we tested patients with unilateral MTL lesions due to stroke to verify the provenance of this signal and its association with the spacing effect (SE)-the improved learning of material encountered in spaced rather than massed presentation. We found that unilateral left or right MTL lesions abolished the early frontal MTL-mediated signal but not the spacing effect. We conclude that the SE does not depend on MTL integrity. We suggest that the early frontal signal at 200-300 ms after immediate picture repetition may serve as a direct biomarker of MTL integrity that may be useful in the early stages of diseases like Alzheimer's.
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- 2018
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19. Functional integration of sensory stimuli in newborns during the neonatal period investigated with fMRI and high-density EEG
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Adam-Darque, Alexandra, Hüppi, Petra Susan, and Michel, Christoph
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ddc:500 - Abstract
L'objectif principal de cette thèse est d'étudier grâce à l'imagerie par résonance magnétique fonctionnelle (IRMf) et l'électroencéphalographie de haute densité (EEG), comment le cerveau en développement répond à une stimulation sensorielle dans trois modalités différentes : l'odorat, le toucher et l'ouïe. Notre travail a démontré que l'olfaction à la naissance repose sur des fonctions cérébrales qui impliquent tous les niveaux du système olfactif cortical. De plus, les nourrissons qui auront des coliques à l'âge de 6 semaines sont plus sensibles dès la naissance à des stimuli non-douloureux (olfactifs) et leur cerveau active plus fortement certaines régions cérébrales. Dans le système somatosensoriel, les réponses individuelles sont complexes et variées, et semblent indiquer que la latéralisation de l'activité tactile émerge progressivement à la naissance. Pour l'audition, nos résultats indiquent que le cerveau des nouveau-nés à terme et des enfants prématurés activent différents réseaux neuronaux pour traiter et distinguer des stimuli vocaux. Cette thèse apporte de nouvelles connaissances sur le développement du traitement sensoriel dans la période néonatale.
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- 2017
20. fMRI-based Neuronal Response to New Odorants in the Newborn Brain
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Adam-Darque, Alexandra, primary, Grouiller, Frédéric, additional, Vasung, Lana, additional, Ha-Vinh Leuchter, Russia, additional, Pollien, Philippe, additional, Lazeyras, François, additional, and Hüppi, Petra S, additional
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- 2017
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21. fMRI-based Neuronal Response to New Odorants in the Newborn Brain.
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Adam-Darque, Alexandra, Grouiller, Frédéric, Vasung, Lana, Leuchter, Russia Ha-Vinh, Pollien, Philippe, Lazeyras, François, and Hüppi, Petra S
- Published
- 2018
- Full Text
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22. Brain maturation, early sensory processing, and infant colic
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Elisa Russia Tuyet Mai Ha Vinh Leuchter, Alexandra Adam-Darque, and Petra Susan Hüppi
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Pediatrics ,medicine.medical_specialty ,ddc:618 ,Sensory processing ,business.industry ,medicine.medical_treatment ,Pediatrics, Perinatology and Child Health ,Brain maturation ,Gastroenterology ,Medicine ,business ,Neuroscience - Published
- 2013
23. Shedding light on excessive crying in babies
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Petra Susan Hüppi, Alexandra Adam-Darque, Philippe Pollien, Dimitri Van De Ville, Lorena G.A. Freitas, Gabriela Bergonzelli, Clara Lucia Garcia-Rodenas, Russia Ha-Vinh Leuchter, Frédéric Grouiller, François Lazeyras, and Julien Sauser
- Subjects
Male ,Parents ,Pediatrics ,Colic ,outcomes ,piriform cortex ,0302 clinical medicine ,Surveys and Questionnaires ,Prevalence ,Prospective Studies ,ddc:616 ,High prevalence ,ddc:618 ,medicine.diagnostic_test ,Crying ,infants ,Functional connectivity ,responsivity ,Brain ,Magnetic Resonance Imaging ,Pathophysiology ,ddc:128.37 ,medicine.anatomical_structure ,Breast Feeding ,depression ,Female ,medicine.symptom ,Brain activation ,medicine.medical_specialty ,Central nervous system ,Mothers ,Sensory system ,ddc:616.0757 ,03 medical and health sciences ,030225 pediatrics ,medicine ,Humans ,patterns ,sleep ,mri ,childhood ,individual-differences ,business.industry ,Infant, Newborn ,Infant ,Magnetic resonance imaging ,ddc:616.8 ,Pediatrics, Perinatology and Child Health ,Linear Models ,business ,030217 neurology & neurosurgery - Abstract
Background Excessive and inconsolable crying behavior in otherwise healthy infants (a condition called infant colic (IC)) is very distressing to parents, may lead to maternal depression, and in extreme cases, may result in shaken baby syndrome. Despite the high prevalence of this condition (20% of healthy infants), the underlying neural mechanisms of IC are still unknown. Methods By employing the latest magnetic resonance imaging (MRI) techniques in newborns, we prospectively investigated whether newborns' early brain responses to a sensory stimulus (smell) is associated with a subsequent crying behavior. Results In our sample population of 21 healthy breastfed newborns, those who developed IC at 6 weeks exhibited brain activation and functional connectivity in primary and secondary olfactory brain areas that were distinct from those in babies that did not develop IC. Different activation in brain regions known to be involved in sensory integration was also observed in colicky babies. These responses measured shortly after birth were highly correlated with the mean crying time at 6 weeks of age. Conclusions Our results offer novel insights into IC pathophysiology by demonstrating that, shortly after birth, the central nervous system of babies developing IC has already greater reactivity to sensory stimuli than that of their noncolicky peers. Impact, Shortly after birth, the central nervous system of colicky infants has a greater sensitivity to olfactory stimuli than that of their noncolicky peers. This early sensitivity explains as much as 48% of their subsequent crying behavior at 6 weeks of life. Brain activation patterns to olfactory stimuli in colicky infants include not only primary olfactory areas but also brain regions involved in pain processing, emotional valence attribution, and self-regulation. This study links earlier findings in fields as diverse as gastroenterology and behavioral psychology and has the potential of helping healthcare professionals to define strategies to advise families.
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