F Mauguière

Claude Bernard University Lyon 1, Villeurbanne, Rhône-Alpes, France

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Publications (388)1197.08 Total impact

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    ABSTRACT: Social pain after exclusion by others activates brain regions also involved in physical pain. Here we evaluated whether monetary reward could compensate for the negative feeling of social pain in the brain. To address this question we used the unique technique of intracranial electroencephalography in subjects with drug resistant epilepsy. Specifically, we recorded theta activity from intracranial electrodes implanted in the insular cortex while subjects experienced conditions of social inclusion and exclusion associated with monetary gain and loss. Our study confirmed that theta rhythm in the insular cortex is the neural signature of social exclusion. We found that while a monetary gain suppresses the effect of social pain in the anterior insula, there is no such effect in the posterior insula. These results imply that the anterior insula can use secondary reward signals to compensate for the negative feeling of social pain. HENCE, HERE WE PROPOSE THAT THE ANTERIOR INSULA PLAYS A PIVOTAL ROLE IN INTEGRATING CONTINGENCIES TO UPDATE SOCIAL PAIN FEELINGS: Finally, the possibility to modulate the theta rhythm through the reward system might open new avenues of research for treating pathologies related to social exclusion. © The Author (2015). Published by Oxford University Press. For Permissions, please email: journals.permissions@oup.com.
    Social Cognitive and Affective Neuroscience 05/2015; DOI:10.1093/scan/nsv054 · 5.88 Impact Factor
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    DESCRIPTION: accepté pour publication (NCCN) Summary Somatosensory evoked potentials (SSEPs) are increasingly performed for the assessment of peripheral neuropathies, but no practical guidelines have been established in this specific application. For this purpose, a survey was conducted among the French-speaking practitioners having an experience of SSEP recording in the context of peripheral neuropathies. The objectives were to determine the relevant indication criteria and technical settings for SSEP recording in this condition. From this survey, SSEPs appeared to be a second-line test when electroneuromyographic investigation was not enough conclusive, providing complementary and valuable information on peripheral proximal conduction and central conduction in the somatosensory pathways. Guidelines for a standardized recording protocol, including the various variables to measure, are proposed. This consensus statement is an important step in the process to recognize the value of this technique in assessing peripheral neuropathies in clinical practice. Keywords: diagnosis; evoked potentials; indication; parameters; peripheral neuropathies; technique.
  • Perrine Devic, Philippe Petiot, François Mauguière
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    ABSTRACT: Diagnosis of chronic inflammatory demyelinating polyneuropathy (CIDP) remains uncertain when nerve conduction studies (NCS) fail to show demyelination. We conducted a retrospective study of patients who presented with clinical criteria of CIDP in whom electrodiagnostic (EDX) criteria of definite or probable CIDP were missing [axonal sensory-motor neuropathy (n=23), normal EDX with pure sensory presentation (n=3)]. All patients received immunomodulatory treatment. Twenty-six patients were evaluated with somatosensory evoked potentials (SSEPs), MRI of spinal roots, CSF analysis, and/or nerve biopsy. Diagnosis of CIDP was considered to be confirmed in patients who responded to immunotherapy. 22 of 26 patients (85%) had SSEPs reflecting abnormal proximal conduction in sensory fibers, including 14 who had only clinical and SSEP data in favor of CIDP. SSEPs were abnormal in 16 of 20 responders (80%) to immunotherapy. SSEP recording contributes to diagnosis of CIDP when NCS fail to detect peripheral demyelination. This article is protected by copyright. All rights reserved. © 2015 Wiley Periodicals, Inc.
    Muscle & Nerve 04/2015; DOI:10.1002/mus.24693 · 2.31 Impact Factor
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    ABSTRACT: BACKGROUND: Radiofrequency thermocoagulation (RFTC) guided by stereoelectroencephalography (SEEG) has proved to be a safe palliative method to reduce seizure frequency in patients with drug-resistant partial epilepsy. In malformation of cortical development (MCD), increasing the number of implanted electrodes over that needed for mapping of the epileptogenic zone could help to maximize RFTC efficiency. OBJECTIVE: To evaluate the benefit of SEEG-guided RFTC in 14 patients suffering from drug-resistant epilepsy related to MCD located in functional cortical areas or in regions poorly accessible to surgery. METHODS: Ten men and 4 women were treated by RFTC. Thermolesions were produced by applying a 50-V, 120-mA current for 10 to 30 seconds within the epileptogenic zone as identified by the SEEG investigation. RESULTS: An average of 25.8 +/- 17.5 thermolesions were made per procedure. The median follow-up after the procedure was 41.7 months. Sixty-four percent of the patients experienced a long-term decrease in seizure frequency of >50%, of whom 6 (43%) presented long-lasting freedom from seizure. When a focal low-voltage fast activity was present at seizure onset on SEEG recordings, 87.5% of patients were responders or seizure free. All of the patients in whom electric stimulation reproduced spontaneous seizures were responders. CONCLUSION: Our results show the good benefit-risk ratio of the SEEG-guided procedure for patients suffering from MCD in whom surgery is risky. This study identifies 2 factors, focal low-voltage, high-frequency activity at seizure onset and lowered epileptogenic threshold in the coagulated area, that could be predictive of a favorable seizure outcome after RFTC. ABBREVIATIONS: LVFA, low-voltage fast activity MCD, malformation of cortical development RFTC, radiofrequency thermocoagulation SEEG, stereoelectroencephalography Copyright (C) by the Congress of Neurological Surgeons
    Neurosurgery 03/2015; DOI:10.1227/NEU.0000000000000723 · 3.03 Impact Factor
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    ABSTRACT: To explore whether painful somatosensory seizures (PSS) are generated in the primary somatosensory cortex (SI area) or in the operculo-insular cortex. We analyzed ictal recordings and data from stimulation using intracerebral electrodes exploring the operculo-insular cortex (including secondary somatosensory [SII] region), SI area, and other areas of the pain matrix (cingulate gyrus and supplementary motor area) in a case series study of 5 patients with PSS. Clinical features of PSS were different from those of seizures arising from the SI area: (1) pain intensity was higher; (2) pain spreading was not from one somatotopic territory to adjacent ones; and (3) the spatial extent of pain was large, fitting better with the size of somatosensory receptive fields of the insula and SII region than of the SI area. The insula and SII region were systematically involved at the onset of seizures, rapidly followed by the opercular portion of SI area. The upper part of SI cortex was involved at a lesser degree, with some delay, and pain duration did not correlate in time with that of the discharge in SI. Ictal pain was consistently reproduced by stimulation of the insula or SII region but never by stimulating the SI area. These data strongly suggest that PSS originate in the operculo-insular cortex and not in the SI area and corroborate the concept that this region is involved in the sensory-discriminative processing of pain inputs. Pain at the onset of PSS has a high value for localizing the epileptogenic area. © 2015 American Academy of Neurology.
    Neurology 01/2015; 84(6). DOI:10.1212/WNL.0000000000001235 · 8.30 Impact Factor
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    ABSTRACT: We have previously shown that an imaging marker, increased periventricular [11C]flumazenil ([11C]FMZ) binding, is associated with failure to become seizure free (SF) after surgery for temporal lobe epilepsy (TLE) with hippocampal sclerosis (HS). Here, we investigated whether increased preoperative periventricular white matter (WM) signal can be detected on clinical [18F]FDG-PET images. We then explored the potential of periventricular FDG WM increases, as well as whole-brain [11C]FMZ and [18F]FDG images analysed with random forest classifiers, for predicting surgery outcome.
    11/2014; 7. DOI:10.1016/j.nicl.2014.11.013
  • Maud Frot, Isabelle Faillenot, François Mauguière
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    ABSTRACT: Previous brain imaging studies have shown robust activations in the insula during nociceptive stimulation. Most activations involve the posterior insular cortex but they can cover all insular gyri in some fMRI studies. However, little is known about the timing of activations across the different insular sub-regions. We report on the distribution of intracerebrally recorded nociceptive laser evoked potentials (LEPs) acquired from the full extent of the insula in 44 epileptic patients. Our study shows that both posterior and anterior subdivisions of the insular cortex respond to a nociceptive heat stimulus within a 200-400 ms latency range. This nociceptive cortical potential occurs firstly, and is larger, in the posterior granular insular cortex. The presence of phase reversals in LEP components in both posterior and anterior insular regions suggests activation of distinct, presumably functionally separate, sources in the posterior and anterior parts of the insula. Our results suggest that nociceptive input is first processed in the posterior insula, where it is known to be coded in terms of intensity and anatomical location, and then conveyed to the anterior insula, where the emotional reaction to pain is elaborated. Hum Brain Mapp, 2014. © 2014 Wiley Periodicals, Inc.
    Human Brain Mapping 11/2014; 35(11). DOI:10.1002/hbm.22565 · 6.92 Impact Factor
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    ABSTRACT: Objective: The present study provides a functional mapping of vestibular responses in the human insular cortex.Methods: 642 electrical stimulations of the insula were performed in 219 patients, using stereotactically implanted depth electrodes, during the pre-surgical evaluation of drug refractory partial epilepsy. We retrospectively identified 41 contacts where stimulation elicited vestibular sensations (VS) and analyzed their location with respect to (1) their stereotactic coordinates (for all contacts), (2) the anatomy of insula gyri (for 20 vestibular sites) and (3) the probabilistic cytoarchitectonic maps of the insula (for 9 vestibular sites).Results: VS occurred in 7.6% of the 541 evoked sensations after electrical stimulations of the insula. VS were mostly obtained after stimulation of the posterior insula, i.e. in the granular insular cortex and the postcentral insular gyrus. The data also suggest a spatial segregation of the responses in the insula, with the rotatory and translational VS being evoked at more posterior stimulation sites than other less definable VS. No left-right differences were observed.Interpretation: These results demonstrate vestibular sensory processing in the insula that is centered on its posterior part. The present data add to the understanding of the multiple sensory functions of the insular cortex and of the cortical processing of vestibular signals. It also indicates that lesion or dysfunction in the posterior insula should be considered during the evaluation of vestibular epileptic seizures. ANN NEUROL 2014. © 2014 American Neurological Association
    Annals of Neurology 10/2014; 76(4). DOI:10.1002/ana.24252 · 11.91 Impact Factor
  • Maud Frot, Michel Magnin, François Mauguière, Luis Garcia-Larrea
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    ABSTRACT: Intracortical evoked potentials to nonnoxious Aβ (electrical) and noxious Aδ (laser) stimuli within the human primary somatosensory (S1) and motor (M1) areas were recorded from 71 electrode sites in 9 epileptic patients. All cortical sites responding to specific noxious inputs also responded to nonnoxious stimuli, while the reverse was not always true. Evoked responses in S1 area 3b were systematic for nonnoxious inputs, but seen in only half of cases after nociceptive stimulation. Nociceptive responses were systematically recorded when electrode tracks reached the crown of the postcentral gyrus, consistent with an origin in somatosensory areas 1-2. Sites in the precentral cortex also exhibited noxious and nonnoxious responses with phase reversals indicating a local origin in area 4 (M1). We conclude that a representation of thermal nociceptive information does exist in human S1, although to a much lesser extent than the nonnociceptive one. Notably, area 3b, which responds massively to nonnoxious Aβ activation was less involved in the processing of noxious heat. S1 and M1 responses to noxious heat occurred at latencies comparable to those observed in the supra-sylvian opercular region of the same patients, suggesting a parallel, rather than hierarchical, processing of noxious inputs in S1, M1 and opercular cortex. This study provides the first direct evidence for a spinothalamic related input to the motor cortex in humans. Hum Brain Mapp, 2012. © 2012 Wiley Periodicals, Inc.
    Human Brain Mapping 10/2013; 34(10). DOI:10.1002/hbm.22097 · 6.92 Impact Factor
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    ABSTRACT: Transcranial electric stimulation elicited muscle motor evoked potentials (TESmMEPs) is one of the best methods for corticospinal tract's function monitoring during spine and spinal cord surgeries. A train of multipulse electric stimulation is required for eliciting TESmMEPs under general anaesthesia. Here, we investigated the best stimulation parameters for eliciting and recording tibialis anterior's TESmMEPs during paediatric scoliosis surgery. Numbers of pulses (NOP), inter-stimulus intervals (ISI) and current intensities allowing the best size tibialis anterior muscle's TESmMEPs under general anaesthesia, were tested and collected during 77 paediatric scoliosis surgery monitoring procedures in our hospital. Individual pulse duration was kept at 0.5ms and stimulating electrodes were positioned at C1 and C2 (International 10-20-EEG-System) during all the tests. The NOP used for eliciting the best tibialis anterior TESmMEPs response was 5, 6, and 7 respectively in 21 (27%), 47 (61%) and 9 (12%) out of the 77 patients. The ISI was 2, 3 and 4 ms respectively in 13 (17%), 55 (71%) and 9 (12%) of them. The current intensity used varied from 300 to 700V (mean: 448±136 V). Most patients had 6 as best NOP (61%) and 3ms as best ISI (71%). These findings support that a NOP of 6 and an ISI of 3 ms should be preferentially used as optimal stimulation settings for intraoperative tibialis anterior muscle's TESmMEPs eliciting and recording during paediatric scoliosis surgery.
    Neurophysiologie Clinique/Clinical Neurophysiology 10/2013; 43(4):243-250. DOI:10.1016/j.neucli.2013.08.001 · 1.46 Impact Factor
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    International journal of cardiology 09/2013; 169(2). DOI:10.1016/j.ijcard.2013.08.100 · 6.18 Impact Factor
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    ABSTRACT: Surgical treatment of epilepsy is a challenge for patients with non-contributive brain magnetic resonance imaging. However, surgery is feasible if the seizure-onset zone is precisely delineated through intracranial electroencephalography recording. We recently described a method, volumetric imaging of epileptic spikes, to delineate the spiking volume of patients with focal epilepsy using magnetoencephalography. We postulated that the extent of the spiking volume delineated with volumetric imaging of epileptic spikes could predict the localizability of the seizure-onset zone by intracranial electroencephalography investigation and outcome of surgical treatment. Twenty-one patients with non-contributive magnetic resonance imaging findings were included. All patients underwent intracerebral electroencephalography investigation through stereotactically implanted depth electrodes (stereo-electroencephalography) and magnetoencephalography with delineation of the spiking volume using volumetric imaging of epileptic spikes. We evaluated the spatial congruence between the spiking volume determined by magnetoencephalography and the localization of the seizure-onset zone determined by stereo-electroencephalography. We also evaluated the outcome of stereo-electroencephalography and surgical treatment according to the extent of the spiking volume (focal, lateralized but non-focal or non-lateralized). For all patients, we found a spatial overlap between the seizure-onset zone and the spiking volume. For patients with a focal spiking volume, the seizure-onset zone defined by stereo-electroencephalography was clearly localized in all cases and most patients (6/7, 86%) had a good surgical outcome. Conversely, stereo-electroencephalography failed to delineate a seizure-onset zone in 57% of patients with a lateralized spiking volume, and in the two patients with bilateral spiking volume. Four of the 12 patients with non-focal spiking volumes were operated upon, none became seizure-free. As a whole, patients having focal magnetoencephalography results with volumetric imaging of epileptic spikes are good surgical candidates and the implantation strategy should incorporate volumetric imaging of epileptic spikes results. On the contrary, patients with non-focal magnetoencephalography results are less likely to have a localized seizure-onset zone and stereo electroencephalography is not advised unless clear localizing information is provided by other presurgical investigation methods.
    Brain 09/2013; DOI:10.1093/brain/awt213 · 10.23 Impact Factor
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    ABSTRACT: A third of patients with intractable temporal lobe epilepsy and hippocampal sclerosis (HS) are not seizure free (NSF) after surgery. Increased periventricular [11C]flumazenil (FMZ) binding, reflecting heterotopic neuron concentration, has been described as one predictor of NSF outcome at the group level. We aimed to replicate this finding in an independent larger cohort and investigated whether NSF outcome can be predicted in individuals. Preoperative [11C]FMZ summed radioactivity images were available for 16 patients with HS and 41 controls. Images were analyzed using SPM8, explicitly including the white matter, and correction for global radioactivity via group-specific ANCOVA. Periventricular increases were assessed with a mask and different cutoffs for distinguishing NSF and seizure free (SF) patients. NSF patients had increased [11C]FMZ binding around the posterior horn of the ventricles ipsilaterally (z = 2.53) and contralaterally (z = 4.44) to the seizure focus compared with SF patients. Compared with controls, SF patients had fewer periventricular increases (two clusters, total volume 0.87 cm3, zmax = 3.8) than NSF patients (two ipsilateral and three contralateral clusters, 6.15 cm3, zmax = 4.8). In individuals and at optimized cutoffs, five (63%) of eight NSF patients and one (13%) of eight SF patients showed periventricular increases compared with controls (accuracy 75%). Only one (2%) of the 41 controls had increases at the same cutoff. The association between periventricular [11C]FMZ increases and NSF outcome after temporal lobe resection for HS has been confirmed in an independent cohort on simple summed activity images. [11C]FMZ-PET may be useful for individual preoperative counseling with clinically relevant accuracy.
    09/2013; 3:242-248. DOI:10.1016/j.nicl.2013.07.008
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    ABSTRACT: IntroductionNeurophysiological studies point to altered cortical neuronal excitability in migraine patients.State of artBetween attacks, migraine brain seems to be “hyperresponsive” to repetitive stimuli, as suggested by evoked potential studies that show a lack of habituation to sensory stimuli. Transcranial magnetic stimulation suggests an impairment of intracortical inhibitory circuits in migraine, especially in migraine with aura. Controversial results are obtained in migraineurs without aura. Repetitive transcranial magnetic stimulation also shows in migraine with aura a paradoxical enhancement of intracortical facilitation by low frequency stimulation and greater increased facilitatory mechanisms by high-frequency stimulation. Importantly, cortical excitability level fluctuates over time in relation to the migraine cycle. The interictal lack of habituation to sensory stimuli normalizes before and during a migraine attack. Changes of cortical excitability consistent with the theory of cortical spreading depression are also observed during migraine aura with magnetoencephalography.PerspectivesThe exact role of cortical excitability changes in migraine pathophysiology and possibly in chronic migraine is still unknown. Further studies are also necessary to clarify the role of migraine preventive drugs on brain excitability.Conclusions In this review, the results of neurophysiological studies conducted in migraine patients will be described and the associated pathophysiological hypotheses will be discussed.
    Revue Neurologique 05/2013; 169(5):427–435. DOI:10.1016/j.neurol.2013.02.001 · 0.60 Impact Factor
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    ABSTRACT: PURPOSE: Mesio-temporal ictal semiology is sometimes observed in patients with large multilobar lesion. In this situation, surgery is often discarded because of the lesion size and/or suspicion of extended or multifocal epileptogenic areas. In this retrospective study we evaluated the surgical outcome of such patients in order to assess whether the electro-clinical presentation of seizures could be a prognostic marker of surgical outcome. METHODS: Among the temporal lobe epilepsy population explored in our department between 2000 and 2011 (240 patients), we identified 7 patients who presented an extensive lesion on brain Magnetic Resonance Imaging (MRI) (multilobar in four, hemispheric in two, and bilateral in one). All patients underwent (18)Fluorodeoxyglucose Positron Emission Tomography, which showed large, hemispheric or multilobar, areas of glucose hypometabolism. Because of the large lesion size, all patients were explored by stereoelectroencephalography (SEEG) before taking a decision regarding surgical indication. RESULTS: SEEG confirmed the temporal origin of the seizures and discarded the possibility of multiple epileptogenic zones. A temporal lobectomy, tailored on the basis of SEEG data, was proposed to the seven patients. The seven patients are classified Engel class I after the surgery (mean follow-up: 37.4±22.1 months). CONCLUSION: Our data thus suggest that, even in the absence of hippocampal MRI abnormality, ictal symptoms compatible with a temporal origin of seizures should be considered as a reliable indicator for surgery eligibility regardless of MRI lesion size. On the basis of our findings, the mesio-temporal semiology of seizures appears as one of the most reliable markers of operability in patients with large MRI lesions. These patients should not be excluded a priori from invasive exploration and surgical treatment, even if a large portion of their lesion is likely to be left in place after surgery.
    Seizure 03/2013; 45(5). DOI:10.1016/j.seizure.2013.02.008 · 2.06 Impact Factor
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    ABSTRACT: Behavioral reactions to sensory stimuli during sleep are scarce despite preservation of sizeable cortical responses. To further understand such dissociation, we recorded intracortical field potentials to painful laser pulses in humans during waking and all-night sleep. Recordings were obtained from the three cortical structures receiving 95% of the spinothalamic cortical input in primates, namely the parietal operculum, posterior insula, and mid-anterior cingulate cortex. The dynamics of responses during sleep differed among cortical sites. In sleep Stage 2, evoked potential amplitudes were similarly attenuated relative to waking in all three cortical regions. During paradoxical, or rapid eye movements (REM), sleep, opercular and insular potentials remained stable in comparison with Stage 2, whereas the responses from mid-anterior cingulate abated drastically, and decreasing below background noise in half of the subjects. Thus, while the lateral operculo-insular system subserving sensory analysis of somatic stimuli remained active during paradoxical-REM sleep, mid-anterior cingulate processes related to orienting and avoidance behavior were suppressed. Dissociation between sensory and orienting-motor networks might explain why nociceptive stimuli can be either neglected or incorporated into dreams without awakening the subject. Hum Brain Mapp, 2011. © 2011 Wiley-Liss, Inc.
    Human Brain Mapping 11/2012; 33(11). DOI:10.1002/hbm.21390 · 6.92 Impact Factor
  • Perrine Devic, Philippe Petiot, François Mauguière
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    ABSTRACT: Introduction: Distal hereditary motor neuropathy (dHMN) is characterized by isolated distal muscle atrophy without sensory deficit. Nevertheless, clinical sensory loss has been reported despite preserved sensory nerve conduction in a few patients, thus differentiating these cases from the classical type 2 Charcot-Marie-Tooth disease (CMT2). Methods: We report 4 patients who presented with clinical sensory and motor neuropathy and normal peripheral sensory nerve conduction studies and were investigated with complete electrophysiological studies, including somatosensory evoked potentials (SEP). Results: These patients had a clinical presentation of classical CMT with isolated axonal motor neuropathy suggestive of dHMN. Interestingly, tibial nerve SEPs showed abnormalities suggestive of proximal involvement of dorsal roots that may explain the clinical somatosensory disturbances. Conclusions: These cases support the concept of spinal CMT that should be recognized as an intermediate form between dHMN and CMT2. SEP recording was helpful in defining a more precise phenotype of spinal CMT. Muscle Nerve 46: 603-607, 2012.
    Muscle & Nerve 10/2012; 46(4):604-9. DOI:10.1002/mus.23456 · 2.31 Impact Factor

Publication Stats

11k Citations
1,197.08 Total Impact Points


  • 1995–2015
    • Claude Bernard University Lyon 1
      Villeurbanne, Rhône-Alpes, France
  • 2012–2014
    • French National Centre for Scientific Research
      Lutetia Parisorum, Île-de-France, France
  • 2010–2013
    • Lyon Neuroscience Research Center
      Lyons, Rhône-Alpes, France
    • Université Jean Monnet
      Saint-Étienne, Rhône-Alpes, France
    • French Institute of Health and Medical Research
      Lutetia Parisorum, Île-de-France, France
  • 2006–2013
    • Hospices Civils de Lyon
      Lyons, Rhône-Alpes, France
    • Centre Hospitalier Le Vinatier
      Брон, Rhône-Alpes, France
  • 1989–2012
    • University of Lyon
      Lyons, Rhône-Alpes, France
  • 1990–2011
    • CHU de Lyon - Hôpital Neurologique et Neurochirurgical Pierre Wertheimer
      Lyons, Rhône-Alpes, France
    • Centre Hospitalier Universitaire de Saint-Étienne
      • Department of Neurology
      Saint-Étienne, Rhône-Alpes, France
  • 2008
    • HCL
      Noida, Uttar Pradesh, India
  • 2005
    • University of Malaga
      • Area of Physiology
      Málaga, Andalusia, Spain
  • 2004–2005
    • The Neurosciences Institute
      لا هویا, California, United States
  • 1992–2004
    • CERMEP
      Rhône-Alpes, France
  • 1999
    • University Joseph Fourier - Grenoble 1
      • Centre d'Investigation Clinique
      Grenoble, Rhône-Alpes, France
  • 1992–1999
    • The Catholic University of America
      Washington, Washington, D.C., United States
  • 1997
    • University of Helsinki
      • Department of Child Neurology
      Helsinki, Uusimaa, Finland
  • 1996
    • Faculté des Sciences Ain Chock - Casablanca
      Anfa, Grand Casablanca, Morocco
  • 1994
    • Catholic University of the Sacred Heart
      • Institute of Neurology
      Roma, Latium, Italy
  • 1986–1992
    • Unité Inserm U1077
      Caen, Lower Normandy, France