Yawning is related to sleep/wake transitions and time
of day, probably reflecting the time course of
sleepiness. As aging modifies sleep-wake and sleepiness
rhythms, does yawning frequency and its time course vary
as a function of age?
Yawning frequency is reduced in aged subjects
compared with their younger counterparts, supporting the
previous report by Walusinski
(2006).....
It is noteworthy that the reduction of yawning
frequency in aged subjects is not spread throughout
wakefulness: aged subjects yawn less frequently than
young adults during the morning and in the mid-afternoon.
This result could be explained by the age-related shift
towards morningness, previously highlighted (for
review, Monk and Kupfer, 2007) and replicated in the
present study. In fact, a recent research (Zilli
et al., 2007) emphasized that morning-types yawn less
frequently than evening-types particularly during
daytime....
Although both elderly and young subjects yawn more
frequently early in the morning and late in the evening,
aged subjects show earlier morning peak and evening rise
compared with the young adults, according to the earlier
sleep times. In addition, aged subjects exhibit two minor
yawning peaks, which occur early in the afternoon and
early in the evening. The time course of sleepiness
across wakefulness is related to the time course of
yawning in both age groups. This finding is consistent
with the association between yawning and sleepiness
emphasized by previous researches (Guggisberg
et al., 2007; Provine
et al., 1987; Zilli
et al., 2007) and it underscores that this link is
evident even in the elderly.
Changes as a function of age in the time course of
yawning are associated with changes in the time course of
sleepiness. The lower sleepiness levels reported by the
aged subjects during morning hours could account for the
reduction of yawning frequency observed in this part of
the day. It is also noticeable that the two additional
yawning peaks, detected in the midst of wakefulness
period in the elderly, approximately correspond to
sleepiness rises. Furthermore, the advanced evening rise
in yawning frequency showed by aged subjects matched up
with the advanced sleepiness increase.
It is remarkable that the rise of yawning before
sleep parallels the increase of sleepiness in both age
groups, whereas yawning peak after the awakening is not
associated with high sleepiness level in the aged
subjects. This discrepancy suggests that the time course
of subjective sleepiness by itself could not give an
explanation for all of the yawning frequency
oscillations: the relationship between yawning frequency
and the proximity of wake&endash;sleep and
sleep&endash;wake transitions should also be taken into
account. It seems reasonable to suppose that sleepiness
level and sleep episode proximity could separately affect
yawning, even though further researches including
sleep-wake rhythm manipulation and sleepiness objective
measurement are necessary to clarify their respective
role.
Le bâillement est corrélé au
rythme veille/sommeil et aux périodes de
transition entre ces deux comportements, reflétant
l'état de somnolence. La fréquence des
bâillements est diminuée chez les sujets
âgés comparativement à celle des
jeunes adultes, comme l'a rapporté le travail
antérieur de Walusinski
(2006).
Il est à noter que la réduction de
cette fréquence liée au vieillissement
n'est pas répartie de façon homogène
au cours du nycthémère. C'est
essentiellement le matin et en milieu d'après midi
que cette réduction a lieu. Ceci peut s'expliquer
par la tendance à l'avance de phase avec des
éveils plus tôt chez les sujets
âgés, chose déjà notée
dans des publications antérieures et
retrouvée ici. En fait, un travail récent
avait montré que les sujets du matin
bâillent moins que ceux du soir (Zilli
et al., 2007).
Les sujets âgés montrent deux pics
d'augmentation de fréquence de leurs
bâillements, tôt dans l'après-midi
(somnolence post-prandiale, sieste fréquente par
fragmentation du temps de sommeil total), et plus
précocément en soirée que chez les
jeunes (avance de phase). Ceci montre bien la
corrélation étroite entre somnolence et
bâillements et souligne ce lien très fort
chez les personnes âgées (Guggisberg
et al., 2007; Provine
et al., 1987; Zilli
et al., 2007). Ces changements d'horaires des
bâillements apparaissent donc associés aux
changement des horaires de somnolence au cours du
nycthémère.
Il est intéressant de noter que l'augmentation
de fréquence des bâillements avant
l'endormissement se retrouve dans les deux groupes
étudiés alors que les bâillements
suivant l'éveil ne sont pas rapportés
à de la somnolence chez les sujets
âgés. Cette différence suggère
que ce n'est pas la sensation subjective de somnolence en
elle-même qui explique les différences de
fréquence des bâillements. Il paraît
raisonnable de supposer que la somnolence et la
proximité de l'endormissement affectent
indépendamment l'apparition des bâillements.
De futurs recheches seront nécessaires pour
préciser tous ces points.
Automatic-voluntary
dissociation of orofaciolingual-pharyngeal
motility
The anterior opercular or biopercular syndrome
(Foix-Chavany syndrome) is a
cortical pseudobulbar palsy due to bilateral lesions of
the anterior brain operculum. It is characterized by
preservation of reflex function and automatic activity,
without mental impairment. Two cases are reported herein
and the relevant literature reviewed. (spanish
language)
The first case was a 73-year-old female with a
history of a stroke occurring seven years previously,
without sequelae in the interim. She presented with
sudden loss of consciousness. The neurological
examination showed a right facial central palsy and
anarthria, with reflex acts such as smiling, blinking and
yawning, not elicited by commands; she also had a
right hemiparesis and walking impairment. A brain CT scan
showed an old ischemic infarction in the region of the
right medial cerebral artery. Because the right motor
involvement did not correlate with the findings of the
initial CT scan, another CT scan two days later showed an
acute brain infarction in the vicinity of the left medial
cerebral artery.
The second case was an 8-year-old girl with mental
retardation and impairment of verbal development, caused
by of biopercular pachygyria.
Facio-pharyngo-glosso-masticatory diplegia and
volitional selective palsy of the oro-facial muscles was
seen in both patients. The neuropsychological assessment
showed cognitive, emotional and social interaction
impairment in both cases as part of the frontal convexity
syndrome in the first case and of mental retardation in
the second. The two patients had difficulty in
mastication and swallowing but were able to smile and
yawn. The prognosis for recovery of verbal
capacity is poor, although generally most patients
recover the ability to swallow.
Dissociation
automatico-volontaire
Le syndrome operculaire ou syndrome de Foix
Chavanny est caractérisé par une paralysie
faciale centrale (atteinte opercule rolandique
bilatérale), une paralysie linguale et
linguo-pharyngée affectant toute la
motricité volontaire tandis que la motilité
automatique, émotionnelle en particulier est
préservée. Ainsi la malade sourit et
bâille.
The life and work of Joseph Babinski (1857-1932) has
been revisited by two French physicians whose enthusiasm
for the subject is reflected in the depth and breadth of
documentary sources. From Babinski's Polish roots, his
father (an intrepid revolutionist), his brother(the gold
miner and famous gastronome Ali-Bab) to the Babinski
circle, his friends, his colleagues and his disciples,
the reader will find a refreshing perspective on a
particularly fascinating period in French medicine.
His scientific contribution is analyzed in detail,
with for the first time a complete bibliography of his
publications. These includes not only the Babinski Sign,
but also the earlier and heretofore less-known concerning
pathological anatomy and histology, the papers on
cutaneous and tendinous reflexes, cerebellar and
vestibular semeiology, hysteria and pithiatism,
localization of spinal cord compression s and the birth
of French neurosurgery.
J. Philippon, neurochirurgien et J. Poirier,
anatomopathologiste ont uni leurs talents d'historiens
pour brosser la fresque de la vie de Joseph Babinski en
embrassant une vaste source documentaire historique et
bibliographique. Depuis ses origines polonaises (son
père fut un ardent patriote révolutionnaire
anti-russe), son frère (explorateur minier et
réputé gastronome, auteur, sous le nom
d'Ali-Bab, d'un fameux recueil culinaire) juqu'à
ses amis, ses collègues et ses
élèves, les auteurs passent en revue et
pénètrent tous les détails d'une vie
qui éclairent les heures les plus glorieuses de
cette période si riche en découvertes de la
médecine française de la fin du XIX°
siècle.
Les contributions de J. Babinski à la
neurologie sont présentées et
analysées en détails, mises en perspective
avec les questions qui se posaient avec acuité,
à l'époque, comme la distinction entre
hémiplégie organique et hystérique;
c'est ainsi qu'est abordé le fameux signe
plantaire que tous les médecinns du monde nomme
encore aujourd'hui signe de Babinski dans leur pratique
quotidienne. Mais les auteurs dévoilent aussi les
travaux antérieurs d'anatomie et
d'histopathologie, ainsi que les contributions de J.
Babinski à l'étude des réflexes
tendineux, de la sémiologie
cérébelleuse et vestibulaire, de
l'hystérie rebaptisée pithiastisme sans
négliger la sémiologie médullaire
permettant la localisation purement clinique mais
précise des compressions médullaires,
ouvrant l'ère de la neurochirurgie
française.
Les auteurs insistent sur la minutie et la
précision de l'examen clinique
réalisé par J. Babinski, presque
obsessionnel. Le 11 octobre 1904, il commence sa
leçon de clinique par ces termes: "j'estime que
les erreurs de diagnostic proviennent bien moins souvent
d'une fausse interprétation que d'une observation
imparfaite des symptômes, qu'elles sont
ordinairament liées à des erreurs de
sémiotique". Tout est dit, rien n'a changé,
et les images n'y changeront rien.
Lire aussi la biographie: "Sous le signe de Babinski"
Hubert Déchy. Association des amis de la BIUM
- 2007
Le
syndrome de Wyburn-Mason ou de Bonnet-Dechaume-Blanc
comprend l'association de malformations
artério-veineuses du maxillaire, de la
rétine, du nerf optique, du thalamus, de
l'hypothalamus et du cortex cérébral. La
prévalence du syndrome n'est pas connue mais il
est très rare : moins de 100 cas ont
été publiés à ce jour.
Wyburn-Mason
syndrome is characterized by the association of
arteriovenous malformations with a metameric topography
located in the facial and ocular-orbital regions or
involving the central nervous system. The syndrome is
very rare with about 100 cases reported in the literature
so far.
Bulbar Structures
Concerned in Primitive Movements
Yawning still occurs after bilateral motor
decortication in man or in decorticate lower mammals. In
the former it is completely uncontrollable, as it may be
in normal subjects. Yawning not only involves a
wide opening of the mouth, but is preceded by a deep
inspiration. The eyes often close and the act is often
followed by pilo-erection and shivering. In biteral motor
decorticate man yawning is accompanied by gross
moves of the large joints (associated movements).
Curious attacks of yawning and respiratory
disturbance may follow an attack of encephalitis
lethargica, which especially damages the hypothalamus
and the region of the substantia nigra. Yawning
would thus appear to depend on the structures in the bulb
or hypothalamus and to be closely related respiratory
activity.
It occurs :
(1) In states of tiredness and sleepiness, in which
there is a depression of adrenergic and an increase of
trophic cholinergic activity throughout the brain.
(2) In conditions of excessive heat, when there is a
general increase of cholinergic activity in the body and
sleepiness.
(3) During anxiety, when a similar general
stimulation of trophic and autonomic functions
occurs.
(4) During the induction of amesthesia with
barbituates, which depress adrenergic activity and induce
sleep.
(5) In animals in states of anaphylactic shock, when
the initial stimulation of all trophic and autonomie is
followed by a depression of adrenergic activity.
(6) During boredom, when adrenergic activity is
deficient.
Yawning thus occurs when there is a general
increase of trophic cholinergic activity within the
nervous system and thus when respiratory activity is
diminished and anoxia tends to develop. Since general
stimulation of adrenergic activity in the body increases
the depth of respiration, the deep inspiration which
precedes a yawn, and the pilo-erection and
shivering, which follow indicate an increased adrenergic
activity. This seems to be an attempt to increase the
oxygenation of the blood by stimulation of the
respiratory centres. The excitation of the structures in
the reticular formation initiated by the activity of the
substantia nigra apparently spreads to neighbouring
nuclei and induces opening of the jaws and the primitive
slight movements of the large joints occurring in
bilateral motor decorticate man.
Joseph
Ducreux, connaissant
les limites du genre de l'autoportrait,
préfère inventer, ici, une image
inhabituelle, humoristique, le montrant bâillant et
s'étirant, avec la satisfaction qui sied. Tenue
décontractée, qui bâille aussi,
couleurs vives, turban de nuit sur le chef, aspect
négligé, tout concourt à faire
partager l'intimité du peintre. Voilà un
tableau original pour l'époque.
Joseph
Ducreux experimented
with the traditional limitations of the genre of
self-portraiture by creating an expressive, humorous, and
rather unorthodox image of himself stretching and
yawning. Dressed informally in a turban and bright red
jacket, Ducreux, in the midst of a huge yawn, opens his
mouth wide, contorting his face with the effort and
stretching his right arm toward the viewer. Holding this
exaggerated pose, his back sways and his stomach pushes
forward; his entire body presses up close to the surface
of the picture.
French painter, pastellist and
engraver, Ducreux lived in Paris from 1760 and from 1762
kept a list of his works. Among the portraits he
completed in his early years were those in pastel of the
well-known connoisseurs Pierre-Jean
Mariette, the
Comte
de Caylus and
Ange-Laurent
de La Live de Jully,
which apparently were copies after Maurice-Quentin de La
Tour. Ducreux has traditionally been seen as de La Tour's
favourite pupil, while Jean-Baptiste Greuze is supposed
to have initiated him into oil painting. From his age, it
can be assumed that by the time Ducreux reached Paris he
had already acquired a grounding in his art.
(see
other works)
Peintre français de
pastels et d'estampes, Ducreux vécût
à Paris de 1760 à 1762. Il paracheva sa
technique des pastels auprès du
célèbre Pierre-Jean
Mariette, le
comte
de Caylus et
Ange-Laurent
de La Live de Jully, qui
copiaient apparamment Maurice-Quentin de La Tour. Ducreux
est traditionnellement considéré comme un
des élèves favoris de de la Tour, alors
qu'il semble que ce soit Jean-Baptiste Greuze qui
l'initia à la peinture à l'huile.
Compte-tenu de son âge il est probable que Ducreux
possédait déjà un bon niveau quand
il arriva à Paris (voir
d'autres tableaux)
Combien de fois
bâillez-vous par jour ? <5 = 24,1%.. 5-10 =
24,5%.. 10-15 = 15.2%.. 15-20 = 9,8%.. >20 =
26,3%
Ressentez-vous des
baillements excessifs ?
59,1% = non, tant
mieux
32,6% = oui et je ne
sais pas pouquoi
8,4% = oui et je prends
des antidépresseurs
1,0% = oui et je prends
des anti-épileptiques
5,5% = oui et je prends
d'autres médicaments
2,4% = oui et j 'ai des
troubles neurologiques
2,3% = oui et j 'ai des
troubles hormonaux
1,7%
= oui et j 'ai des tics moteurs
1,6% = oui et j 'ai des
tocs
déclenchez-vous
facilement le bâillement d'autrui ? 75,1%
êtes-vous sensible
au bâillement d'autrui ? 71,0%
Charles
Brower
A new idea is
delicate. It can be killed by a sneer or a yawn; it can
be stabbed to death by a joke or worried to death by a
frown on the right person's brow.
Une idée
neuve est fragile. On peut la tuer par un ricanement ou
un bâillement; elle peut être
poignardée à mort par un jeu de mots,
menacée par l'inquiétude d'un froncement de
sourcils de celui qui
l'écoute.