References of "Faymonville, Marie-Elisabeth"
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See detailEditorial : Hypnose : mieux comprendre pour mieux l'utiliser
FAYMONVILLE, Marie-Elisabeth ULg

in Douleur et Analgésie (2008), 21(1), 1

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See detailHypnose et conscience
FAYMONVILLE, Marie-Elisabeth ULg

in Douleur et Analgésie (2008), 21(1), 3-6

Hypnotic-like behavior has been reported from the dawn of history. The early origins are shrouded in mystery and magic; but Franz Anton Mesmer, an Austrian physician, conducted his therapeutic sessions ... [more ▼]

Hypnotic-like behavior has been reported from the dawn of history. The early origins are shrouded in mystery and magic; but Franz Anton Mesmer, an Austrian physician, conducted his therapeutic sessions under the name of ‘‘animal magnestism’’. He proposed a theory that the ‘‘magnetic’’ influence could be transfered by iron bars. However a committee of leading scientists of the day showed that the ‘‘magnetic’’ influence could be transfered as well by wooden rods as by iron bars and that influence upon the patient was a result of imagination. Mesmer was obviously wrong in his theory, but he was the first attempting to use modern physical science to replace some of the superstition of his day. This in turn became opposition between supporters of physiological theories and those of psychological theories. Salpetriere, with Charcot, saw a pathological state in hypnosis, an artificial hysterical neurosis. On the other hand, the Nancy school of thought, represented by Bernheim, Liebault and Liegeois, suggested that it was a normal psychological phenomenon. The fight between the two schools was very bitter. Other theories initially inspired by the Pavlov school of thought came to light; these were replaced by those inspired by experimental psychology and a third psychoanalytic theory became predominant. A description of the hypnotic state revealed the reality and non-reality of the hypnotic state. This was the outcome of functional neuro-imaging techniques that are currently revolutionising our knowledge of cerebral functioning and research in the area of cognitive neuroscience allows questions about consciousness and its neurobiological substrate to be asked. Research into hypnosis requires a distinction to be made between ‘‘the state of consciousness’’ and ‘‘conscious content’’. Various functional neuro-imaging studies are reported investigating the area of ‘‘neurophenomenology’’ in the hypnotic process. [less ▲]

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See detailPerception of pain in the minimally conscious state with PET activation: an observational study.
Boly, Mélanie ULg; Faymonville, Marie-Elisabeth ULg; Schnakers, Caroline et al

in Lancet Neurology (2008), 7(11), 1013-20

BACKGROUND: Patients in a minimally conscious state (MCS) show restricted self or environment awareness but are unable to communicate consistently and reliably. Therefore, better understanding of cerebral ... [more ▼]

BACKGROUND: Patients in a minimally conscious state (MCS) show restricted self or environment awareness but are unable to communicate consistently and reliably. Therefore, better understanding of cerebral noxious processing in these patients is of clinical, therapeutic, and ethical relevance. METHODS: We studied brain activation induced by bilateral electrical stimulation of the median nerve in five patients in MCS (aged 18-74 years) compared with 15 controls (19-64 years) and 15 patients (19-75 years) in a persistent vegetative state (PVS) with (15)O-radiolabelled water PET. By way of psychophysiological interaction analysis, we also investigated the functional connectivity of the primary somatosensory cortex (S1) in patients and controls. Patients in MCS were scanned 57 (SD 33) days after admission, and patients in PVS 36 (9) days after admission. Stimulation intensities were 8.6 (SD 6.7) mA in patients in MCS, 7.4 (5.9) mA in controls, and 14.2 (8.7) mA in patients in PVS. Significant results were thresholded at p values of less than 0.05 and corrected for multiple comparisons. FINDINGS: In patients in MCS and in controls, noxious stimulation activated the thalamus, S1, and the secondary somatosensory or insular, frontoparietal, and anterior cingulate cortices (known as the pain matrix). No area was less activated in the patients in MCS than in the controls. All areas of the cortical pain matrix showed greater activation in patients in MCS than in those in PVS. Finally, in contrast with patients in PVS, those in MCS had preserved functional connectivity between S1 and a widespread cortical network that includes the frontoparietal associative cortices. INTERPRETATION: Cerebral correlates of pain processing are found in a similar network in controls and patients in MCS but are much more widespread than in patients in PVS. These findings might be objective evidence of a potential pain perception capacity in patients in MCS, which supports the idea that these patients need analgesic treatment. [less ▲]

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See detailBewusstseinsstörungen - Diagnose und Prognose
Laureys, Steven ULg; FAYMONVILLE, Marie-Elisabeth ULg; BOLY, Mélanie ULg et al

in Junginger, T. (Ed.) Grenzsituationen der Intensivmedizin-Entscheidungsgrundlagen (2008)

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See detailRevelations from the unconscious: studying residual brain function in coma and related states.
Laureys, Steven ULg; Boly, Mélanie ULg; Schnakers, Caroline ULg et al

in Bulletin et Mémoires de l'Académie Royale de Médecine de Belgique (2008), 163(7-9), 381-8388-90

The purpose of our research is to contribute to a better understanding of the residual brain function of patients who survive an acute brain damage but remain in a coma, vegetative state, minimally ... [more ▼]

The purpose of our research is to contribute to a better understanding of the residual brain function of patients who survive an acute brain damage but remain in a coma, vegetative state, minimally conscious state or locked-in syndrome. The diagnosis, prognosis, therapy and medical management of these patients remain difficult. These studies are also of interest scientifically, as they help to elucidate the neural correlates of human consciousness. We here review our studies on bedside behavioral evaluation scales, electrophysiology and functional neuroimaging in these disorders of consciousness and conclude by discussing methodological and ethical issues and current concepts of the standards for care and quality of life in these challenging conditions. [less ▲]

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See detailLa buprénorphine transdermique. L'état actuel dans les domaines clinique et pharmacologique.
Faymonville, Marie-Elisabeth ULg; Libbrecht, Dominique ULg

in Revue Médicale de Liège (2008), 63(11), 671-6

Our understanding of the pathophysiologic mechanisms of chronic pain progresses; the complexity of the problem justifies our need for new molecules and new ways of administration that will help to further ... [more ▼]

Our understanding of the pathophysiologic mechanisms of chronic pain progresses; the complexity of the problem justifies our need for new molecules and new ways of administration that will help to further optimise and better individualize our pharmacologic therapies. Whereas acute pain can be considered an alarm signal, chronic pain constitutes, per se, a syndrome that requires a meticulous selection of the analgesic drug(s). Since pain is permanent, the continuous administration of the analgesic is recommended rather than an on demand administration. Transdermic modes of administration are of value for the treatment of chronic pain because they allow a progressive delivery of the active compound together with the maintenance of stable plasma levels of the drug. Buprenorphine is a semi-synthetic opioid that is available in the sublingual, injectable, or transdermic forms. The matrix patch of buprenorphine represents a major asset for the treatment of chronic pain, whether it be cancerous in origin, or not. Its efficacy and safety have been clearly demonstrated in randomised double blind trials as well as in post-marketing surveillance observations. Buprenorphine, administered as a transdermal therapeutic system, induces a dose-related pain relief, whatever the nature of the pain and the age of the patient. Buprenorphine also exerts an analgesic action on neuropathic pain. It differs from other opioids by its affinity as a partial agonist on mu and kappa receptors, and as a complete agonist of ORL-1 receptors. Therefore, transdermal buprenorphine will be useful to all physicians having to control severe pain by powerful opioids. [less ▲]

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See detailHypnose et perception de la douleur
Vanhaudenhuyse, Audrey ULg; Boveroux, Pierre ULg; Boly, Mélanie ULg et al

in Revue Médicale de Liège (2008), 63(5-6), 424-8

Improvement in functional neuroimaging allows researchers to disentangle the brain mechanisms involved in the pain modulation encountered during hypnosis. It has been shown that the anterior cingulate and ... [more ▼]

Improvement in functional neuroimaging allows researchers to disentangle the brain mechanisms involved in the pain modulation encountered during hypnosis. It has been shown that the anterior cingulate and prefrontal cortices are important in the modulation of incoming sensory and noxious input. Moreover, clinical studies in certain types of surgery (eg thyroidectomy, mastectomy and plastic surgery) have demonstrated that hypnosis may avoid general anesthesia. [less ▲]

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See detailMesurer la douleur chez le patient non communicant.
Chatelle, Camille ULg; Vanhaudenhuyse, Audrey ULg; Mergam, Anne-Nora ULg et al

in Revue Médicale de Liège (2008), 63(5-6), 429-37

Pain is a subjective experience. Its assessment is based on the subject's direct verbal report. This method of assessment is, however, impossible in patients who cannot communicate their feelings. In this ... [more ▼]

Pain is a subjective experience. Its assessment is based on the subject's direct verbal report. This method of assessment is, however, impossible in patients who cannot communicate their feelings. In this context, indirect measurements such as behavioral observations or physiological measurements are needed. To facilitate the assessment of pain in non-communicative patients, numerous standardized behavioral scales have been developed. The aim of this review is to discuss the main validated pain scales employed in end-stage dementia, newborn and preverbal children, and severely brain damaged patients with a disorder of consciousness such as coma, the vegetative state or the minimally conscious state. [less ▲]

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See detailfMRI study of hypnosis-induced analgesia
Boly, Mélanie ULg; Balteau, Evelyne ULg; Schnakers, Caroline ULg et al

in Journal of Neurology (2007, May), 254(Suppl. 3), 38-39

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See detailNaloxone-insensitive epidural placebo analgesia in a chronic pain patient.
Kupers, Ron; Maeyaert, Jan; Boly, Mélanie ULg et al

in Anesthesiology (2007), 106(6), 1239-42

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See detailInteret de la revalidation aerobie dans la prise en charge de la fibromyalgie
Maquet, Didier ULg; Croisier, Jean-Louis ULg; Demoulin, Christophe ULg et al

in Revue Médicale de Liège (2006), 61(2), 109-16

This study assesses the influence of a muscular aerobic revalidation program on the management of the fibromyalgia syndrome. After 3 months, benefits consisting of increased muscle performances associated ... [more ▼]

This study assesses the influence of a muscular aerobic revalidation program on the management of the fibromyalgia syndrome. After 3 months, benefits consisting of increased muscle performances associated with a reduction of pain and an improvement of quality of life were documented. This study confirms the value of aerobic muscle exercise in fibromyalgia patients. [less ▲]

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See detailFunctional neuroanatomy of the hypnotic state.
Faymonville, Marie-Elisabeth ULg; Boly, Mélanie ULg; Laureys, Steven ULg

in Journal of Physiology - Paris (2006), 99(4-6), 463-9

The neural mechanisms underlying hypnosis and especially the modulation of pain perception by hypnosis remain obscure. Using PET we first described the distribution of regional cerebral blood flow during ... [more ▼]

The neural mechanisms underlying hypnosis and especially the modulation of pain perception by hypnosis remain obscure. Using PET we first described the distribution of regional cerebral blood flow during the hypnotic state. Hypnosis relied on revivification of pleasant autobiographical memories and was compared to imaging autobiographical material in "normal alertness". The hypnotic state was related to the activation of a widespread set of cortical areas involving occipital, parietal, precentral, premotor, and ventrolateral prefrontal and anterior cingulate cortices. This pattern of activation shares some similarities with mental imagery, from which it mainly differs by the relative deactivation of precuneus. Second, we looked at the anti-nociceptive effects of hypnosis. Compared to the resting state, hypnosis reduced pain perception by approximately 50%. The hypnosis-induced reduction of affective and sensory responses to noxious thermal stimulation were modulated by the activity in the midcingulate cortex (area 24a'). Finally, we assessed changes in cerebral functional connectivity related to hypnosis. Compared to normal alertness (i.e., rest and mental imagery), the hypnotic state, significantly enhanced the functional modulation between midcingulate cortex and a large neural network involved in sensory, affective, cognitive and behavioral aspects of nociception. These findings show that not only pharmacological but also psychological strategies for pain control can modulate the cerebral network involved in noxious perception. [less ▲]

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See detailCerebral processing of auditory and noxious stimuli in severely brain injured patients: Differences between VS and MCS
Boly, Mélanie ULg; Faymonville, Marie-Elisabeth ULg; Peigneux, Philippe ULg et al

in Neuropsychological Rehabilitation (2005), 15(3-4, Jul-Sep), 283-289

We review cerebral processing of auditory and noxious stimuli in minimally conscious state (MCS) and vegetative state (VS) patients. In contrast with limited brain activation found in VS patients, MCS ... [more ▼]

We review cerebral processing of auditory and noxious stimuli in minimally conscious state (MCS) and vegetative state (VS) patients. In contrast with limited brain activation found in VS patients, MCS patients show activation similar to controls in response to auditory, emotional and noxious stimuli. Despite an apparent clinical similarity between MCS and VS patients, functional imaging data show striking differences in cortical segregation and integration between these two conditions. However, in the absence of a generally accepted neural correlate of consciousness as measured by functional neuroirnaging, clinical assessment remains the gold standard for the evaluation and management of severely brain damaged patients. [less ▲]

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See detailThe cognitive modulation of pain: hypnosis- and placebo-induced analgesia.
Kupers, Ron; Faymonville, Marie-Elisabeth ULg; Laureys, Steven ULg

in Progress in Brain Research (2005), 150

Nowadays, there is compelling evidence that there is a poor relationship between the incoming sensory input and the resulting pain sensation. Signals coming from the peripheral nervous system undergo a ... [more ▼]

Nowadays, there is compelling evidence that there is a poor relationship between the incoming sensory input and the resulting pain sensation. Signals coming from the peripheral nervous system undergo a complex modulation by cognitive, affective, and motivational processes when they enter the central nervous system. Placebo- and hypnosis-induced analgesia form two extreme examples of how cognitive processes may influence the pain sensation. With the advent of modern brain imaging techniques, researchers have started to disentangle the brain mechanisms involved in these forms of cognitive modulation of pain. These studies have shown that the prefrontal and anterior cingulate cortices form important structures in a descending pathway that modulates incoming sensory input, likely via activation of the endogenous pain modulatory structures in the midbrain periaqueductal gray. Although little is known about the receptor systems involved in hypnosis-induced analgesia, studies of the placebo response suggest that the opiodergic and dopaminergic systems play an important role in the mediation of the placebo response. [less ▲]

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See detailThe locked-in syndrome : what is it like to be conscious but paralyzed and voiceless?
Laureys, Steven ULg; Pellas, Frédéric; Van Eeckhout, Philippe et al

in Progress in Brain Research (2005), 150(Boundaries of Consciousness: Neurobiology and Neuropathology), 495-511

The locked-in syndrome (pseudocoma) describes patients who are awake and conscious but selectively deefferented, i.e., have no means of producing speech, limb or facial movements. Acute ventral pontine ... [more ▼]

The locked-in syndrome (pseudocoma) describes patients who are awake and conscious but selectively deefferented, i.e., have no means of producing speech, limb or facial movements. Acute ventral pontine lesions are its most common cause. People with such brainstem lesions often remain comatose for some days or weeks, needing artificial respiration and then gradually wake up, but remaining paralyzed and voiceless, superficially resembling patients in a vegetative state or akinetic mutism, In acute locked-in syndrome (LIS), eye-coded communication and evaluation of cognitive and emotional functioning is very limited because vigilance is fluctuating and eye movements may be inconsistent, very small, and easily exhausted. It has been shown that more than half of the time it is the family and not the physician who first realized that the patient was aware. Distressingly, recent studies reported that the diagnosis of LIS on average takes over 2.5 months. In some cases it took 4-6 years before aware and sensitive patients, locked in an immobile body, were recognized as being conscious. Once a LIS patient becomes medically stable, and given appropriate medical care, life expectancy increases to several decades. Even if the chances of good motor recovery are very limited, existing eye-controlled, computer-based communication technology currently allow the patient to control his environment, use a word processor coupled to a speech synthesizer, and access the worldwide net. Healthy individuals and medical professionals sometimes assume that the quality of life of an LIS patient is so poor that it is not worth living. On the contrary, chronic LIS patients typically self-report meaningful quality of life and their demand for euthanasia is surprisingly infrequent. Biased clinicians might provide less aggressive medical treatment and influence the family in inappropriate ways. It is important to stress that only the medically stabilized, informed LIS patient is competent to consent to or refuse life-sustaining treatment. Patients suffering from LIS should not be denied the right tot die - and to die with dignity - but also, and more importantly, and pain and symptom management. In our opinion, there is an urgent need for a renewed ethical and medicolegal framework for our care of locked-in patients. [less ▲]

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See detailZerebrale Funktionen bei hirngeschädigten Patienten. Was bedeuten Koma, "vegetative state“, "minimally conscious state“, "Locked-in-Syndrom“ und Hirntod?
Faymonville, Marie-Elisabeth ULg; Pantke, Karl-Heinz; Berré, Jacques et al

in Anaesthesist (2004), 53(12), 1195-1202

Comatose, vegetative, minimally conscious or locked-in patients represent a problem in terms of diagnosis, prognosis, treatment and everyday management at the intensive care unit. The evaluation of ... [more ▼]

Comatose, vegetative, minimally conscious or locked-in patients represent a problem in terms of diagnosis, prognosis, treatment and everyday management at the intensive care unit. The evaluation of possible cognitive functions in these patients is difficult because voluntary movements may be very small, inconsistent and easily exhausted. Functional neuroimaging cannot replace the clinical assessment of patients with altered states of consciousness. Nevertheless, it can describe objectively how deviant from normal the cerebral activity is and its regional distribution at rest and under various conditions of stimulation. The quantification of brain activity differentiates patients who sometimes only differ by a brief and incomplete blink of an eye. In the present paper, we will first try to define consciousness as it can be assessed at the patient's bedside. We then review the major clinical entities of altered states of consciousness encountered in the intensive care unit. Finally, we discuss the functional neuroanatomy of these conditions as assessed by positron emission tomography (PET) scanning. [less ▲]

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See detailReporting systems in healthcare from a case-by-case experience to a general framework: an example in anaesthesia
Nyssen, Anne-Sophie ULg; Aunac, Sophie; Faymonville, Marie-Elisabeth ULg et al

in European Journal of Anaesthesiology (2004), 21(10), 757-765

Reporting systems are becoming more widespread in healthcare. Since they may become mandatory under the pressure of insurance companies and administrative organizations, it is important to begin to go ... [more ▼]

Reporting systems are becoming more widespread in healthcare. Since they may become mandatory under the pressure of insurance companies and administrative organizations, it is important to begin to go beyond a case-by-case approach and to move to a system where there is a general reflection on the best conditions of development and setting up of such systems in medicine. In this paper, we review existing reporting systems, break down their components, examine how they are constructed and propose some ideas on how to articulate them in a dynamic process in order to improve the validity of the tool as mediator of safety, quality and well-being at work. [less ▲]

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See detailIndications des corticoides par voie peridurale dans les douleurs rachidiennes et radiculaires
Fontaine, Robert ULg; Tomasella, Marco ULg; Martin, Didier ULg et al

in Revue Médicale de Liège (2004), 59(10), 557-64

Back pain is very frequent in western countries and it represents a very high social cost. The treatment is based on five modalities: medication, physiotherapy, invasive technics, rehabilitation programs ... [more ▼]

Back pain is very frequent in western countries and it represents a very high social cost. The treatment is based on five modalities: medication, physiotherapy, invasive technics, rehabilitation programs and psycho-social approaches. Several treatments may be proposed simultaneously and introduced gradually. Steroid administration by epidural injection is frequently used in Belgium, even though no prospective randomised studies have shown a real benefit over the long term. The indications for epidural injection must be carefully chosen. These include subacute pain (less than six months) in the lower limbs despite a well observed medical treatment. Patients are invited to give informed consent; the technic must be performed in an appropriate environment by an experienced physician. The initial treatment of back pain is medical. This pathology is multifactorial and the relief of symptoms is often incomplete. The patient should be urged to feel responsible for and involved in his treatment. [less ▲]

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See detailNeurophysiological mechanisms of hypnosis
Faymonville, Marie-Elisabeth ULg; Maquet, Pierre ULg; Laureys, Steven ULg

in International Journal of Psychophysiology (2004, September), 54(1-2), 43-44

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See detailPrise en charge de la douleur chronique en équipe pluridisciplinaire
Fontaine, Robert ULg; Fuchs, Sonia; Hardy, Régine ULg et al

in Revue Médicale de Liège (2004), 59(2), 81-88

Assessment of chronic pain is one of medicine's most difficult challenges. A structured and flexible multidisciplinary approach allows full characterisation of the various components of the pain syndrome ... [more ▼]

Assessment of chronic pain is one of medicine's most difficult challenges. A structured and flexible multidisciplinary approach allows full characterisation of the various components of the pain syndrome. This then allows the use of a rational combination of pharmacologic, physical, psychological, and surgical techniques. It is essential to gain the patient's confidence, collaboration, and compliance. Patients can better manage their situation when their needs are clarified and when care is oriented toward concrete therapeutic objectives. [less ▲]

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