Illusions neurobiologiques : le flux sanguin cérébral régional dans le syndrome de Cotard et la schizophrénie
DOI :
https://doi.org/10.18192/osurj.v4i1.7311Résumé
Le syndrome de Cotard est une affection rare, qui se caractérise par des délires nihilistes ou d'immortalité, souvent accompagnés de pensées suicidaires de dépression et d'anxiété. Ces symptômes diffèrent selon les individus mais sont souvent considérés comme des manifestations d’un trouble neuropsychiatrique. Le syndrome de Cotard reste insuffisamment étudié, en notamment dans le contexte de pathologies psychiatriques comme la schizophrénie. La cause de ce syndrome a été étudiée de façon plus approfondie dans une étude de cas récente dirigée par Nomura et al. (2024), au sujet d’un patient âgé de 52 ans atteint de schizophrénie et d'une légère déficience intellectuelle. Ce patient a subi beaucoup de fractures lombaires a la suite d’une tentative de suicide, et après son admission à l'hôpital, il a été diagnostiqué avec le syndrome de Cotard. Cette étude à évaluer les modifications longitudinales du flux sanguin cérébral régional par tomographie monophotonique (SPECT) chez un patient atteint de schizophrénie présentant un syndrome de Cotard. Les symptômes du syndrome semblent diminuer avec l’administration de la lurasidone, un antipsychotique atypique prescrit en psychiatrie, comme en témoignent les résultats du SPECT et les variations du rCBF. Le lien identifié entre le développement du syndrome de Cotard et une augmentation du rCBF donne un fondement solide pour mieux comprendre la nature de cette affection ainsi que les troubles neuropsychiatriques en général.
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