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Biomedical subjects

C Derouesné

Publications and source records attributed to C Derouesné.

At least 19 recordsLinked to original sources
PubMed1998

Entropy maps characterize drug effects on brain dynamics in Alzheimer's disease.

Non-linear quantifiers of brain electrical dynamics (entropy maps computed from the degradation of temporal forecasting of EEG signals) were studied in relation to drug treatment of Alzheimer's disease. A placebo condition was compared to three drug doses (50, 100 and 200 mg). A significant general effect of the drug was found when compared to placebo and specific contrasts between placebo and each of the three drug doses only reveal a significant entropy increase for the highest dose. These effects were localized bilaterally in fronto-temporal areas and support changes in the dynamics of the cerebral structures involved in memory processes.

Acoustic Stimulation↗
PubMed1997

[Electrophysiologic study in a patient presenting with expanding cerebral lacunae].

A 42-year-old man was affected with multiple cerebral lesions suggesting expanding lacunae. He had suffered for about 15 years of headaches and blurred vision. Neurological examination showed a Parinaud syndrome and a skew deviation. Magnetic resonance imaging showed an enlargement of the third and lateral ventricles and multiple intraparenchymatous lesions with a signal similar to that of the cerebrospinal fluid. These lesions were located in the mesencephalon and right thalamic region. Important discrepancies between the topography of the lesion and the clinical data were observed. Neurological examination, ocular movements during wake and neuropsychological testing suggested sub-cortical dysfunction. These results suggest functional rather than lesional repercussion of expansive lacunae.

Adult↗
PubMed1996

Utilization of the Draw a Person Test in the elderly.

The purpose of this study was to assess quantitative and qualitative changes that occurred in the drawing of the human figure during depression and dementia in the elderly. A modified scale version of the Draw a Person Test (DAP) is presented. The first study (80 subjects) enabled the reduction of the number of items from 73 to 20 according to interrater reliability and diagnostic sensitivity to differentiate patients with dementia from control subjects. The second study (160 subjects: 51 with dementia, 70 with major depression, 39 elderly controls) used this 20-item DAP for cognitive assessment. The second study also featured an additional qualitative assessment (DAP 50) considering five components based upon a projective examination of the drawings. Combination of the 20-item DAP and the DAP 50 provides a complete approach to patients in accordance with the affective dimension. Results showed the ability of the 20-item DAP to discriminate dementia from depression with a better cutoff score of 7 and the usefulness of the DAP 50 in the investigation of impaired components during depression and dementia in the elderly, with the goal of specifying key aspects of psychopathology in dementia.

Aged↗
PubMed1996

Sexual behavioral changes in Alzheimer disease.

The frequency and correlates of sexual behavioral changes in Alzheimer disease (AD) were assessed in two studies. In the first study, we reviewed the medical records of 135 consecutive community-living patients who fit the criteria of the National Institute of Neurological and Communicative Disorders and Stroke/Alzheimer Disease and Related Disorders Association for probable or possible AD, and we asked spouses to complete a questionnaire that included two questions about sexual activity. Indifference to sexual activity was reported by 70% of the spouses, and sexual behavioral modifications were reported by 50%. No correlation was found between sexual changes and the general characteristics of the patients, the severity of the disease, or depressive symptomatology. Sexual changes were correlated to the severity of behavioral and mood disorders, mainly to a reduction of activity and emotional deficit. Seventy-seven of the patients had a second examination after an interval of 18.9 +/- 9.9 months. The links between sexual changes and the other variables were similar to those found by the first examination. In the second study, a questionnaire was sent by mail to the spouses of 100 patients. No relationship was found between sexual changes and the severity of cognitive deficits, previous sexual agreement, age, or gender. Sexual changes were considered a factor of maladjustment for the couple by 46% of the spouses.

Aged↗
PubMed1996

Affective disturbances in Alzheimer's disease.

OBJECTIVE: To evaluate the emotional disturbances in patients with Alzheimer's disease (AD) using both a categorical and a dimensional approach. DESIGN: Prospective study. SETTING: Outpatient clinic in a neurological department from a general University Teaching Hospital. MEASURES: A semi-structured interview was used to fill in the Hamilton Depression Rating Scale, the Retardation Rating Scale for depression, the Tyrer and Covi scales for anxiety, and the Depressive Mood Scale for emotional disturbances. The cognitive status was assessed by the Mini-Mental State Examination and the Mattis Dementia Rating Scale. PATIENTS: One hundred eighteen consecutive AD outpatients fitting the criteria for probable or possible AD, according to the National Institute of Neurological and Communication Disorders and Stroke and the Alzheimer's Disease and Related Disorders Association, were compared with 34 community-dwelling healthy older controls and with 20 inpatients meeting the diagnostic criteria for depression according to the Diagnostic and Statistical Manual of Mental Disorders, 3rd Edition-Revised. RESULTS: No AD patient met the criteria for Major Depressive Episode or Generalized Anxiety Disorder, but 10 (8%) met the criteria for Dysthymic Disorder. AD patients scored significantly higher than the control group but lower than the depressed group for depressive and anxious symptomatology. Depressive symptomatology was correlated negatively to the cognitive status and positively to anxious symptomatology. Two main dimensions in emotional disturbances were described using the Depressive Mood Scale: Emotional Deficit (anhedonia, hypoexpressiveness) and Loss of Control (felt irritability, hyperexpressiveness). Emotional Deficit was correlated positively to the depressive symptomatology and correlated negatively to the cognitive status and the Loss of Control dimension. Loss of Control was correlated positively to the severity of the depressive and anxious symptomatology and weakly to cognitive performance. CONCLUSION: Affective changes were found frequently in AD patients, but no major affective disorder was found. The dimensional approach seems to be more appropriate than the categorical approach to describe the emotional disturbances in these patients.

Affect↗
PubMed1996

A special form of cerebral lacunae: expanding lacunae.

The case of a 42 year old man with headache, blurred vision, and diplopia allowed the description of a particular form of cerebral lacunae-that is, expanding lacunae. Brain MRI showed hydrocephalus and multiple lesions in the thalamomesencephalic region. The radiological features of these lesions were similar to the histological brain coronal section of a case reported in 1983 in which expanding lacunae were related to a dilatation of the perivascular spaces and a focal segmental necrotising angiitis. The role of the lymphatic drainage of the brain is discussed to explain the dilatation of the perivascular spaces. The hypothesis of a hydrodynamic factor being responsible for the expanding character of the lacunae was suggested by the location of the lesions and the influence of various clinical events on the symptomatology.

Adult↗
PubMed1995

[Conversion hysteria].

Conversion disorder is characterized by symptoms or deficits affecting voluntary motor or sensory function that suggest a neurological condition. The symptoms or deficits are related to psychological factors but not intentionally produced or feigned. They could be associated with true neurological disorders and their diagnosis is difficult. Neurologically they do not conform to known neurological mechanisms but instead follow the individual conceptualization of a condition and vary according to attention and emotions. Psychologically they are related to a psychic conflict or a stressful event. They could be associated to other manifestations of the hysterical neurosis or various mental conditions.

Conversion Disorder↗
PubMed1995

Economic analysis of Alzheimer's disease in outpatients: impact of symptom severity.

To assess the economic burden of Alzheimer's disease (AD), we carried out a cross-sectional prevalence cost-of-illness study in France. Fifty-one probable AD patients (NINCDS-ADRDA) actually treated in ambulatory care were recruited in two university outpatient centers. Demographic, clinical (including actual Mini-Mental State Examination scores), and economic data were collected by clinical investigators and trained interviewers. Total costs included actual expenditures such as direct medical costs and direct nonmedical costs, as well as indirect costs (loss of earnings due to loss of productivity). Cost valuation was based on the societal perspective using an opportunity costing approach. We found that indirect costs represented a significant portion of total costs (36%-40%). In terms of expenditures, patients and caregivers were found to bear the major part of AD total costs. We found a positive and significant correlation between disease severity and costs. Our findings support the hypothesis of a relationship between disease evolution and healthcare costs.

Aged↗
PubMed1994

[Complaints of memory loss in the elderly].

Frequency of memory complaints increases with age. Such complaints can be the presenting symptom of Alzheimer's disease. Most cases, however, are not related to Alzheimer's disease. They are included in the constructs of benign senescent forgetfulness or age-associated memory impairment. In the later, memory complaints are considered as the subjective counterpart of the age-associated decline in memory test performance. Actually, memory complaints are associated with various factors: perceptual disorders, general health, functional disability, affective disturbances, psychosocial changes... The first step in the management of memory complaints is to rule out Alzheimer's disease and affective disturbances which could require specific therapeutic measures. Most often, memory complaints are the only presenting symptom: the signification of complaints should be analysed in each individual considering all the possibly causal factors in order to elaborate the appropriate management.

Aged↗
PubMed1994

Factors associated with low cognitive performance in general practice.

In the preparatory phase of a randomised controlled trial data were collected to assess the magnitude of changes on cognitive functions in 1628 volunteers (age range 45-75 years) that were recruited from general practitioners' patient population. Subjects were administered a short neuropsychological battery of tests including three paper-and-pencil tests, which assessed immediate recall, delayed memory, and attention. Being on antihypertensive medication was associated with low results for all three tests in every age group, and in all strata according to blood pressure levels. Psychotropic drug use was correlated with low results for all three tests. Differences between psychotropic drug users and nonusers increased with age. Antihypertensive treatment and psychotropic drug use seem to be important to consider in longitudinal studies of cognitive decline in aging.

Aged↗
PubMed1994

The phenotype of "pure" autosomal dominant spastic paraplegia.

We studied 23 families with "pure" autosomal dominant spastic paraplegia. Examination of 142 at-risk individuals allowed identification of 70 patients, including 12 who were clinically affected but unaware of symptoms. The frequency of lower limb muscle weakness, decreased vibration sense, hyperreflexia in the upper limbs, and sphincter disturbances increased with the disease duration. The distribution of age at onset was unimodal, with a mean onset of 29 years (range, 1 to 68). The clinical manifestations of "early-onset" (< 29 years) and "late-onset" (> 29 years) patients were not significantly different. Age at onset varied as much within families as among families; anticipation and imprinting did not occur. No clinical criteria allowed differentiation among the families studied. Only linkage studies can provide accurate classification of this disease.

Adult↗
PubMed1993

Infarcts in the middle cerebral artery territory. Pathological study of the mechanisms of death.

Correlates of the size of infarcts, the time from stroke to death, and the mechanisms of death were studied in 77 consecutive patients who died from infarction in the middle cerebral artery territory. The area of infarcts was assessed by planimetry on schemas of representative brain levels and the results were expressed as a ratio of infarcted area on the whole MCA territory. No clear relationship was found between the size of infarcts in the MCA territory, and any of the characteristics of the patients, but extensive infarcts were more frequent when the internal carotid artery was occluded. No evidence was found of an adverse effect of age, diabetes or initial hyperglycemia on the size of infarcts. The mechanisms of death were not linked to sex, age, high blood pressure, diabetes, blood glucose level at admission, presence and location of an arterial occlusion, or etiology of the infarct. On the contrary, they varied as a function of interval from stroke to death. Transtentorial herniation, the main cerebral cause of death, occurred mainly in the first week and was related to the large size of infarcts. Rare recurrences of stroke and frequent extracerebral mechanisms of death (mainly pneumonia, pulmonary embolism and cardiopathy) occurred later on.

Aged↗
PubMed1991

[Intellect and mood disorders in multiple sclerosis].

Recent studies showed that mild or moderate cognitive deficits and affective disturbances are frequent in patients with multiple sclerosis and can be found early in the course of the disease. Cognitive deficits are related to brain lesions but not clearly to functional disability. Affective disturbances are partly determined by the presence of brain involvement, but also by an emotional reaction to the disorder. Psychological disorders must be taken in account for a better management of the patients and their family.

Cognition Disorders↗
PubMed1991

[Memory, aging and Alzheimer's disease].

Memory disorders in elderly can be related to various conditions. The concept of "Age-Associated Memory Impairement" is grounded on a age-related memory deficit in memory testing associated with a memory complaint which is considered as the subjective manifestation of the memory deficit. Actually, memory deficit in objective testing and memory complaints do not appear correlated. Impairment in memory performance is mostly related to neurobiologic brain changes associated with aging or Alzheimer's disease. Conversely, memory complaints are more related to psychosocial factors. However, clinical data and qualitative analysis of the memory disturbances are requested to understand the precise significance of memory deficits in objective testing.

Adult↗
PubMed1991

[Quantified EEG in the diagnosis of Alzheimer's type dementia].

79 subjects (mean age 70.2 ans, 31 males, 48 females) selected as probable dementia of the Alzheimer type, at the early stage of the disease and 17 normal aged people (mean age: 72.2, 5 males, 12 females) were recorded with a 16 channel computerized-EEG (C-EEG) with topographical analysis of the observed changes and with classical visual analysis of the EEG. Quite simple C-EEG parameters as mean dominant frequency (MF) and alpha to theta ratio are able to discriminate patients from normal with a greater accuracy than visual analysis. The values of 8.6 for the MF and 1.3 for the alpha/theta ratio are proposed as cut off values between normal and DAT patients. The topographical analysis appear to be of no additional usefulness in the discrimination of the two groups.

Aged↗
PubMed1991

[Comparison of SPECT and quantified EEG features in Alzheimer's type dementia].

Forty-one patients with probable dementia of the Alzheimer type (DAT) have been studied by computerized EEg (C-EEG) and single photon emission tomography (SPECT) using 123-IMP. Four groups have been distinguished according to SPECT hypoperfusion topography: frontal, temporo-parietal, fronto-parietal and fronto-temporo-parietal. C-EEG parameters were much more disturbed in the 2 latter than in the 2 former groups. Thus a normal C-EEG could indicate a dominant frontal or temporo-parietal form of DAT. Therefore some bias due to duration or rate of disease progression cannot be excluded. So far the important finding is that EEG changes are diffuse and do not reflect the topography of SPECT hypoperfusion questioning the value of EEG topographical analysis in DTA.

Aged↗
PubMed1991

[EEG value for the prediction of the evolution of Alzheimer's type dementia].

Twenty patients selected as probable dementia of the Alzheimer type (DAT) have been examined two times during a mean follow-up period of 14.5 months. Two groups have been distinguished at the end of this period: a cognitively impaired one and a stable one. EEG features at T1, at T2 or the difference T1-T2 does not allow an accurate and predictive discrimination between the two groups. But we cannot conclude that EEG is useless for prediction of the rate of progression of the disease in DAT because most of the cognitively stable patients are also stable for mean frequency. So mean frequency could be an interesting marker of evolutivity but this to be tested with more patients including more subjects reaching the severe stage of dementia.

Aged↗