Harmonizing neuropsychological assessment for mild neurocognitive disorders in Europe

INTRODUCTION Harmonized neuropsychological assessment for neurocognitive disorders, an international priority for valid and reliable diagnostic procedures, has been achieved only in specific countries or research contexts. METHODS To harmonize the assessment of mild cognitive impairment in Europe, a workshop (Geneva, May 2018) convened stakeholders, methodologists, academic, and non-academic clinicians and experts from European, US, and Australian harmonization initiatives. RESULTS With formal presentations and thematic working-groups we defined a standard battery consistent with the U.S. Uniform DataSet, version 3, and homogeneous methodology to obtain consistent normative data across tests and languages. Adaptations consist of including two tests specific to typical Alzheimer's disease and behavioral variant frontotemporal dementia. The methodology for harmonized normative data includes consensus definition of cognitively normal controls, classification of confounding factors (age, sex, and education), and calculation of minimum sample sizes. DISCUSSION This expert consensus allows harmonizing the diagnosis of neurocognitive disorders across European countries and possibly beyond

Troubles de l'orientation spatiale: développement d'une batterie d'évaluation et corrélats neuroanatomiques

Ce travail s'intéresse à la création de nouvelles épreuves testant les aptitudes à s'orienter dans l'espace suite à une lésion hémisphérique droite pour détecter et préciser les symptômes d'une éventuelle désorientation topographique. Quatre épreuves originales sont proposées à des patients et des sujets contrôles. Chacune évalue un mécanisme cognitif nécessaire à la navigation : imagerie mentale, changement de perspective, rappel de liens spatiaux familiers et reconnaissance de repères. Les résultats indiquent que l'ensemble des tâches est sensible à la présence d'une lésion droite mais surtout que certains des tests sont plus pertinents pour évaluer les troubles de l'orientation spatiale. Il s'agit des épreuves estimant les aspects relatifs aux traitements des directions (rotations) ; traitements qui semblent spécifiquement atteints dans la désorientation topographique. De plus des premières normes pour chaque test (cut-off, validité, fidélité) ont été créées et les corrélats neuroanatomiques - sensiblement différents entre ces quatre mécanismes - ont été étudiés

Neuroanatomic correlates of distance and direction processing during cognitive map retrieval

Navigating toward a goal and mentally comparing distances and directions to landmarks are processes requiring reading information off the memorized representation of the environment, that is, the cognitive map. Brain structures in the medial temporal lobe, in particular, are known to be involved in the learning, storage, and retrieval of cognitive map information, which is generally assumed to be in allocentric form, whereby pure spatial relations (i.e., distance and direction) connect locations with each other. The authors recorded functional magnetic resonance imaging activity, while participants were submitted to a variant of a neuropsychological test (the Cognitive Map Reading Test; CMRT) originally developed to evaluate the performance of brain-lesioned patients and in which participants have to compare distances and directions in their mental map of their hometown. Our main results indicated posterior parahippocampal, but not hippocampal, activity, consistent with a task involving spatial memory of places learned a long time ago; left parietal and left frontal activity, consistent with the distributed processing of navigational representations; and, unexpectedly, cerebellar activity, possibly related to the role of the cerebellum in the processing of (here, imaginary) self-motion cues. In addition, direction, but not distance, comparisons elicited significant activation in the posterior parahippocampal gyrus

Harmonizing neuropsychological assessment for mild neurocognitive disorders in Europe

Introduction:  Harmonized neuropsychological assessment for neurocognitive disorders, an international priority for valid and reliable diagnostic procedures, has been achieved only in specific countries or research contexts. Methods:  To harmonize the assessment of mild cognitive impairment in Europe, a workshop (Geneva, May 2018) convened stakeholders, methodologists, academic, and non-academic clinicians and experts from European, US, and Australian harmonization initiatives. Results:  With formal presentations and thematic working-groups we defined a standard battery consistent with the U.S. Uniform DataSet, version 3, and homogeneous methodology to obtain consistent normative data across tests and languages. Adaptations consist of including two tests specific to typical Alzheimer's disease and behavioral variant frontotemporal dementia. The methodology for harmonized normative data includes consensus definition of cognitively normal controls, classification of confounding factors (age, sex, and education), and calculation of minimum sample sizes. Discussion:  This expert consensus allows harmonizing the diagnosis of neurocognitive disorders across European countries and possibly beyond

Harmonizing neuropsychological assessment for mild neurocognitive disorders in Europe

International audienc

Harmonizing neuropsychological assessment for mild neurocognitive disorders in Europe

Harmonized neuropsychological assessment for neurocognitive disorders, an international priority for valid and reliable diagnostic procedures, has been achieved only in specific countries or research contexts. Methods: To harmonize the assessment of mild cognitive impairment in Europe, a workshop (Geneva, May 2018) convened stakeholders, methodologists, academic, and non-academic clinicians and experts from European, US, and Australian harmonization initiatives. Results: With formal presentations and thematic working-groups we defined a standard battery consistent with the U.S. Uniform DataSet, version 3, and homogeneous methodology to obtain consistent normative data across tests and languages. Adaptations consist of including two tests specific to typical Alzheimer's disease and behavioral variant frontotemporal dementia. The methodology for harmonized normative data includes consensus definition of cognitively normal controls, classification of confounding factors (age, sex, and education), and calculation of minimum sample sizes. Discussion: This expert consensus allows harmonizing the diagnosis of neurocognitive disorders across European countries and possibly beyond

Persistent headaches one year after bacterial meningitis: prevalence, determinants and impact on quality of life

International audienceBackground: Little is known on headaches long-term persistence after bacterial meningitis and on their impact on patients' quality of life.Methods: In an ancillary study of the French national prospective cohort of community-acquired bacterial meningitis in adults (COMBAT) conducted between February 2013 and July 2015, we collected self-reported headaches before, at onset, and 12 months (M12) after meningitis. Determinants of persistent headache (PH) at M12, their association with M12 quality of life (SF 12), depression (Center for Epidemiologic Studies Depression Scale) and neuro-functional disability were analysed.Results: Among the 277 alive patients at M12 87/274 (31.8%), 213/271 (78.6%) and 86/277 (31.0%) reported headaches before, at the onset, and at M12, respectively. In multivariate analysis, female sex (OR: 2.75 [1.54-4.90]; p < 0.001), pre-existing headaches before meningitis (OR: 2.38 [1.32-4.30]; p < 0.01), higher neutrophilic polynuclei percentage in the CSF of the initial lumbar puncture (OR: 1.02 [1.00-1.04]; p < 0.05), and brain abscess during the initial hospitalisation (OR: 8.32 [1.97-35.16]; p < 0.01) were associated with M12 persistent headaches. Neither the responsible microorganism, nor the corticoids use were associated with M12 persistent headaches. M12 neuro-functional disability (altered Glasgow Outcome Scale; p < 0.01), M12 physical handicap (altered modified Rankin score; p < 0.001), M12 depressive symptoms (p < 0.0001), and M12 altered physical (p < 0.05) and mental (p < 0.0001) qualities of life were associated with M12 headaches.Conclusion: Persistent headaches are frequent one year after meningitis and are associated with quality of life alteration

One-Year Sequelae and Quality of Life in Adults with Meningococcal Meningitis: Lessons from the COMBAT Multicentre Prospective Study

Trial registration: ClinicalTrial.Gov identification number NCT01730690.International audienceIntroduction: COMBAT is a prospective, multicentre cohort study that enrolled consecutive adults with community-acquired bacterial meningitis (CABM) in 69 participating centres in France between February 2013 and July 2015 and followed them for 1 year.Methods: Patients aged at least 18 years old, hospitalised with CABM were followed during their hospitalisation and then contacted by phone 12 months after enrolment. Here we present the prevalence of sequelae at 12 months in a subgroup of patients with meningococcal meningitis.Results: Five of the 111 patients with meningococcal meningitis died during initial hospitalisation and two died between discharge and 12 months, leaving 104 patients alive 1 year after enrolment, 71 of whom provided 12-month follow-up data. The median age was 30.0 years and 54.1% of the patients had no identified risk factor for meningitis. More than 30% reported persistent headache, more than 40% were not satisfied with their sleep and 10% had concentration difficulties. Hearing loss was present in about 15% of the patients and more than 30% had depressive symptoms. About 13% of the patients with a previous professional activity had not resumed work. On the SF-12 Health Survey, almost 50% and 30% had physical component or mental component scores lower than the 25th percentile of the score distribution in the French general population. There was a non-significant improvement in the patients' disability scores from hospital discharge to 12 months (p = 0.16), but about 10% of the patients had residual disability.Conclusions: Although most patients in our cohort survive meningococcal meningitis, the long-term burden is substantial and therefore it is important to ensure a prolonged follow-up of survivors and to promote preventive strategies, including vaccination

Relationship between serotypes, disease characteristics and 30-day mortality in adults with invasive pneumococcal disease

International audienc