Les investigations respiratoires nocturnes chez le patient en situation de polyhandicap

The lack of nocturnal investigation of people with multiple disabilities prevents us from detecting pathologies like sleep apnea and global alveolar hypoventilation. These two deficiencies have serious consequences on the quality of these patients’ life. In order to actually do this evaluation, we suggest a six-step approach: first, the spotting of suggestive clinical signs, then the consultation between the patient – with his close relatives – and the healthcare practitioners. At that point, the process can be stopped insofar as there is no will to set up additional treatment. If on the contrary, the patient's life project matches with the possibility of a ventilatory treatment, further examination can be planned: the screening, with a tool as simple as nocturnal saturometry, then the diagnostic with HAS-recommended tools, polygraph and capnographic tests. Last but not least, the ventilator treatment's setting up by an experts’ team ends the process, once all the other possible options have been evaluated. A regular revaluation will enable us to reset the ventilation and above all to draw up an assessment of the global gains and losses, to eventually stop the treatment at any moment if need be, that is to say whenever the disadvantages exceed the benefits.     

Intelligence and handedness: Meta-analyses of studies on intellectually disabled,typically developing,and gifted individuals

Understanding the relationship between cerebral laterality and intelligence is important in elucidating the neurological underpinnings of individual differences in cognitive abilities. A widely used, behavioral indicator for cerebral laterality, mainly of language, is handedness. A number of studies have compared cognitive abilities between groups of left- and right-handers, while others have investigated the handedness prevalence between groups of different cognitive abilities. The present study comprises five meta-analyses of studies that have assessed the handedness prevalence in (a) individuals with intellectual disability (ID) of unknown/idiopathic nature compared to typically developing (TD) individuals, and (b) individuals with intellectual giftedness (IG) compared to TD individuals. Nineteen data sets totaling 16,076 participants (5795 ID, 8312 TD, and 1969 IG) were included in the analyses. Elevated levels of atypical handedness were found to be robust only for the ID to TD comparison. Findings constrain the range of acceptable theories on the handedness distribution for different intelligence levels.     

Neural correlates of self‐injurious behavior in Prader–Willi syndrome

Individuals with Prader–Willi syndrome (PWS), a genetic disorder caused by mutations to the q11‐13 region on chromosome 15, commonly show severe skin‐picking behaviors that can cause open wounds and sores on the body. To our knowledge, however, no studies have examined the potential neural mechanisms underlying these behaviors. Seventeen individuals with PWS, aged 6–25 years, who showed severe skin‐picking behaviors, were recruited and scanned on a 3T scanner. We used functional magnetic resonance imaging (fMRI) while episodes of skin picking were recorded on an MRI‐safe video camera. Three participants displayed skin picking continuously throughout the scan, three participants did not display skin picking, and the data for one participant evidenced significant B0 inhomogeneity that could not be corrected. The data for the remaining 10 participants (six male, four female) who displayed a sufficient number of picking and nonpicking episodes were subjected to fMRI analysis. Results showed that regions involved in interoceptive, motor, attention, and somatosensory processing were activated during episodes of skin‐picking behavior compared with nonpicking episodes. Scores obtained on the Self‐Injury Trauma scale were significantly negatively correlated with mean activation within the right insula and left precentral gyrus. These data indicate that itch and pain processes appear to underlie skin‐picking behaviors in PWS, suggesting that interoceptive disturbance may contribute to the severity and maintenance of abnormal skin‐picking behaviors in PWS. Implications for treatments are discussed. Hum Brain Mapp 36:4135–4143, 2015. © 2015 Wiley Periodicals, Inc.     

Psychiatric disorders and characteristics of abuse in sexually abused children and adolescents with and without intellectual disabilities

The purpose of this study was to compare sexually abused children and adolescents, with and without intellectual disabilities (ID), in terms of post-abuse psychiatric disorders, features of the sexual abuse, and sociodemographic characteristics. The study included sexually abused children aged 6–16 years, who were sent to three different child mental health units for forensic evaluation; there were 102 cases (69 girls and 33 boys) with ID and 154 cases (126 girls and 28 boys) without ID. Researchers retrospectively examined the files, social examination reports, and the judicial reports of the cases. It was determined that in the group with ID, sexual abuse types including penetration and contact had higher rates, they were exposed to more frequent repeated abuses, the abuses were revealed with their own reports at a later period and lower rates, and post-abuse pregnancies were more frequent. It was also determined that the abuser was a familiar person and a family member at lower rates and more than one abuser was encountered more frequently, compared to the group without ID. While no difference was determined between the two groups in terms of the frequency of post-abuse post-traumatic stress disorder (PTSD) and major depressive disorder (MDD), conduct disorder (CD) was observed more frequently in the group with ID. This study emphasizes that sexual abuse, which is an important problem in individuals with ID, has different features and effects.