[A TPE programme for patients with neurodegenerative diseases and their carers]. / Un programme d'ETP pour les patients porteurs d'une maladie neurodégénérative et leurs aidants.

The team of the geriatric department of the Grenoble-Alpes (38) University Hospital Center has created the Accompagner therapeutic education program to meet the needs of patients suffering from neurocognitive disorders in the context of a neurodegenerative disease and their families. Presentation and current organization of the workshops.

The Self-Pleasantness Judgment Modulates the Encoding Performance and the Default Mode Network Activity.

In this functional magnetic resonance imaging (fMRI) study, we evaluated the effect of self-relevance on cerebral activity and behavioral performance during an incidental encoding task. Recent findings suggest that pleasantness judgments reliably induce self-oriented (internal) thoughts and increase default mode network (DMN) activity. We hypothesized that this increase in DMN activity would relate to increased memory recognition for pleasantly-judged stimuli (which depend on internally-oriented attention) but decreased recognition for unpleasantly-judged items (which depend on externally-oriented attention). To test this hypothesis, brain activity was recorded from 21 healthy participants while they performed a pleasantness judgment requiring them to rate visual stimuli as pleasant or unpleasant. One hour later, participants performed a surprise memory recognition test outside of the scanner. Thus, we were able to evaluate the effects of pleasant and unpleasant judgments on cerebral activity and incidental encoding. The behavioral results showed that memory recognition was better for items rated as pleasant than items rated as unpleasant. The whole brain analysis indicated that successful encoding (SE) activates the inferior frontal and lateral temporal cortices, whereas unsuccessful encoding (UE) recruits two key medial posterior DMN regions, the posterior cingulate cortex (PCC) and precuneus (PCU). A region of interest (ROI) analysis including classic DMN areas, revealed significantly greater involvement of the medial prefrontal cortex (mPFC) in pleasant compared to unpleasant judgments, suggesting this region's involvement in self-referential (i.e., internal) processing. This area may be responsible for the greater recognition performance seen for pleasant stimuli. Furthermore, a significant interaction between the encoding performance (successful vs. unsuccessful) and pleasantness was observed for the PCC, PCU and inferior frontal gyrus (IFG). Overall, our results suggest the involvement of medial frontal and parietal DMN regions during the evaluation of self-referential pleasantness. We discuss these results in terms of the introspective referential of pleasantness judgments and the differential brain modulation based on internally- vs. externally-oriented attention during encoding.

An implicit spatial memory alignment effect.

The memory alignment effect is the advantage of reasoning from a perspective which is aligned with the frame of reference used to encode an environment in memory. It usually occurs when participants have to consciously take a perspective to perform a spatial memory task. The present experiment assesses whether the memory alignment effect can occur without requiring to consciously take a given perspective, when the misaligned perspective is only perceptively provided. In others words, does the memory alignment effect still arise when it is only implicitly prompted? Thirty participants learned a sequence of four objects' positions in a room from a north-as-up survey perspective. During the testing phase, they had to point to the direction of a target object from another object ('the reference') with a fixed north-up orientation. The background behind the reference object displayed either a uniform color (control condition) or a misaligned ground-level perspective. The latter displayed a reference object's position information which was either congruent with the studied environment (congruent misaligned condition) or incongruent (incongruent misaligned condition). Mean pointing errors were higher in the congruent misaligned condition than in the control condition, whereas the incongruent misaligned condition did not differ from the control one. The present study shows that the memory alignment effect can arise without requiring a conscious misaligned perspective taking. Moreover, the perceived misaligned perspective must share the same spatial content as the memorized spatial representation in order to induce an alignment effect.

Mutual interferences between automatic ongoing spatial-updating with self-motion and source recall.

Recent models suggest that spatial updating of position with self-motion is a key component of remembering. In the first experiment, participants simultaneously performed a spatial task and a source recall. In the spatial task, blindfolded participants rotated to a new orientation and then pointed to an object's position. They pointed either from their new orientation (in the updating condition), or as if they were still in their starting orientation (in the ignoring condition). In the updating condition, participants had to accurately integrate their own movement whereas, in the ignoring condition, they had to ignore it. If spatial updating and episodic memory rely on the same network, only the updating condition should interfere with source recall. Results are in line with this prediction. A second experiment using a semantic memory task instead of source recall showed no interference effect. These results suggest that episodic memory and spatial updating are functionally linked.

Differential hippocampal and retrosplenial involvement in egocentric-updating, rotation, and allocentric processing during online spatial encoding: an fMRI study.

The way new spatial information is encoded seems to be crucial in disentangling the role of decisive regions within the spatial memory network (i.e., hippocampus, parahippocampal, parietal, retrosplenial,…). Several data sources converge to suggest that the hippocampus is not always involved or indeed necessary for allocentric processing. Hippocampal involvement in spatial coding could reflect the integration of new information generated by "online" self-related changes. In this fMRI study, the participants started by encoding several object locations in a virtual reality environment and then performed a pointing task. Allocentric encoding was maximized by using a survey perspective and an object-to-object pointing task. Two egocentric encoding conditions were used, involving self-related changes processed under a first-person perspective and implicating a self-to-object pointing task. The Egocentric-updating condition involved navigation whereas the Egocentric with rotation only condition involved orientation changes only. Conjunction analysis of spatial encoding conditions revealed a wide activation of the occipito-parieto-frontal network and several medio-temporal structures. Interestingly, only the cuneal areas were significantly more recruited by the allocentric encoding in comparison to other spatial conditions. Moreover, the enhancement of hippocampal activation was found during Egocentric-updating encoding whereas the retrosplenial activation was observed during the Egocentric with rotation only condition. Hence, in some circumstances, hippocampal and retrosplenial structures-known for being involved in allocentric environmental coding-demonstrate preferential involvement in the egocentric coding of space. These results indicate that the raw differentiation between allocentric versus egocentric representation seems to no longer be sufficient in understanding the complexity of the mechanisms involved during spatial encoding.

Ongoing egocentric spatial processing during learning of non-spatial information results in temporal-parietal activity during retrieval.

Deficits in amnesic patients suggest that spatial cognition and episodic memory are intimately related. Among the different types of spatial processing, the allocentric, relying on the hippocampal formation, and the egocentric-updated, relying on parieto-temporal connections have both been considered to functionally underlie episodic memory encoding and retrieval. We explore the cerebral correlates underlying the episodic retrieval of words previously learnt outside the magnet while performing different spatial processes, allocentric and egocentric-updated. Subsequently and during fMRI, participants performed an episodic word recognition task. Data processing revealed that the correct recognition of words learnt in egocentric-updated condition enhanced activity of the medial and lateral parietal, as well as temporal cortices. No additional regions were activated in the present study by retrieving words learnt in allocentric condition. This study sheds new light on the functional links between episodic memory and spatial processing: The temporo-parietal network is confirmed to be crucial in episodic memory in healthy participants and could be linked to the egocentric-updated process.

Bias in self-motion perceived speed can enhance episodic memory.

Prior experiences of a stimulus facilitate reprocessing of that stimulus on a subsequent occasion. This relative ease and speed with which information is processed is defined as fluency and can constitute a basis for memory judgment. Fluency can also be manipulated on line by perceptual bias (e.g., levels of noise), leading to an increase in recognition for items processed more fluently (e.g., items with less noise). Previous experiments using Remember-Know paradigm have shown an impact of perceptual fluency only on familiarity and not on recollection. Recent episodic memory models have postulated a strong link between episodic memory and spatial processes, especially with egocentric updating (Gomez et al. in Acta Psychol 132(3):221-227, 2009). The present experiment was conducted to determine whether self-motion fluency affects recognition performance and particularly has an impact on "Remember" responses. Thirty participants learned a 4-min path movie and then had to recognize among short paths if they were part of the learned path, followed by a Remember-Know procedure for recognized items. Self-motion fluency was manipulated with the presence of nimble acceleration applied on a small part of the recognition paths. Results show that the presence of a self-motion fluency increases significantly the proportion of remember responses solely on learned paths. This study spotlights for the first time a specific fluency effect on recollection and indicates an implication of egocentric-updating processing in episodic memory retrieval.