Eye Direction Detection and Perception as Premises of a Social Brain: A Narrative Review of Behavioral and Neural Data.

The eyes and the gaze are important stimuli for social interaction in humans. Impaired recognition of facial identity, facial emotions, and inference of the intentions of others may result from difficulties in extracting information relevant to the eye region, mainly the direction of gaze. Therefore, a review of these data is of interest. Behavioral data demonstrating the importance of the eye region and how humans respond to gaze direction are reviewed narratively, and several theoretical models on how visual information on gaze is processed are discussed to propose a unified hypothesis. Several issues that have not yet been investigated are identified. The authors tentatively suggest experiments that might help progress research in this area. The neural aspects are subsequently reviewed to best describe the low-level and higher-level visual information processing stages in the targeted subcortical and cortical areas. A specific neural network is proposed on the basis of the literature. Various gray areas, such as the temporality of the processing of visual information, the question of salience priority, and the coordination between the two hemispheres, remain unclear and require further investigations. Finally, disordered gaze direction detection mechanisms and their consequences on social cognition and behavior are discussed as key deficiencies in several conditions, such as autism spectrum disorder, 22q11.2 deletion, schizophrenia, and social anxiety disorder. This narrative review provides significant additional data showing that the detection and perception of someone's gaze is an essential part of the development of our social brain.

Misuse of opioid analgesics in elderly patients: a review.

Opioid analgesic (OA) addiction occurs frequently among the elderly, and results in high morbidity and mortality due to geriatric pathologies associated with pharmacokinetic modifications. However, patients with this type of addiction are under-identified and specific screening tools should be more widely used to detect the risk factors for OA addiction. Before initiating an opioid prescription, exhaustive research into associated treatments (to track drug interaction) and opioid prescriptions by other clinicians (a phenomenon known as "doctor shopping") is required. Specific specialist care, as has been developed in the United States, is still scarce in France and treatment is provided through collaboration between geriatricians and psychiatrists. Optimisation of the treatment of somatic and psychiatric comorbidities is key to effective management.

[Analgesic opioids misuse in the elderly: A review]. / Mésusage d'antalgiques opioïdes chez le sujet âgé : une mise au point.

Analgesic opioids addiction (AOA) is very frequent in the elderly, and results in a high morbi-mortality due to geriatric associated pathologies with pharmacokinetics modifications. However, it is poorly detected in these subjects and specific screening tools should be widely used to detect the risk factors for AOA prevention. Before initiating opioid prescription, exhaustive search of associated treatments (to track drug interaction) and of opioid prescription by other clinicians (doctor shopping) are requisite. Specific care sectors, as developed in the United States are still scarce in France and care support is provided by the collaboration between geriatricians and psychiatrists. Optimisation of somatic and psychiatric comorbidities is a core part of the guidelines.