Biomedical subjects

Marc-André Bédard

Publications and source records attributed to Marc-André Bédard.

8 recordsLinked to original sources

PubMed2005

Early Huntington's disease affects movements in transformed sensorimotor mappings.

This study examined the effect of transformed visual feedback on movement control in Huntington's disease (HD). Patients in the early stages of HD and controls performed aiming movements towards peripheral targets on a digitizing tablet and emphasizing precision. In a baseline condition, HD patients were slower but showed few precision problems in aiming. When visual feedback was inverted in both vertical and horizontal axes, patients showed problems in initial and terminal phases of movement where feedback is most critical. When visual feedback was inverted along a single axis as in a mirror-inversion, HD patients showed large deviations and over-corrections before adaptation. Adaptation was similar in both groups. These results suggest that HD impairs on-line error correction in novel movements.

Adult↗

PubMed2004

Assessment of executive dysfunction during activities of daily living in schizophrenia.

Many neuropsychological studies have described deficits of memory and executive functions in patients with schizophrenia, and the severity of these deficits seems to be determinant in predicting the community outcome of these patients [Schizophr. Bull. 26 (2000) 119]. However, neuropsychological evaluation does not provide valuable information about how the cognitive deficits directly affect daily living, that is, which cognitive deficit affects which behavior. The present study aimed at determining whether executive dysfunction in schizophrenia could be directly measured by analyzing three activities of daily living (ADL), in addition to assessing the ecological validity of commonly used neuropsychological tests. Within specific ADL (choosing a menu, shopping the ingredients, cooking a meal), the sequences of behaviors that have been performed by 27 control subjects and 27 patients with schizophrenia were both analyzed by using a preset optimal sequence of behavior. When compared with control subjects, patients with schizophrenia showed more omissions when choosing the menu, more sequencing and repetitions errors during the shopping task, and more planning, sequencing, repetition and omission errors during the cooking task. These behavioral errors correlated significantly with negative, but not with positive symptoms of the patients. Furthermore, they also correlated with the poor performances on executive neuropsychological tests, especially those sensitive to shifting and sequencing abilities, but not with memory tests. These results suggest that executive deficits in schizophrenia may specifically affect ADL and that such deficits can be quantitatively assessed with a behavioral scale of action sequences.

Activities of Daily Living↗

PubMed2004

Lack of efficacy of a nicotine transdermal treatment on motor and cognitive deficits in Parkinson's disease.

UNLABELLED: Studies assessing the efficacy of nicotine in Parkinson's disease (PD) have generated contradictory results. The controversy seems to stem from uncontrolled factors including the lack of objective measures, the practice effect in a test-retest design, and the absence of plasmatic dosage. This study aimed at further controlling these factors using transdermal nicotine in PD. METHODS: Twenty-two nonsmoking PD patients received a transdermal nicotine treatment over 25 days in increasing titrated doses. Motor and cognitive assessments were carried out on days 11 and 25 (low-dose and high-dose assessments, respectively) and after a 14-day washout period. RESULTS: Patients tolerated nicotine poorly. Thirteen (59%) withdrew, mostly because of acute side effects. In the remaining nine patients, nicotine neither improved nor worsened motor or cognitive functioning in comparison with 10 age, gender and education matched controls. CONCLUSIONS: Transdermal nicotine is not effective in treating motor and cognitive deficits in PD. The results obtained with our objective measures confirm a recent double-blind, placebo-controlled study that used clinical measures. It is possible that nicotine lacks specificity in targeting critical nicotinic receptors that might be involved in PD pathophysiology. The low tolerability may be related to such a lack of specificity of nicotine, which would directly stimulate the autonomic nervous system.

Administration, Cutaneous↗

PubMed2004

Practice effect and test-retest reliability of attentional and executive tests in middle-aged to elderly subjects.

There is a lack of data about the practice effect and test-retest reliability (TRR) on many attentional and executive tests in neuropsychology. In this study, 37 subjects aged 52 to 80 were tested three times with an inter-assessment interval of 14 days. The battery included the Rey Auditory Verbal Learning Test, the Stroop interference test, the Letter-Number Sequencing test, Wechsler Adult Intelligence Scale-III (WAIS-III), the Ruff 2 and 7 Selective Attention Test, the Tower of London, the Verbal Fluency test, and simple, choice, and sequential reaction time tests. The results showed that tasks were generally subject to a practice effect, except for those with alternate forms. In all tests, there were a number of scores demonstrating good TRR, but others, although largely used in clinical practice, failed to reach acceptable TRR standards. Usually, time derived scores were associated with the best TRR.

Aged↗

PubMed2003

Mild procedural learning disturbances in neuroleptic-naive patients with schizophrenia.

This study investigated whether drug-naive patients with schizophrenia present procedural learning disturbances, given that this function is known to involve the striatum and that structural abnormalities of the striatum have been described in these patients. Eleven neuroleptic-free schizophrenic patients were compared with 11 healthy control subjects on a visuomotor procedural learning task (the Mirror Drawing Test). Average performance and learning rate did not differ between the two groups. However, schizophrenia patients were lower in learning smoothness (the consistency with which performance improves from trial to trial), which would indicate difficulty in benefiting from past experience to perform better on a current task. Because low smoothness has recently been found to be associated with striatal dysfunction, these results might indicate a premature dysfunction of the striatum in young drug-naive patients with schizophrenia. However, this dysfunction is not severe enough to prevent learning.

Adult↗

PubMed2003

[Benzodiazepines: Consequences on memory in the elderly].

Studies conducted with a healthy voluntary population with a unique medication indicate that benzodiazepines (BZD) are known to induce memory deficits. However, this group does not correspond to the population usually using these medication on a regular basis, knowingly the elderly people. Few studies have been conducted with this target population to determine the impact of BZD on their memory. However, some findings suggest that there are important consequences on the functioning of memory of the elderly people taking BZD. The current data go as far as suggesting that BZD exacerbate memory deficits in the elderly. This could even constitute a risk factor that could hasten cognitive decline and thus increase development of dementia.

English Abstract↗

PubMedDate not supplied

Cognitive deficits and striatal dopaminergic denervation in Parkinson's disease: a single photon emission computed tomography study using 123iodine-beta-CIT in patients on and off levodopa.

Cognitive deficits affecting executive (frontal) functions have been widely described in Parkinson's disease (PD). However, dopa therapies are generally ineffective at reversing these deficits, except for tasks involving a sharing of attention such as working memory or simultaneous processing tasks. The aim of this study was to assess the relation between the nigrostriatal dopaminergic denervation in PD, as measured by SPECT with (123)Iodine-beta-CIT and the cognitive deficits, as measured by a simultaneous processing task, which had already been shown to be sensitive to dopa treatment. Ten patients with PD and ten control subjects were selected and matched for age, sex, and education. All subjects were assessed using computed visuo-auditory tasks which allow for the measurement of three cognitive processing conditions: 1) a Selective Processing Time; 2) a Competitive Processing Time; and 3) a Simultaneous Processing Time. Patients with PD were assessed both with (ON) and without (OFF) their usual dopaminergic treatment. The simultaneous processing condition but not the selective or the competitive conditions took significantly more time for patients with PD OFF than for either the control subjects or the patients with PD ON. In addition, when patients with PD were OFF, the simultaneous processing condition was correlated with the (123)Iodine-beta-CIT binding, but not when they were ON. These results suggest that nigrostriatal DA denervation may be involved in the specific impairment that patients with PD experience with simultaneous cognitive processing.

Aged↗

PubMedDate not supplied

Poor tolerability of a transdermal nicotine treatment in Parkinson's disease.

Studies assessing the effect of transdermal nicotine in Parkinson's disease (PD) have generated mixed results regarding its efficacy to treat motor and cognitive deficits. These studies generally reported good tolerability in nonsmoking PD patients. The authors report the tolerability data of an open trial with transdermal nicotine in PD. Twenty-two therapeutically well-controlled nonsmoking PD patients received a transdermal nicotine treatment over 25 days according to the following fixed titration schedule: 7 mg for the first 11 days, 14 mg for the next 11 days, and 21 mg for the last 3 days. Fourteen PD patients (64%) had side effects such as nausea, vomiting, and dizziness, and 10 of them withdrew from the study. Factors such as age, body mass index, disease duration, and motor disability were not related to this intolerance. Transdermal nicotine can produce unpleasant adverse effects in patients with PD. Given that similar doses of nicotine were better tolerated in previous studies, the authors suspect the pharmacokinetic profile of the transdermal delivery system to be a determining factor in the effect of nicotine treatment in PD.

Administration, Cutaneous↗