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Biomedical subjects

I Rouleau

Publications and source records attributed to I Rouleau.

11 recordsLinked to original sources

Quantitative and qualitative analyses of clock drawings in Alzheimer's and Huntington's disease.

Although visuoconstructive impairment has been reported in both Alzheimer's (DAT) and Huntington's (HD) disease, there is little knowledge concerning how this cognitive deficit differs quantitatively and qualitatively in these two progressive dementias. To address this issue, the present study compared performances on the Clock Drawing Test (CDT: command and copy) of 25 DAT patients, 25 equally demented HD patients, and 25 elderly normal controls (NC). In the command condition, both patients groups were significantly impaired compared to the NC group. Although there was no significant difference between DAT and HD patients' total quantitative scores, a qualitative error analysis revealed a number of dissociations between the two patient groups. Graphic difficulties, very common in HD patients, were virtually absent in DAT patients; in contrast, conceptual errors were almost exclusively seen in DAT patients and were related to the severity of their dementia. Perseveration and "stimulus-bound" responses were also more frequent in DAT patients, and both groups made visuospatial errors. In the copy condition, the DAT, but not the HD, patients evidenced a marked improvement in performance. These results indicate that while both DAT and HD patients have significant visuoconstructive difficulties even in the early stages of their disorders, the specific cognitive processes underlying their quantitative impairments are quite different. It is possible that the DAT patients' conceptual errors are yet another indicator of the deterioration of their semantic knowledge.

Aged

Neurobehavioral manifestations in obstructive sleep apnea syndrome before and after treatment with continuous positive airway pressure.

Obstructive sleep apnea syndrome (OSAS) is characterized by recurrent apneas during sleep, resulting in repetitive hypoxemic episodes and a constant interruption of the normal sleep pattern. Vigilance impairment and neuropsychological deficits are among the main symptoms seen in this condition. One of the major questions in this field concerns the reciprocal interactions between nocturnal hypoxemia, sleep disruption, excessive daytime sleepiness and cognitive deficits. Results of this study suggest that vigilance impairment is attributable mostly to nocturnal hypoxemia. However, in cognitive deficits, hypoxemia seems to play a major role in executive and psychomotor tasks, whereas attention and memory functions appear to be related to vigilance impairment. After treatment, hypoxemia-related deficits and some degree of sleepiness persist. These results raise the possibility of an irreversible anoxic central nervous system (CNS) damage in severe OSAS.

Adult

Relative localizing value of common tests used in the preoperative investigation of epileptic patients.

We have compared the relative localizing value of common tests in the presurgical evaluation of epilepsy in 73 patients with depth electrode (SEEG) confirmed epileptogenic foci and excellent surgical outcome. We found the tests of abnormality (CT, amytal, neuropsychology) to be frequently non-informative and often discordant with SEEG. The EEG was concordant with the SEEG in 38% of cases and provided lateralization in 78%. EEG was less localizing than ictal behavior in frontals but not in temporals. The need for SEEG is rather evident in these results but could become attenuated by the development of the localizing power of scalp EEG.

Electroencephalography

Obstructive sleep apnea syndrome: pathogenesis of neuropsychological deficits.

Neuropsychological deficits have been documented in patients with obstructive sleep apnea syndrome (OSAS). Both nocturnal hypoxemia and impairement of daytime vigilance have been suggested as the pathogenesis of these deficits, yet it remains difficult to find good correlations between cognitive deficits and either of these physiological parameters. In the present study, 10 normal controls were compared to 10 moderately and 10 severely apneic patients, all recorded in a sleep laboratory for two consecutive nights, with a vigilance and neuropsychological assessment made during the intervening day. Relative to the controls, moderate and severe OSAS showed differences in many cognitive functions, although the severely affected showed the greater differences. Moreover, severe apneics were also worse than moderate apneics on tests that were found to be normal in the latter group. This suggests a discontinuity in the appearance of neuropsychological deficits as OSAS progresses. Further analyses revealed that reductions in general intellectual measures, as well as in executive and psychomotor tasks were all attributable to the severity of hypoxemia, while other attention and memory deficits were related to vigiance impairment. Therefore, both vigilance impairment and nocturnal hypoxemia may differentially contribute to the cognitive dysfunctions found in OSAS.

Adult

Interhemispheric EEG coherence before and after partial callosotomy.

Measures of interhemispheric EEG coherence during REM and NREM sleep reflect the functional connectivity of the right and left hemispheres mediated by the corpus callosum. Surface recordings of interhemispheric coherence in two patients reflected fairly accurately the degree of anatomical section produced by partial callosotomy. With further development, EEG coherence may prove useful as a noninvasive method for assessing interhemispheric integration under different physiological and experimental conditions.

Adult

Short-term and long-term memory deficit following intracarotid Amytal injection: further support for the memory consolidation hypothesis.

To test the three main hypotheses of the human amnesic syndrome (encoding, consolidation, retrieval), we designed an original protocol for memory assessment under Amytal that included, in addition to a retrograde memory measure, both short-term and long-term anterograde memory measures. Twenty epileptic patients with SEEG-confirmed unilateral temporal lobe foci were given right and left injections on successive days. Only the long-term memory measure for material presented under Amytal was significantly related to the presence of a temporal contralateral epileptogenic focus, even if it was assessed when the hemisphere had completely recovered from the effect of Amytal. Short-term memory deficits were observed equally often after injections ipsilateral and contralateral to the epileptogenic focus, and no retrograde amnesia was observed. These results are consistent with the consolidation hypothesis.

Adolescent

Nocturnal sleep recording in partial epilepsy: a study with depth electrodes.

It has been known for centuries that sleep and epilepsy have strong reciprocal influences. This is true for all kinds of epilepsies, although the nature of this influence varies quite markedly for each type. This extensive literature cannot be reviewed here, but some recent applications of these early studies will be given.

Electroencephalography

Hypnogenic paroxysmal dystonia: epilepsy or sleep disorder? A case report.

A patient was studied who every night experienced several attacks characterized by loud screaming, violent movements of limbs and trunk, and a tonic phase. No epileptiform activity was noted preceding or following these attacks. Prolonged EEG and videotape recordings before and after sleep deprivation, along with neuropsychological and pharmacological data, support the hypothesis of a seizure disorder involving the left temporal region. Nocturnal attacks completely disappeared with carbamazepine. This therapeutic effect was still present after six months of treatment. Sleep organization was also greatly influenced by this medication. The most striking change was the marked and sustained increase of stages 3 and 4 NREM sleep after treatment.

Adult