Troubles de la mémoire autobiographique et autres altérations cognitives dans les Troubles de l'alimentation et des conduites alimentaires

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Social cognition in epilepsy: State of the art and perspectives

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Manquements au droit à l’information du sujet âgé cognitivement dépendant

International audienceRésumé Les auteurs rappellent qu’un des droits fondamentaux du sujet âgé cognitivement dépendant est celui d’être informé clairement de ce qui le concerne (santé, finances, entourage) mais ce droit peut être aisément méconnu. Ceci relève sans doute d’intentions altruistes (éviter des souffrances) mais ne prend guère en compte les effets délétères occasionnés dès lors que le sujet n’est plus considéré comme acteur de sa propre vie. Ainsi nous pouvons considérer trois exemples de situations courantes de mésinformation du sujet âgé cognitivementdépendant : l’annonce du diagnostic de maladie neurocognitive et notamment de maladie d’Alzheimer (annonce partielle ou au seul profit de l’entourage) ; l’absence d’annonce du décès d’un proche (enfant-conjoint) dès lors que le sujet âgé présente une altération cognitive patente ; le manque de clarté dans l’annonce de l’institutionnalisation. Cet exposé n’a pas vocation à juger des comportements soignants, médicaux ou d’aidants mais à témoigner des limites d’un système de prise en soin, marqué par le manque, sinon l’absence, de contrôlesjuridiques concernant notamment l’institutionnalisation

Awareness dimensions and associated factors in Alzheimer's disease

International audienceABSTRACTObjectives – We recently reported the major role depression and apathy in awareness among Alzheimer patients, using the stage of the disease as an exposure factor and exploring different assessment methods. We aimed here to explore the different dimensions of awareness using the various domains of awareness assessed by different sub-scales in awareness scales.Method – Sixty-one Alzheimer patients were examined using four awareness scales relating to three assessment methods : (a) patient-caregiver discrepancy; (b) clinical rating; and (c) prediction of performance discrepancy. Global cognition, executive functioning, autonomy, depression and apathy were also assessed. Multivariate logistic models were performed using disease stage as an exposure factor for awareness scales and sub-scales. Correlations across the different factors and patient and caregiver awareness ratings were computed.Results – The patient-caregiver discrepancy and clinical rating methods (a, b) both identified the factors associated with awareness, in the overall scales and the sub-scales as being depression and/or apathy. Depression correlated with patient self-ratings while apathy correlated with caregiver-ratings. The prediction of performance discrepancy method (c) identified different factors in the overall scale, executive factors in three sub-scales involving executive domains and memory factor in a subscale involving mnesic domain.Discussion – The awareness scales using a referential based on a human rating (a, b) suggest that awareness is unidimensional with depression impacting self-reports and apathy influencing caregiver/clinical reports. Those with referential based on a test rating (c) appear more associated with the dimensions assessed. This highlights the role of the reference system for awareness assessment in Alzheimer’s disease

Amélioration mnésique postopératoire un an après traitement chirurgical de l’épilepsie du lobe temporal

International audiencer e v u e n e u r o l o g i q u e 1 6 7 (2 0 1 1) 2 3 1-2 4 4 i n f o a r t i c l e Historique de l'article : Reç u le 6 avril 2010 Reç u sous la forme ré visé e le 5 juillet 2010 Accepté le 31 aoû t 2010 Disponible sur Internet le 14 dé cembre 2010 Mots clés : E ´ pilepsie du lobe temporal Ré section temporale anté rieure Tests neuropsychologiques Mé moire Pé riode postopé ratoire Keywords: Epilepsy Temporal lobe r e ´ s u m e ´ Introduction.-Plusieurs travaux ont montré qu'une ré section au niveau du lobe temporal (RT), pratiqué e dans le cas d'une e ´ pilepsie du lobe temporal mé dian (ELT) pharmaco-ré sistante, peut se traduire par un dé clin des performances en mé moire anté rograde ou mé moire du passé. Cependant, la plupart de ces travaux n'ont pas utilisé de critè res d'inclusion stricts pour constituer des groupes de patients homogè nes. Dans la pré sente e ´ tude, nous avons e ´ valué l'impact d'une RT sur les performances mné siques en ré alisant un suivi neuropsychologique longitudinal de patients atteints d'ELT, patients sé lectionné s selon des critè res dé mographiques et cliniques restreints. Me´thode.-Trente patients atteints d'ELT unilaté rale (17 droites et 13 gauches) ont e ´ té e ´ valué s a ` 4 tests de mé moire anté rograde et a ` six tests de mé moire du passé , trois mois avant la RT, ainsi que cinq mois et 12 mois aprè s l'opé ration. Re´sultats.-Suite a ` la RT, les performances en mé moire anté rograde sont amé lioré es un an aprè s l'opé ration. Seuls les patients opé ré s dans l'hé misphè re droit amé liorent leur mé moire autobiographique. Conclusions.-Une amé lioration postopé ratoire des capacité s mné siques a e ´ té observé e dè s lors que les patients pré sentaient des caracté ristiques cliniques spé cifiques. # 2010 Elsevier Masson SAS. Tous droits ré servé s. a b s t r a c

One-Year Postoperative Autobiographical Memory Following Unilateral Temporal Lobectomy for Control of Intractable Epilepsy

International audiencePurpose: To examine the effects of temporal lobec-tomy (TL), particularly concerning its lateralization. Methods: Patients completed autobiographical memory tests, preoperatively and 1-year postoperatively. Results: (a) right TL (RTL) patients recalled significantly more memories from the year after surgery than from the year before TL; (b) their pre to postoperative improvement on autobiographical memory scores was positively correlated to improvement of delayed story recall scores; and (c) 1 year after surgery, performance on recent personal memory recall was normalized for RTL patients only. Conclusion: We suggest that, in the absence of recurrent seizures, the relative integrity of the left hemisphere together with residual right hemisphere structures sustains postoperative autobiographical memory consolidation, at least 1 year post-operatively

Neuropsychological assessment in pediatric epilepsy surgery: A French procedure consensus

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French neuropsychological procedure consensus in epilepsy surgery

International audienceIntroduction: Neuropsychological assessment is an integral component of the surgical procedure in patients with epilepsy. As no French consensus for neuropsychological assessment was available, the main goal of this work was to define French neuropsychological procedure consensus in regard to literature review.Method: A panel of expert in neuropsychology was created within the framework of the French League Against Epilepsy. A systematic search of publications from 1950 to 2017 listed in PubMed database was conducted leading to a classification of articles according to their level of scientific evidence. French neuropsychological procedure consensus was then carried out with an expert panel of expert.Results: Low scientific evidence of neuropsychological data was reported. A panel of expert proposed a comprehensive neuropsychological assessment procedure including the exploration of intellectual efficiency, long-term memory, short-term and working memory, attention, executive functions, processing speed and motor skills, language, visual processing, praxis, psychobehavioral, and social cognition.Discussion: A common procedure for assessing cognitive and psychobehavioral function is now available in patients with epilepsy undergoing surgical evaluation have been established, they may help to improve the quality of care and the patient experience. This work highlights the need of furthers investigations and the necessity to develop specific tools with normative data