In Context
In Context
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DOI：
10.4324/9781315647982-4
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发表时间：
1981-12
期刊：
影响因子：
--
通讯作者：
Mark Graham
中科院分区：
文献类型：
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作者：
Mark Graham
发现药物是家族遗传的并不少见，但在布鲁诺·杜布瓦的案例中，这种联系要更极端一些。从他的父亲一直追溯到未来几代，杜布瓦家族一直与医学联系在一起。更令人难以置信的是，每一代人都对大脑和行为之间的关系产生了兴趣。他的曾祖父与现代神经学之父之一Duchenne de Boulogne保持着通信，而他的祖父在法国巴黎的Pitié-Salpétrière医院接受约瑟夫·巴宾斯基的培训，杜布瓦和他的父亲都曾在那里接受培训，现在杜布瓦在那里领导着大脑和脊柱研究所(ICM)的一个团队。当谈到他丰富的神经科血统时，杜布瓦远非自吹自擂，而是相当回避谈论他的家庭。当他谈到他在ICM的认知、神经成像和大脑疾病团队的工作时，他要舒服得多，而且立即吸引人。这个团队是在杜布瓦的两位伟大导师弗朗索瓦·勒米特和伊夫·阿吉德领导的神经心理学和神经化学系之间的交界处发展起来的，目的是加深我们对额叶在支撑认知的系统组织中的作用的理解。当这些系统出现故障时会发生什么？自然，神经退行性疾病是该团队研究和杜布瓦临床工作的主要焦点，而目光敏锐的《柳叶刀神经学》的读者可能已经认识到杜布瓦是几篇改变了阿尔茨海默氏症概念化方式的开创性论文的作者。2007年，杜布瓦是国际工作组的主要成员之一，该工作组在一篇论文中提出了阿尔茨海默病的新诊断标准，这篇论文对阿尔茨海默病的研究方法产生了深远的影响。“在2007年的论文发表之前，我常说阿尔茨海默病的诊断有三个主要规则，”杜布瓦解释说。“首先，阿尔茨海默病的诊断只能在死后作出；其次，临床诊断只能是可能的；第三，因为诊断阿尔茨海默病很困难，所以只有在患者患有严重疾病时才能诊断，所以他们精神错乱。”他说，在他看来，这些都远远不够。我不明白为什么我们要在…之前依赖于某个严重程度的门槛
It's not uncommon to fi nd that medicine runs in families, but in the case of Bruno Dubois the association is a little more extreme. From his father all the way back for fi ve generations, the Dubois family has been associated with medicine. Even more incredibly, each generation has cultivated an interest in the relationship between the brain and behaviour. His great-great-great-grandfather kept up a correspondence with one of the fathers of modern neurology, Duchenne de Boulogne, while his grandfather was trained by Joseph Babinski at the Pitié-Salpêtrière Hospital in Paris, France, where Dubois and his father both trained, and where Dubois now leads a team at the Brain and Spine Institute (ICM). Far from being boastful when it comes to his rich neurological pedigree, Dubois rather shies away from talking about his family. He's far more comfortable, and instantly engaging, when he's talking about the work of his Cognition, Neuroimaging, and Brain Diseases team at the ICM. The team grew at the interface between the departments of neuropsychology and neurochemistry, which were led by Dubois' two great mentors, François Lhermitte and Yves Agid, respectively, with the aim to further our understanding of the role of the frontal lobes in the organisation of the systems that underpin cognition. And what happens when those systems go wrong? Naturally, neurodegenerative diseases are a major focus of the team's research and of Dubois' clinical work, and eagle-eyed readers of The Lancet Neurology will probably already have recognised Dubois as an author of several seminal papers that have changed the way Alzheimer's disease is conceptualised. In 2007, Dubois was a leading member of the International Working Group that proposed new diagnostic criteria for Alzheimer's disease in a paper that has had a profound infl uence on the way Alzheimer's disease is approached. " Before the 2007 paper, I used to say there were three main rules for the diagnosis of Alzheimer's disease " , Dubois explains. " First, the defi nitive diagnosis of Alzheimer's disease can only be made post mortem; second, the clinical diagnosis could only be probable; and third, because it's diffi cult to diagnose Alzheimer's disease, it can only be done when patients have severe disease, so they are demented " , he says, none of which seemed to him to be remotely adequate. " I didn't see why we should rely on a certain threshold of severity before we …