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 Dysfonctionnement frontal et cognition sociale dans les troubles bipolaires et schizophréniques - étude comportementale et par IRM fonctionnelle -

Abstract :     This monograph provides an approach to Kraepelin's dichotomy of bipolar and schizophrenic disorders by studying the dysfunction of both the executive and social cognition systems, especially the theory of mind. The aim of the first part was to assess the theory of mind's dysfunction in the euthymic phase of the bipolar disorder, in order to compare with the published data on schizophrenia. Our results emphasize the dysfunction of only the theory of mind's cognitive component with an over-mentalizing propensity, while the affective component was left unscathed, quite different from schizophrenia. Therefore, executive and theory of mind dysfunction, as well as social deficit, characterize both psychotic disorders. Given the differences revealed through fMRI between the two psychotic disorders regarding the neural underpinnings of the executive deficit (hypofrontality), we aimed to confirm the difference between these disorders by a more complex approach, including neurocognition and social cognition. A new paradigm has been developed for assessing theory of mind's impact on the executive function within a virtual social interaction context. By using this method in a first fMRI study in normal participants, we identified the specific executive regions modulated by theory of mind intervention, thus contributing to behavioural adjustment to the social context. The same fMRI paradigm has been applied in a comparative study of bipolar and schizophrenic patients. This study showed an abnormal modulation of the executive system by the theory of mind, with respect to healthy subjects. Of particular relevance to this analysis is the finding that the dysfunctional activation profile of bipolar patients was of an intermediate degree between healthy subjects and schizophrenic patients. In spite of certain similarities of genetic, cognitive and clinical phenotypes, our results suggest a different involvement of the neurocircuits underlining the neurocognitive and social cognitive functions. Furthermore, these results help to explain the different social outcome of bipolar and schizophrenic disorders and also support the categorical nosographic approach in the coming versions of international classifications 
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Contributor : Mircea Polosan <>
Submitted on : Monday, February 28, 2011 - 1:41:16 PM
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Mircea Polosan.  Dysfonctionnement frontal et cognition sociale dans les troubles bipolaires et schizophréniques - étude comportementale et par IRM fonctionnelle -. Neurosciences [q-bio.NC]. Université de Grenoble, 2010. Français. ⟨tel-00570379⟩

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