I support the application of the “evolution as tinkering” idea to vocalization and emphasize that some of the subcortical parts of the brain circuits used for speech organs retain features common to nonprimate mammals, and in some cases to lower vertebrates, pointing up the importance of cortical evolution as suggested by MacNeilage.

I have suggested that the prefrontal cortex constitutes an ?executive committee? with five streams coming from posterior cortex and subcortical areas to five pre-frontal executive regions, each of which chairs at least one on-going ?sub-committee? and vies with the other executives for taking over central control of conscious attention and willed action. It is through the dynamic interaction of this executive committee that unified conscious experiences and a sense of continuous self-identity are created. There is growing evidence that the (...) amygdala-orbitofrontal brain circuit, in particular, is crucial to impulse control, ?knowledge of good and evil,? personality, personhood, and even ?how X-me made Y-me do something.? There are striking examples of the ways that orbitofrontal and anterior cingulate ?committee members? can stage an insurrection against the dorsolateral prefrontal cortex executive chair. (shrink)

Emotional states of consciousness, or what are typically called emotional feelings, are traditionally viewed as being innately programed in subcortical areas of the brain, and are often treated as different from cognitive states of consciousness, such as those related to the perception of external stimuli. We argue that conscious experiences, regardless of their content, arise from one system in the brain. On this view, what differs in emotional and non-emotional states is the kind of inputs that are processed by (...) a general cortical network of cognition, a network essential for conscious experiences. Although subcortical circuits are not directly responsible for conscious feelings, they provide non-conscious inputs that coalesce with other kinds of neural signals in the cognitive assembly of conscious emotional experiences. In building the case for this proposal, we defend a modified version of what is known as the higher-order theory of consciousness. (shrink)

Deep Brain Stimulation is an invasive device-based neuromodulation technique that allows the therapeutic direct stimulation of subcortical and deep cortical structures following the surgical placement of stimulating electrodes. DBS is approved by the U.S. Federal Drug Administration for the treatment of movement disorders and obsessive-compulsive disorder, while new indications, including Major Depressive Disorder, are in experimental development. We report the case of a patient with MDD who received DBS to the ventral internal capsule and ventral striatum bilaterally and presented (...) with 2 weeks of voltage-dependent Tourette-like symptoms including brief transient episodes of abrupt-onset and progressively louder coprolalia and stuttered speech; tic-like motor behavior in his right arm and leg; rushes of anxiety, angry prosody, angry affect; and moderate amnesia without confusion. We describe the results of the inpatient neuropsychiatric workup leading to the diagnosis of iatrogenic voltage-dependent activation of cortico-subcortical circuits and discuss insights into the pathophysiology of Tourette as well as safety considerations raised by the case. (shrink)

This review article summarizes various functions of the dorsolateral prefrontal cortex that are related to language processing. To this end, its connectivity with the left-dominant perisylvian language network was considered, as well as its interaction with other functional networks that, directly or indirectly, contribute to language processing. Language-related functions of the DLPFC comprise various aspects of pragmatic processing such as discourse management, integration of prosody, interpretation of nonliteral meanings, inference making, ambiguity resolution, and error repair. Neurophysiologically, the DLPFC seems to (...) be a key region for implementing functional connectivity between the language network and other functional networks, including cortico-cortical as well as subcortical circuits. Considering clinical aspects, damage to the DLPFC causes psychiatric communication deficits rather than typical aphasic language syndromes. Although the number of well-controlled studies on DLPFC language functions is still limited, the DLPFC might be an important target region for the treatment of pragmatic language disorders. (shrink)

Although most aspects of world and self-consciousness are inherently subjective, neuroscience studies in humans and non-human animals provide correlational and causative indices of specific links between brain activity and representation of the self and the world. In this article we review neuroanatomic, neurophysiological and neuropsychological data supporting the hypothesis that different levels of self and world representation in vertebrates rely upon i) a 'basal' subcortical system that includes brainstem, hypothalamus and central thalamic nuclei and that may underpin the primary (...) (or anoetic) consciousness likely present in all vertebrates; and ii) a forebrain system that include the medial and lateral structures of the cerebral hemispheres and may sustain the most sophisticated forms of consciousness (e.g. noetic (knowledge based) and autonoetic, reflective knowledge). We posit a mutual, bidirectional functional influence between these two major brain circuits. We conclude that basic aspects of consciousness like primary self and core self (based on anoetic and noetic consciousness) are present in many species of vertebrates and that, even self-consciousness (autonoetic consciousness) does not seem to be a prerogative of humans and of some non-human primates but may, to a certain extent, be present in some other mammals and birds. (shrink)

An adequate understanding of ‘the self’ and/or ‘primary-process consciousness’ should allow us to explain how affective experiences are created within the brain. Primitive emotional feelings appear to lie at the core of our beings, and the neural mechanisms that generate such states may constitute an essential foundation process for the evolution of higher, more rational, forms of consciousness. At present, abundant evidence indicates that affective states arise from the intrinsic neurodynamics of primitive self-centred emotional and motivational systems situated in (...) class='Hi'>subcortical regions of the brain. Accordingly, a neural understanding of ‘the self’ may arise from a study of how various biological value-coding systems converge and interact with coherent brainstem representations of the body and nearby attentional/waking systems of the brain. Affective feelings may be caused by the neurodynamics of basic emotional circuits interacting with the neural schema of bodily action plans. One key brain area where such interactions occur is found within centromedial diencephalic midbrain areas such as the periventricular and periaqueductal gray and nearby tectal and tegmental zones. Here I will envision that a Simple Ego-type Life Form is instantiated in those circuits The ability of this ’primal SELF’ to resonate with primitive emotional values may help yield the raw subjectively experienced feelings of pleasure, lust, anger, hunger, desire, fear, loneliness and so forth. A study of such systems is a reasonable starting point for the neurological analysis of affective feelings, which may lie at the periconscious core of all other forms of animal consciousness. If such a neurodynamic process was an essential neural preadaptation for the emergence of higher levels of consciousness, it may help us close the explanatory gap between brain circuit states and the psychological nature of affective feelings. Thereby, it may also help us conceptualize the nature of psychological binding within higher forms of consciousness in new ways. (shrink)

The neurobiological systems that mediate the basic emotions are beginning to be understood. They appear to be constituted of genetically coded, but experientially refined executive circuits situated in subcortical areas of the brain which can coordinate the behavioral, physiological and psychological processes that need to be recruited to cope with a variety of primal survival needs (i.e., they signal evolutionary fitness issues). These birthrights allow newborn organisms to begin navigating the complexities of the world and to learn about (...) the values and contingencies of the environment. Some of these systems have been identified and characterized using modern neuroscientific and psychobiological tools. The fundamental emotional systems can now be defined by the functional psychobiological characteristics of the underlying circuitries ? characteristics which help coordinate behavioral, physiological and psychological aspects of emotionality, including the valenced affective feeling states that provide fundamental values for the guidance of behavior. The various emotional circuits are coordinated by different neuropeptides, and the arousal of each system may generate distinct affective/neurodynamic states and imbalances may lead to various psychiatric disorders. The aim of this essay is to discuss the underlying conceptual issues that must be addressed for additional progress in understanding the nature of primary process affective consciousness. (shrink)

In this paper we examine the functional anatomy of volition, as revealed by modern brain imaging techniques, in conjunction with neuropsychological data derived from human and non-human primates using other methodologies. A number of brain regions contribute to the performance of consciously chosen, or ‘willed', actions. Of particular importance is dorsolateral prefrontal cortex , together with those brain regions with which it is connected, via cortico-subcortical and cortico-cortical circuits. That aspect of free will which is concerned with the (...) voluntary selection of one action rather than another critically depends upon the normal functioning of DLPFC and associated brain regions. Disease, or dysfunction, of these circuits may be associated with a variety of disorders of volition: Parkinson's disease, ‘utilization’ behaviour, ‘alien’ and ‘phantom’ limbs, and delusions of ‘alien control’ . Brain imaging has allowed us to gain some access to the pathophysiology of these conditions in living patients. At a philosophical level, the distinction between ‘intentions to act', and ‘intentions in action’ may prove particularly helpful when addressing these complex disturbances of human cognition and conscious experience. The exercise and experience of free will depends upon neural mechanisms located in prefrontal cortex and associated brain systems. (shrink)

Behrendt & Young (B&Y) propose an explanation for schizophrenia in terms of a cortical default in the interaction between consciousness and cognition. However, schizophrenia more likely involves miscommunication between subcortical and cortical affective circuits in the brain, a default in the interaction between consciousness and emotion. The typical “affective” nature of hallucinations in schizophrenia provides compelling evidence for subcortical involvement.

Can we properly define and explain the human mind an aesthetic mind? The purpose of the paper is to answer this and the related questions that it implies. How do we understand the conceptual field of the aesthetic? What do we mean when we speak about an aesthetic experience or when we express an aesthetic judgement? The first move consists in shaping the outlines of the «aesthetic» as a cluster-concept. Having identified the conceptual core of aesthetic as an expressive synthesis (...) between the emotional and cognitive layers of the experience, I try to develop a theoretical paradigm consistent with it and, consequentially, a mental mechanism of the aesthetic. The next step consists, therefore, in replacing the causal monism involved in the adaptationist paradigm by a plurality of factors. Consequently, I claim that at the origin of the aesthetic mechanism there are four factors. These factors are: 1) the mimetic assimilation of the real; 2) the "seeking" or the pleasure of exploration; 3) the pleasure of exercising preferences as a degree of freedom and an advantage in the conduct of life; 4) the impulse to play. All these factors are dispositions rooted in the system of primary emotions and represent the preconditions for the epigenetic emergence of the aesthetic mechanism. Conclusively, this mechanism is considered a dynamic activity of the brain that integrates into a single space of mutual resonance and harmonization neocortical and subcortical neural circuits: aspects of mental life emotionally attuned and aspects that are specific of cognitive processing of information. (shrink)

Male sexual arousal (SA) has been known as a multidimensional experience involving closely interrelated and coordinated neurobehavioral components that rely on widespread brain regions. Recent functional neuroimaging studies have shown relation between abnormal/altered dynamics in these circuits and male sexual dysfunction. However, alterations in the topological1 organization of structural brain networks in male sexual dysfunction are still unclear. Here, we used graph theory2 to investigate the topological properties of large-scale structural brain networks, which were constructed using inter-regional correlations of (...) cortical thickness between 78 cortical regions (subcortical regions were not included due to the used cortical surface model) in 40 patients with psychogenic erectile dysfunction (pED) and 39 normal controls. Compared with normal controls, pED patients exhibited a less optimal global topological organization with reduced global and increased local efficiencies. Our results suggest disrupted neural integration among distant brain regions in pED patients, consistent with previous reports of impaired white matter structure and abnormal functional integrity in pED. Additionally, disrupted global network topology in pED was observed to be primarily relevant to altered subnetwork and nodal properties within the networks mediating the cognitive, motivational and inhibitory processes of male SA, possibly indicating disrupted integration of these networks in the whole brain networks and might account for pED patients’ abnormal cognitive, motivational and inhibitory processes for male SA. In total, our findings provide evidence for disrupted integrity in large-scale brain networks underlying the neurobehavioral processes of male SA in pED and provide new insights into the understanding of the pathophysiological mechanisms of pED. (shrink)

It is becoming increasingly clear that acquiring cognitive skills is feasible only with significant developmental constraints. However, recent research provides the strongest evidence to date for constructivist development. Here, we examine how these two apparently conflicting perspectives may be reconciled. Specifically, we suggest that subcortical and cortical structures possess divergent developmental strategies, with many subcortical structures satisfying Fodor's criteria for modularity. These structures constitute an early behavioral system that guides the construction of later emerging cortical structures, for which (...) there is little evidence for modularity. Thus, we focus on how the dynamic time course of development itself implicitly constrains the emergence of cortical representations, reducing the requirement for built-in encodings of knowledge in cortical circuits, as on the traditional nativist conception. (shrink)

New findings point to a role for mesolimbic DA circuits in the generation of dreaming. We disagree with Solms about these structures having an exclusive role in generating dreams. We review data suggesting that dreaming can be interrupted at different levels of processing and that anterior-subcortical lesions associated with dream cessation are unlikely to produce selective hypodopaminergic dynamic impairments. [Hobson et al.; Nielsen; Solms].

The neural networks that constitute corticostriatothalamocortical circuits between prefrontal cortex and subcortical structure provide a heuristic framework for bridging gaps between neurocircuitry and executive dysfunction in attention deficit hyperactivity disorder (ADHD). “Cool” and “Hot” executive functional theory and dual pathway models are supposed to be applied within the neuropsychology of ADHD. The theoretical model elaborated response inhibition and delayed gratification in ADHD. We aimed to review and summarize the literature about the circuits on ADHD and ADHD-related comorbidities, (...) as well as the effects of neurocircuitry on the executive dysfunction in ADHD. (shrink)

The present commentary emphasizes that the acquisition of fear always involves complex changes in several quasi-independent response systems. Stimulus-specific electrodermal response differentiation as well as the bias to overestimate the belongingness of certain stimulus pairs mainly indicates cognitive processes of selective orienting and attention. Emotion, however, also involves the activation of subcortical motivational circuits. Why certain stimuli acquire rapid access to these basic motivational systems is not explained by the expectancy bias model.

The attempt to derive mental function from brain structure is highly constrained by study of the allometric changes among brain components with evolution. In particular, even if homologous structures in different species produce similar computations, they may be constituents of larger systems (e.g., cortical-subcortical loops) that exhibit different composite operations as a function of relative size and connectivity in different-sized brains. The resulting evolutionary constraints set useful and specific conditions on candidate hypotheses of brain circuit computation.

ObjectiveFreezing of gait is detrimental to patients with idiopathic Parkinson’s disease. Its pathophysiology represents a multilevel failure of motor processing in the cortical, subcortical, and brainstem circuits, ultimately resulting in ineffective motor output of the spinal pattern generator. Electrophysiological studies pointed to abnormalities of oscillatory activity in freezers that covered a broad frequency range including the theta, alpha, and beta bands. We explored muscular frequency domain activity with respect to freezing, and used deep brain stimulation to modulate these (...) rhythms thereby evaluating the supraspinal contributions to spinal motor neuron activity.MethodsWe analyzed 9 PD freezers and 16 healthy controls. We studied the patients after overnight withdrawal of dopaminergic medication with stimulation off, stimulation of the subthalamic nucleus or the substantia nigra pars reticulate, respectively. Patients performed a walking paradigm passing a narrow obstacle. We analyzed the frequency-domain spectra of the tibialis anterior and gastrocnemius muscles in ‘regular gait’ and during the ‘freezing’ episodes.ResultsIn stimulation off, PD freezers showed increased muscle activity of the alpha and low-beta band compared to HC in both TA and GA. This activity increase was present during straight walking and during the freezes to similar extent. STN- but not SNr-DBS decreased this activity and paralleled the clinical improvement of freezing.ConclusionWe found increased muscle activation of the alpha and lower beta band in PD freezers compared to HC, and this was attenuated with STN-DBS. Future studies may use combined recordings of local field potentials, electroencephalography, and electromyography to interrogate the supraspinal circuit mechanisms of the pathological activation pattern of the spinal pattern generator. (shrink)

Findlay & Walker's target article proposes a model of saccade generation related to the underlying neuroscience. A problem with such models is the number of brain areas showing oculomotor function. Traditionally, therefore, models have been partial, usually concentrating either on cortex (Liu et al. 1997; Pierrot Deseilligny et al. 1995) or on the superior colliculus and brainstem circuits (Moschovakis 1994; Van Gisbergen et al. 1993). Findlay & Walker's model attempts to integrate both levels within a functional framework. To some (...) extent it falls between two stools. For example, some functions that the authors ascribe to subcortical regions may actually occur at the cortical level. (shrink)

Neurophenomenology maintains that the intelligent behavior we recognize in living beings is based on the fact that they are intentionally directed toward and are embodied and embedded in a world, which they actively constitute. This is the way in which it understands the intentionality of the mind and its meaning-making essence. Meaning-making, however, presupposes organization and synthesis of sensed reality elements within a horizon of temporality. But whence is the opening-up of this horizon given to the living? Attempts have been (...) made to “transplant” Husserl’s transcendental phenomenological analysis of temporality (“internal timeconsciousness”) into the neural infrastructure of living organisms. We critique the main available relevant views and proposals put forward, focusing on the problematic way in which they assimilate Husserl’s analysis of intentionality and temporality. After distinguishing the desiderative (ephetic) phenomena on different levels of organization of the living being, we develop the argument that temporality, in the sense of the temporal horizon of lived time, is rooted in the deepest desiderative phenomenon, that of primordial orexis. Primordial orexis is directed not toward concrete or specific objects or sensory contents, but toward evolutionarily/survivally significant values. Then, we interpret Panksepp’s psychological and behavioral neuro-ethological findings regarding a SEEKING system in dopaminergic circuits in the subcortical frontal brain as an orectic value-seeking neural system and show that Panksepp’s results underpin our idea that such a system makes possible the opening-up of the primordial temporal horizon. As an application of the idea, we claim that primordial orexis (also) relates to truth or evidence as value and, in perception, conditions the meaning-giving process leading to the evident appearing of the perceptual object as a constitution that unfolds in the context of the orectically opened-up temporal horizon. (shrink)

A ubiquitous feature of active sleep in mammals and birds is its relative abundance in early development. In rat pups across the first two postnatal weeks, active sleep promotes the expression of synchronized oscillatory activity within and between cortical and subcortical sensorimotor structures. Sensory feedback from self-generated myoclonic twitches – which are produced exclusively during active sleep – also triggers neural oscillations in those structures. We have proposed that one of the functions of active sleep in early infancy is (...) to provide a context for synchronizing developing structures. Specifically, neural oscillations contribute to a variety of neurodevelopmental processes, including synapse formation, neuronal differentiation and migration, apoptosis, and the refinement of topographic maps. In addition, synchronized oscillations promote functional connectivity between distant brain areas. Consequently, any condition or manipulation that restricts active sleep can, in turn, deprive the infant animal of substantial sensory experience, resulting in atypical developmental trajectories. The synchronization of rhythmic neural activity across brain structures provides evidence of communication. In developing sensorimotor networks, such oscillations are triggered most clearly and prominently during REM sleep. We propose that REM sleep provides a context for the emergence and expression of functional connectivity in the developing sensorimotor system. (shrink)

The Meaning Circuit Hypothesis (MCH) is a synthesis of ideas providing John Wheeler’s outline of ultimate physics, which he fine-tuned over several decades from the 1970s onward. It is a ‘working hypothesis’ in which ‘existence is a ‘meaning circuit”’ that portrays the world as a “system self-synthesized by quantum networking.” It was strongly advocated by him for roughly two decades and since then has had an increasingly strong impact on the approach of many investigators of quantum theory; in particular, elements (...) such as the quantum participator and ‘it from bit’ are now considered by others as candidate components of a foundation for quantum theory in which information is involved essentially. Therefore, it is worthy of review and critique. (shrink)

In this commentary we discuss the possibility of subcortical consciousness and its implications for fetal anesthesia and analgesia. We review the neural development of structural and functional elements that may participate in conscious representation, with a particular focus on the experience of pain. (Published Online May 1 2007).

Merker argues that subcortical regions are sufficient for the constitution of consciousness as “immediate, unreflective experience” as distinguished from self-consciousness. My point here is that Merker neglects the differentiation between pre-reflective self-awareness and reflective self-consciousness. Pre-reflective self-awareness allows us to immediately and unreflectively experience our self, which functionally may be mediated by what I call self-related processing in subcortical regions. (Published Online May 1 2007).

Par habitude, par nécessité ou en raison de la faiblesse de notre intelligence dépassée par le tsunami des savoirs et des informations, nos façons ordinaires de nourrir la vie des idées consistent à la découper en secteurs, à la compartimenter en disciplines, à l'atomiser en petites spécialités étiquetées bien comme il faut. Il s'agira ici de suivre le chemin inverse, de briser les enclos, s'encanailler, provoquer des courts-circuits au petit bonheur la chance et, si possible, des étincelles. D'associer des (...) éléments trop souvent séparés dans les analyses : physique et philosophie, pensée et action, réalité et imagination, hasard et destin, infini mathématique et engagement existentiel, intelligence analytique et courage physique, Einstein et Rolling Stones, image et mirage, langage et impesanteur, raison et déraison... Mettons le nez dehors, inventons une chimie nouvelle, bâtissons des molécules littéraires à partir d'atomes disciplinaires! É. K."--Page 4 of cover. (shrink)

Reading disability has been considered as a disconnection syndrome. Recently, an increasing number of studies have emphasized the role of subcortical regions in reading. However, the majority of research on reading disability has focused on the connections amongst brain regions within the classic cortical reading network. Here, we used graph theoretical analysis to investigate whether subcortical regions serve as hubs during reading both in Chinese children with reading disability and in age-matched typically developing children using a visual rhyming (...) judgment task and a visual meaning judgment task. We found that the bilateral thalami were the unique hubs for typically developing children across both tasks. Additionally, subcortical regions were also unique hubs for typically developing children but only in the rhyming task. Among these subcortical hub regions, the left pallidum showed reduced connectivity with inferior frontal regions in the rhyming judgment but not semantic task in reading disabled compared with typically developing children. These results suggest that subcortical-cortical disconnection, which may be particularly relevant to the phonological and phonology-related learning process, may be associated with Chinese reading disability. (shrink)

In this conceptual article, the authors explore the possibilities of another approach to examining the human dimensions of wildland fire. They argue that our understanding of this issue could be enhanced by considering a cultural studies construct known as the ‘‘circuit of culture.’’ This cross-disciplinary perspective provides increased analytic power by accounting for the meaningful role of 5 cultural processes in terms of their location and interrelation within social experience. The authors compare the circuit of culture approach with a body (...) of recent literature focused on wildland fire. The authors make the case that this research has moved in a positive direction since wildland fire first ignited social scientific interest in the 1980s, but it is still missing key cultural processes. Ultimately, following the circuit allows us to make more nuanced statements about meaning, something much needed in the face of the wicked problem of wildland fire. (shrink)

The first National Health Service (NHS) was introduced in the United Kingdom providing free universal health care (UHC) at the point of use. Within decades, increasing European countries adopted the same intervention to improve the health of citizens on the entire life span. Today, several reasons put at risk (1) empirically, the sustainability and fairness of these systems, (2) theoretically, the same consistency of solidarity, as vulnerable patients struggle most to receive essential care. Preserving solidarity from the pressure of modern (...) medicine and society needs to identify a fair and sustainable type of coverage at the same time. This paper aims (1) to describe the short circuit of solidarity in European NHSs; (2) to discuss alternative versions of UHC and support redistributive neo-universalism; (3) to promote the role of medical humanities in implementing this solution. (shrink)

The shared circuits model (SCM) is a useful explanatory framework that can be applied to interpersonal synchrony by incorporating temporal dynamics. Temporally precise predictive simulations and mirroring enable interpersonal synchrony. When partners' movements are highly synchronous, the self/other distinction can be blurred.

In this article I discuss some of the findings of an on-going ethnographic study of two once-weekly circuit training classes held in one of the growing number of private health and fitness clubs. The article has four aims. First, to demonstrate and explore the active role of the body in a central practice of body modification/maintenance: i.e. circuit training. Second, to demonstrate that circuit training is a social structure which both shapes the activity of the agent and is shaped by (...) that (shaped) agent. I aim also to explore this structuration process. Third, to draw out a number of aspects of the sociality of body maintenance/modification. Training, I argue, is a form of symbolic interaction, localized within specific and durable social networks. The final aim of the article is to weave these various claims together into a coherent overall account of circuit training as a form of body modification. As an investigation of the embodied nature of practices of body maintenance and the active role of social agents in relation to these practices the article rejoins an important strand of sociological investigations of ‘the body’. At the same time, however, the article seeks to challenge those approaches, often rooted in Foucauldian analysis, which portray the body as ‘docile’ in relation to body maintenance. Foucauldian inspired studies often reify practices of modification as ‘technologies’ or ‘apparatuses’, ignoring the active role of embodied agents in these practices and eliding the difference between texts which prescribe ways of acting and the more messy and complex reality of those ways of acting. (shrink)

Cet article illustre de façon concrète et détournée les relations villes-campagnes. Les circuits courts alimentaires sont considérés comme vertueux (réduction des intermédiaires et des distances, « locavorisme »), mais qu’en est-il vraiment de leur durabilité, compte-tenu de leur complexité logistique? Pour le producteur, premier maillon de la chaîne, la commercialisation et le transport représentent travail et coûts supplémentaires. Les circuits courts ne sont pas moins énergivores : flux entre fermes et points de vente fragmentés en une multitude de (...) petits volumes. L’auteur propose plusieurs formes d’organisation pour pallier à ces inconvénients : mutualiser le transport entre producteurs partenaires et promouvoir une coopération logistique territoriale, consolider le transfert de flux en le déléguant à un prestataire extérieur. L’enjeu de la logistique et le rôle des intermédiaires non commerciaux sont clé. (shrink)