[Sneddon syndrome: a rare cause of vascular dementia]. / Le syndrome de Sneddon: une cause rare de démence vasculaire.

Few vascular dementias are diagnosed in memory clinic consultations. One type, a rare etiology, Sneddon syndrome, can lead patients to consult for an isolated memory complaint. We report the cases of two patients, aged 63 and 66 years, who presented frontocortical cognitive profile and behavior disorders. Seronegative Sneddon syndrome, complicated with dementia, was diagnosed in each case by noticing an association between, on MRI, an atrophy and several ischemic cerebrovascular accident aftermaths, and a livedo racemosa. Management of vascular risks factors improves the prognosis.

[Diagnosis contribution of biomarkers in Alzheimer disease: A case of frontotemporal dementia]. / Apport diagnostic des marqueurs biologiques de la maladie d'Alzheimer (MA) dans une observation de dégénérescence lobaire fronto-temporale (DLFT).

INTRODUCTION: Cerebrospinal fluid biomarkers are a fundamental contribution for the diagnosis of Alzheimer disease, in particular for young people. CASE REPORT: We report a case of Alzheimer disease of a 51-years old man whose clinical presentation corresponded to frontotemporal behavioural criteria. The clinical evaluation noticed some troubles in verbal memory. Only the CSF biomarkers confirmed the diagnosis. CONCLUSION: There are different phenotypes of presenile Alzheimer disease and among them we note frontotemporal dementia. It is very important to identify them to introduce a specific treatment.

[Diagnostic criteria for mild cognitive impairment in a cohort of 100 subjects]. / Critères diagnostiques des troubles cognitifs légers dans une cohorte de 100 patients.

INTRODUCTION: Tracking can be proposed for subjects with prodromal sates of Alzheimer disease (AD) or people with mild cognitive impairment (MCI) at risk to develop dementia who present a memory complaint. PATIENTS AND METHODS: We present a cohort of 100 subjects who attended a French memory unit with a diagnostic of MCI. We applied the different definitions used in daily practice. We used the following diagnostic criteria: amnestic MCI (MCIa), multiple domain impairment (MDI), single non-memory dysfunction impairment (SDI), and prodromal Alzheimer's disease (Prod-AD), using only the neuropsychological episodic memory criteria. We also analyzed the population of subjects presenting MCI and vascular risk factors. RESULTS: Ninety-nine subjects met the criteria of MCIa, 43 met the criteria of isolated MCIa; 56 met the criteria of MDI; one met the criteria of SDI; 40 met the criteria of MAPD; 58 met the criteria of MCI with vascular risk factors. DISCUSSION: Using the diagnostic criteria of MCI can lead to clinical ambiguity because the population recruited on the bases of memory complaint is highly variable. Moreover, many subjects meet many definitions. This overlap of the classifications further complicates the decision to favor one criterion over another. In clinical practice, a classification system using the concepts of MCI, MDI and SDI seems to be quite operational but cut-offs are necessary for the tests applied, in addition to a clarified choice of which tests to use.

[Usefulness of the 10 pictures reminding test for memory assessment for the diagnosis of Alzheimer's disease, mild cognitive impairment and anxiety/depression]. / Apport de l'épreuve des dix images au diagnostic des troubles de mémoire dans la maladie d'Alzheimer, le déficit cognitif léger et le syndrome anxiodépressif.

INTRODUCTION: Episodic memory is often considered to be essential in the neuropsychological examination of elderly people consulting in the memory clinics. Therefore, the performance of three different episodic memory tests were compared in Alzheimer's disease (AD), mild cognitive impairment (MCI) and anxiety/depression. METHODS: Seventy-six patients with AD, 46 with MCI, and 36 with anxiety/depression performed three memory tests: (1) three-words immediate and delayed recall of the MMSE test; (2) 10-pictures reminding test; (3) 16-items free and cued reminding test. RESULTS: Patients with AD and MCI differed from the depressed/anxious participants on all subcomponents of the memory tests. Only the three-words immediate and delayed recall in the MMSE test as well as the immediate recall (encoding) of the free and cued reminding test (16-items) did not differ between AD and MCI. Significant correlations were also evidenced between the free and cued recall of the 10 pictures and the score of the 16-items for all patients. Scores of total and free recalls distinguished the three group of patients; also, a trend was observed for the free recall between the patients with AD and MCI. CONCLUSION: The three-words immediate and delayed recall of the MMSE test is linked with hippocampic dysfunction. Also, the present study suggests that the 10-pictures reminding test, is a simple and reliable test for investigating memory, in addition to other evaluation tests. Finally, further studies would be necessary to assess the sensitivity and specificity of the tests.

[Amnesic presentations of the compulsive obsessional confusions (about 3 patients appearing in a consultation of memory)]. / Présentations amnésiques des troubles obsessionnels compulsifs.

Disorders or complaints of memory are a frequent cause of consultation in depression, major anxiety and psychiatry disease with personality disorders. We report 3 patients with obsessive compulsive disorder (OCD), without diagnosis and treatment, examined in a specialized memory consultation. They always had OCD with cognitive checking. Diagnosis of transient global amnesia and temporal complex seizure were discussed in 2 cases. Psychometric impairment only was observed in first free recall of a verbal memory task and was no specific. Behavioural during testing seemed to be very important to analyse. First, a 49-year-old man consulted because he had stereotyped transient amnesia lasted one minute, 2 or 3 times a week, since 6 months. He was a teacher. Transient amnesia always occurred during lessons. Suddenly he didn't know where he was or what he was speaking about. Episodes lasted one minute. After them, he had no confusion and no difficulty in concentration but intense anxiety. In an another hand, when he was in his car, after lessons, he could forget where he was during some minutes. CT scan and EEG were normal. Neuropsychological tests only objectived impairment in first free recall of Grober and Buschke's words. Patient explained that he could not prevent to check responses. He told us checking obsessive compulsive disorder during since long time ago. We discussed clear differences which existed between seizure and ruminations or preoccupations. Secondly, a 55-year-old woman was afraid of her memory performances. She was medical secretary and had no problem in her work but she would like a memory consultation to reassure herself. She was neither depressed nor anxious. She presented curious production in fluency task. She had to produce as many animals's names as possible: she could say 35 names which was an excellent performance but only in alphabetic order! Neuropsychological tests objectived impairment in her first free recall of Grober and Buschke's words. She tried in her first free recall to remember words in alphabetic order. She explained how she was bound to range everything in alphabetic order! She had a lot of rituals. She thought that she had an obsessive compulsive disorder but never consulted about this. The observation illustrated suspiscions about memory operations which could be observed in patients group with obsessive compulsive disorders. Finally, a 62-year-old man told us that he had presented a transient global amnesia during 4 hours. He had an important appointment and was upset about that. He didn't go to it and wandered in his flat. He always asked the same questions and forgot everything. He had no neurological deficit. He was anxious, sad and cried several times. He perfectly remembered the episod and thought that he had a panic attack! Verbal memory tests only objectived difficulties in his first free recall of Grober and Buschke words as the two others patients. He had a story of obsessive compulsive disorder with checking and rituals. In this observation, we discussed clear differences which existed between panic attacks and global transient amnesia. We analyzed patterns of neuropsychological performances which illustrated clinical features of obsessive compulsive disorder. These three patients impaired in their first free recall of verbal memory task. It is not a specific result. We observed during psychometric evaluation, strategic processing which impaired episodic memory: patients tried to check their performances. Memory complaints only were observed in checking obsessive compulsive disorder. It is a difficulty or a doubt about memory capacities. Difficulties could be due to particular cognitive processes who pertubate normal memory capacities.

[Memory complaints and anxiety. Apropos of 40 patients attending a specialized memory consultation]. / Plainte mnésique et anxiété. A propos de 40 patients reçus dans une consultation spécialisée de mémoire.

This study reports results of the specialized memory consultation based on 2 successive examinations, one by a neurologist, the other by a psychologist, of 40 anxious subjects with or without social phobias. Traumatic events were frequent and we observed Alzheimer's disease in the family of 41.9% of subjects. Anxious subjects obtained a high score in Mac Nair questionnaire [44.05 (16,49)]. Their principal complaints were attentional difficulties. They obtained normal but low performances for free recall of 10 pictures, logical memory (QM), and inverse span. Mac Nair score was only correlated with logical memory score. Standardized psychometric evaluation showed short-term memory difficulties. Attention seems to be unstable and anxious individuals have relatively limited attentional resources. They are preoccupied by their anxiety and thus have less ability to focus on tasks.

Visual memory impairment in patients with obsessive-compulsive disorder: a controlled study.

Memory processes were compared in 26 patients presenting DSM-III-R obsessive-compulsive disorder (OCD) with 20 sex-, age- and education-matched normal controls. A significant between-group difference was found: visual memory was significantly lower in OCD, whereas no significant between-group differences in verbal memory were observed. A subsample of 17 OCD were also compared with the 20 control subjects on an explicit-memory free-recall task and an implicit-memory completion task using neutral, obsessive and guilt-responsibility words to test the effects of an emotional verbal input on memory functioning. No between-group difference was found, suggesting that emotionally laden word processing did not modify implicit and explicit memory performances.