L'analyse lacrymale (un nouvel outil diagnostique dans la sclérose en plaques)

LILLE2-BU Santé-Recherche (593502101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Differential processing of natural scenes in posterior cortical atrophy and in Alzheimer’s disease, as measured with a saccade choice task

Though atrophy of the medial temporal lobe, including structures (hippocampus and parahippocampal cortex) that support scene perception and the binding of an object to its context, appears early in Alzheimer disease (AD) few studies have investigated scene perception in people with AD. We assessed the ability to find a target object within a natural scene in people with typical AD and in people with atypical AD (posterior cortical atrophy). Pairs of colored photographs were displayed left and right of fixation for one second. Participants were asked to categorize the target (an animal) either in moving their eyes toward the photograph containing the target (saccadic choice task) or in pressing a key corresponding to the location of the target (manual choice task) in separate blocks of trials. For both tasks performance was compared in two conditions: with isolated objects and with objects in scenes. Patients with atypical AD were more impaired to detect a target within a scene than people with typical AD who exhibited a pattern of performance more similar to that of age-matched controls in terms of accuracy, saccade latencies and benefit from contextual information. People with atypical AD benefited less from contextual information in both the saccade and the manual choice tasks suggesting a higher sensitivity to crowding and deficits in figure/ground segregation in people with lesions in posterior areas of the brain

Antidepressant Use and Orthostatic Hypotension in Older Adults Living with Mild-to-Moderate Alzheimer Disease

Objectives: Antidepressant use is often reported as a risk factor for Orthostatic Hypotension (OH), however this relationship has never been explored in those with mild/moderate Alzheimer Disease (AD), who may represent a particularly vulnerable cohort. Methods: We performed a cross-sectional analysis of baseline data from the NILVAD study. Participants with mild-moderate AD were recruited from 23 centres in 9 countries. Systolic and Diastolic Blood Pressure (SBP/DBP) was recorded in the seated position and after both 1 & 5 minutes of standing. OH was defined as a drop of 6520 mmHg SBP/ 65 10 mmHg DBP. We examined the relationship between antidepressant use, orthostatic BP drop and the presence of OH, controlling for important covariates. Results: Of 509 participants (72.9 \ub1 8.3 years, 61.9% female), two-fifths (39.1%; 199/509) were prescribed a regular antidepressant. Antidepressant use was associated with a significantly greater SBP and DBP drop at 5 minutes (\u3b2: 1.83, 0.16-3.50, P = 0.03 for SBP; \u3b2: 1.13, 0.02-2.25, P < 0.05 for DBP). Selective Serotonin Reuptake Inhibitor (SSRI) use was associated with a significantly greater likelihood of OH (OR 2.0, 1.1-3.6, P = 0.02). Both findings persisted following robust covariate adjustment. Conclusions: In older adults with AD, antidepressants were associated with a significantly greater SBP/DBP drop at 5 minutes. SSRI use in particular may be a risk factor for OH. This emphasises the need to screen older antidepressant users, and particularly those with AD, for ongoing orthostatic symptoms in order to reduce the risk of falls in this vulnerable cohort. This article is protected by copyright. All rights reserved