Crise suicidaire et maladie d’Alzheimer débutante : intérêt d’une analyse neuropsychologique détaillée

RésuméIntroduction Le risque de développer une maladie d’Alzheimer augmente avec l’âge. Le rôle de celle-ci comme un facteur de risque indépendant de suicide n’est pas bien compris et demeure complexe et mal élucidé. L’objectif de cet article est d’envisager une compréhension neuropsychologique de la crise suicidaire dans le cas d’une maladie d’Alzheimer débutante. Méthode Une évaluation cognitive globale (Mini-Mental State Examination, Batterie Rapide d’Évaluation Frontale) complétée de l’exploration de l’inhibition cognitive selon ses fonctions d’accès (tâche de lecture en présence de distracteurs), de suppression (Trail Making Test), et de freinage (Stroop, Hayling, Go/No-Go) a été réalisée chez une femme souffrant d’une maladie d’Alzheimer (MMSE à 21/30) avant et après réalisation d’une tentative de suicide dans un contexte de dépression. Résultats L’échelle d’Hamilton était cotée à 24/52, l’échelle de dépression de Cornell à 21/38. L’intentionnalité suicidaire était modérée avec un score à 15/25 à l’échelle d’intentionnalité suicidaire de Beck. Initialement préservées, le déclin des fonctions exécutives a coïncidé avec l’émergence d’une crise suicidaire dans un contexte de dépression chez une patiente souffrant de maladie d’Alzheimer. Les fonctions de l’inhibition cognitive étaient altérées dans ses trois composantes, après ajustement des facteurs de confusion. Conclusion Une évaluation détaillée des fonctions exécutives et singulièrement de l’inhibition cognitive dans la population des patients atteints d’une maladie d’Alzheimer permettrait de détecter les personnes les plus à risque de passage à l’acte et de proposer une surveillance plus étroite dans le cadre des soins généraux de leur maladie. AbstractIntroduction The role of Alzheimer\u27s disease as a risk factor for suicide is unclear. The aim of this study was to understand neuropsychological component of the suicidal crisis in Alzheimer\u27s disease. Method Using an extensive neuropsychological battery, different aspects of cognitive inhibition were particularly examined: Access to relevant information (using the Reading with distraction task), suppression of no longer relevant information (Trail Making Test, Rule Shift Cards), and restraint of cognitive resources to relevant information (Stroop test, Hayling Sentence Completion test, Go/No-Go). One female Alzheimer depressed case was assessed before and after a suicide attempt. Results Ten days after the patient\u27s suicide attempt, dementia was still moderate with a MMSE score at 21/30 but with a worsening of executive functions (FAB at 8/18) in the context of depression and suicide. The Hamilton-Depression Rating Scale was at 24 (maximal score at 52), and the Cornell Scale for Depression was at 21 (maximal score at 38). Suicidal intent was moderate with a score of 9 on the Beck Suicide Intent Scale (maximal score at 25). The patient did not present a delirium, psychotic symptoms, or anosognosia. Her episodic memory was altered as shown by her semantic performance on verbal fluency (naming 12 animals in 120 seconds) and on lexical fluency (naming 8 words beginning with the letter P). Initially preserved, executive function declined during a suicidal crisis in a context of depression in Alzheimer\u27s disease case. Neuropsychological testing confirmed a dysexecutive syndrome (FAS at 8/18), with an impairment in her conceptualization capacity (MCST) and a deficit in cognitive inhibition and its access (reading task in the presence of distractors), deletion (TMT) and restraint (Stroop, Go/No-Go, Hayling) functions. Computed tomography has shown no signs of intracranial expansive process. Conclusion Assessing predictors of suicide and means of completion in patients with dementia may help the development of interventions to reduce risk of suicide among the growing population of individuals with dementia. Because of Alzheimer\u27s-related cognitive inhibition impairment, identification and intervention addressing the complex issues of depression, executive dysfunction and dementia may help clinicians to mitigate the risk of suicide in patients with Alzheimer\u27s disease

Identification and frequency of consumption of wild edible plants over a year in central Tunisia: a mixed-methods approach

Objective: To identify wild plants used as food and assess their frequency of consumption over a year in a region of Tunisia where agriculture is undergoing a major transformation from smallholder farming to an intensive high-input agricultural system. Design: Qualitative ethnobotanical study followed by a survey of women's frequency of consumption of wild plants conducted using FFQ at quarterly intervals. Setting: Sidi Bouzid governorate of central Tunisia. Participants: Mixed-gender group of key informants (n 14) and focus group participants (n 43). Survey sample of women aged 20-49 years, representative at governorate level (n 584). Results: Ethnobotanical study: thirty folk species of wild edible plants corresponding to thirty-five taxa were identified by key informants, while twenty folk species (twenty-five taxa) were described by focus groups as commonly eaten. Population-based survey: 98 % of women had consumed a wild plant over the year, with a median frequency of 2 d/month. Wild and semi-domesticated fennel (Foeniculum vulgare Mill. and Anethum graveolens) was the most frequently consumed folk species. Women in the upper tertile of wild plant consumption frequency were more likely to be in their 30s, to live in an urban area, to have non-monetary access to foods from their extended family and to belong to wealthier households. Conclusions: In this population, wild edible plants, predominantly leafy vegetables, are appreciated but consumed infrequently. Their favourable perception, however, offers an opportunity for promoting their consumption which could play a role in providing healthy diets and mitigating the obesity epidemic that is affecting the Tunisian population

Deficit of cognitive inhibition in depressed elderly: a neurocognitive marker of suicidal risk

BACKGROUND: Cognitive deficits, in relation to ventral and dorsal prefrontal cortex dysfunctions, have been associated with a higher risk of suicidal acts in young adult patients. Although a public health concern, much less is known about the neurocognitive basis of suicidal behavior in elderly. Here, we aimed at assessing alterations in cognitive inhibition, a suspected major mechanism of the suicidal vulnerability, in suicidal depressed elderly.METHODS: We compared 20 currently depressed patients, aged 65 and older who recently attempted suicide to 20 elderly subjects with a current depression but no personal history of suicide attempt and 20 elderly controls. Using an extensive neuropsychological battery, we particularly examined different aspects of cognitive inhibition: access to relevant information (using the Reading with distraction task), suppression of no longer relevant information (Trail Making Test, Rule Shift Cards), and restraint of cognitive resources to relevant information (Stroop test, Hayling Sentence Completion test, Go/No-Go). RESULTS: After adjustment for age, intensity of depression, Mini-Mental State Examination score and speed of information processing, suicidal depressed elderly showed significant impairments in all 3 domains of cognitive inhibition in comparison to both control groups. LIMITATIONS: Our results need replication in a larger sample size. CONCLUSIONS: Our study suggests that the inability to inhibit neutral information access to working memory, restrain and delete irrelevant information may impair the patient\u27s capacity to respond adequately to stressful situations subsequently leading to an increased risk of suicidal behavior during late-life depression. Interventions may be developed to specifically target cognitive impairment in the prevention of suicide in depressed elderly

Contribution de la neuropsychologie à la compréhension de la violence : données cliniques et modèles théoriques

La violence a longtemps été étudiée en faisant référence aux théories psychosociales, développementales et psychanalytiques. Il apparaît que l\u27importance de facteurs neurologiques et particulièrement neuropsychologiques a été sous-estimée. Si tous les lésés cérébraux ne montrent pas de signes de violence, ceux qui présentent des lésions circonscrites des aires préfrontales ventromédianes sont néanmoins les plus disposés à avoir ce type de manifestations. Le but de notre travail est de décrire les déficits neuropsychologiques qui sont généralement associés aux comportements violents et qui sont rapportés par la majorité des études récentes. Ces perturbations feront l\u27objet d\u27une discussion par rapport à trois modèles actuels du fonctionnement frontal

Bilingualism and adult differences in inhibitory mechanisms: Evidence from a bilingual stroop task

The present investigation examined the functioning of inhibitory mechanisms in younger and older bilinguals using a bilingual version of the Stroop test. The study predicted different patterns of age related decline in inhibitory mechanisms (inter- and intralingual interference) in bilinguals depending on their level of proficiency. Consistent with expectations, older bilinguals were slower when they responded in their non-dominant language. Furthermore, older unbalanced bilinguals showed greater interlingual interference when they responded with their second language to visual stimuli written in their dominant language. Balanced bilinguals showed equivalent interference effects between all conditions. These findings suggest that manipulating two languages may enhance the efficiency of inhibitory mechanisms

Crystal structure, optical properties, vibrational, thermal and biological study of a new polymeric Cd(II) hybrid material

International audienceThis paper describes a new polymeric one-dimensional chlorocadmate(II) compound synthesized with a slow evaporation method. The crystal structure was determined by single-crystal X-ray diffraction. It crystallizes in the Tetragonal system, P 4/n space group, with the following room temperature cell parameters: a = 15.9451(14) Å, c = 11.1726(10) Å with Z = 2 and V = 2840.6(6) Å3. The examination of the structure shows that the anionic part is formed of covalent polymeric chains of (CdCl5)n and isolated CdCl4 tetrahedrons. Hirshfeld surface analysis was used to verify the contributions of the different intermolecular interactions. UV–Vis measurements were employed to figure out the optical behavior of the reported crystal. The vibrational properties were investigated through IR spectroscopy. TG-DSC thermal analysis revealed that the compound remains stable up to 130 °C. For the in vitro antibacterial activity test, results showed that there is no significant difference (p ≥ 0.05) between the inhibition zones caused by the compound and the amine. However, DPPH and ABTS tests showed that the free radical scavenging activity of the tested compound was higher than the amine

Le test de Stroop: Une étude développementale auprès d'un échantillon d'enfants français

International audienc

The Stroop test: A developmental study in a French children sample aged 7 to 12 years

International audienc

The Stroop test: A developmental study in a French children sample aged 7 to 12 yearsLe test de Stroop : une étude développementale auprès d’un échantillon d’enfants français âgés de 7 à 12 ans

The Stroop test is a commonly used task in psychology to assess executive function and more specifically inhibition. International studies consistently show improved Stroop task performance with age, whereas available French normative data displays the opposite pattern, with poor clinical sensibility (Albaret & Migliore, 1999). To provide an alternative and useful Stroop test for children, we examined developmental data based on a well-known French protocol validated in adult (GREFEX study group, 2001). The three-standard conditions of the Stroop task (i.e. naming, reading and interference) were administered to 120 typically developing school children (7–12 years), while taking into account the effects of gender, parental educational level and intelligence (both crystallized and fluid intelligence, as measured by the Wechsler intelligence scale). The time to complete each condition (in seconds) was recorded, as well as the number of uncorrected and corrected errors. Results show a continuous increase of performance in “reading” and “naming” control conditions between 7 and 12 years, suggesting an improvement in the lexical access speed and the automation of decoding abilities during reading. Most importantly, a significant reduction of time Stroop effect with age was found (difference between interference and naming conditions), but no interaction with gender. Stroop performances are related to fluid intelligence once age is statistically controlled, but not to parental educational level. The developmental pattern found from the Stroop GREFEX version is consistent with international data and more broadly with executive function and inhibition development. These findings open the prospect of useful normative standardization of this task, with valuable clinical applications perspectives.Scopu