Résumé
Subcortical vascular mild cognitive impairment (svMCI) is a common prodromal stage of vascular dementia. Although mounting evidence has suggested abnormalities in several single brain network metrics, few studies have explored the consistency between functional and structural connectivity networks in svMCI. Here, we constructed such networks using resting-state fMRI for functional connectivity and diffusion tensor imaging for structural connectivity in 30 patients with svMCI and 30 normal controls. The functional networks were then parcellated into topological modules, corresponding to several well-defined functional domains. The coupling between the functional and structural networks was finally estimated and compared at the multiscale network level (whole brain and modular level). We found no significant intergroup differences in the functional–structural coupling within the whole brain; however, there was significantly increased functional–structural coupling within the dorsal attention module and decreased functional–structural coupling within the ventral attention module in the svMCI group. In addition, the svMCI patients demonstrated decreased intramodular connectivity strength in the visual, somatomotor, and dorsal attention modules as well as decreased intermodular connectivity strength between several modules in the functional network, mainly linking the visual, somatomotor, dorsal attention, ventral attention, and frontoparietal control modules. There was no significant correlation between the altered module-level functional–structural coupling and cognitive performance in patients with svMCI. These findings demonstrate for the first time that svMCI is reflected in a selective aberrant topological organization in multiscale brain networks and may improve our understanding of the pathophysiological mechanisms underlying svMCI.
Résumé
Este texto retoma a questão da natureza terapêutica da psicanálise para levar em conta o novo Paradigma da complexidade, que traz consigo a questão seminal da auto-organização dos seres vivos. Nos anos 40/50 do século XX, ocorre mudança radical na ciência com o aparecimento da cibernética, que leva a uma profunda reconfiguração ao abordar a realidade com ideias de sistema, auto-organização, indeterminação e de não linearidade. Desses fatos podemos reconhecer o surgimento de uma nova epistemologia, uma epistemologia complexa na medida em que não nos aproximamos da realidade de uma maneira reducionista, septada, mas de forma tal que todas as dimensões da realidade sejam vistas como configurando um sistema ser vivo ambiente. Então, o que mudou em psicanálise com a mudança de paradigma? Pensar por um novo vértice não modifica aquilo que é observado, mas seu entendimento. Psicanálise continua a ser Psicanálise e continua dependendo dessa relação bipessoal que ocorre no setting. Como são trazidos argumentos pouco abordados em nosso meio, o autor estende-se na descrição dos trabalhos que evidenciam novas abordagens de realidade e dos novos termos para descrevê-las que foram incorporados recentemente no vocabulário científico (AU)
This text retakes the question of the therapeutic nature of psychoanalysis to take into account the new Complexity paradigm, which brings with it the seminal question of the self-organization of living beings. It is a question of including Psychoanalysis in the context of the other human sciences, since we all have the object of the human being in its manifold manifestations. The work of Strachey (1934) was a landmark in its time, translated and reedited several times. It has been very useful for many years, since it is practically the only one to propose an explanation for the way of acting of psychoanalysis. In the 40s/50s of the twentieth century, radical change in science occurs with the emergence of cybernetics that leads to a profound reconfiguration in approaching reality with ideas of system, selforganization, indeterminacy and non-linearity. From these facts we can recognize the emergence of a new epistemology, a complex epistemology insofar as we do not approach reality in a reductionist way, septate, but in such a way that all dimensions of reality are seen as configuring a system living being - environment. So, what has changed in psychoanalysis with the paradigm shift? Thinking about a new vertex does not change what is observed, but its understanding. Psychoanalysis continues to be Psychoanalysis and continues depending on this two-person relationship that occurs in the setting. The arguments brought being little discussed in our midst, the author extends the description of the works that demonstrate new approaches to reality and the new terms to describe them which have recently been incorporated into the scientific vocabulary
Este texto retoma la cuestión de la naturaleza terapéutica del psicoanálisis para tener en cuenta el nuevo Paradigma de la complejidad, que trae consigo la cuestión seminal de la autoorganización de los seres vivos. En los años 40/50 del siglo XX, ocurre un cambio radical en la ciencia con la aparición de la cibernética que lleva a una profunda reconfiguración al abordar la realidad con ideas de sistema, autoorganización, indeterminación y no linealidad. De estos hechos podemos reconocer el surgimiento de una nueva epistemología, una epistemología compleja en la medida en que no nos acercamos a la realidad de una manera reduccionista, septada, sino de forma tal que todas las dimensiones de la realidad sean vistas como configurando un sistema ser vivo - medio ambiente. Entonces, ¿qué cambió en Psicoanálisis con el cambio de paradigma? Pensar por un nuevo vértice no modifica lo que se observa, sino su entendimiento. El psicoanálisis sigue siendo Psicoanálisis y continúa dependiendo de esa relación bi-personal que ocurre en el setting. Como se tratan argumentos poco abordados en nuestro medio, el autor se extiende en la descripción de los trabajos que evidencian nuevos enfoques de realidad y de los nuevos términos para describirlas que fueron incorporados recientemente en el vocabulario científico