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BACKGROUND: Populations living in European countries are becoming increasingly diverse. As performance on traditional neuropsychological tests is heavily influenced by culture, language, (level and quality of) education, literacy, and other factors, neuropsychological assessment practices need to be adapted to account for this diversity. METHOD: The European Consortium for Cross-Cultural Neuropsychology (ECCroN) aims to improve assessment of culturally, educationally, and linguistically diverse individuals across Europe by 1) collaborating on the validation and implementation of cross-cultural neuropsychological tests and 2) working on initiatives geared at improving interpreter use and training programs for neuropsychologists. RESULT: The consortium was founded in late 2019 and currently consists of 16 experts based in 9 countries - some of whom work in multinational contexts. The first meetings of the network stressed several points. First, ECCroN aims to develop and/or validate cross-culturally applicable tests, as opposed to race-based norms for existing tests; for example, current projects aim to validate measures of social cognition and language (naming) in patients with migration backgrounds. Second, ECCroN emphasizes the importance of taking into account diversity across the entire spectrum, both in populations traditionally considered to be 'majority' and 'minority' groups, e.g. best practices should be developed for those with little education regardless of native-born or migrant status. Third, ECCroN aims to identify and share suitable instruments to measure factors potentially influencing the assessment, such as bilingualism, acculturation and educational quality. CONCLUSION: Joint efforts should be undertaken to develop, validate, publish, and implement cross-cultural tests across European countries to reduce misdiagnoses in diverse patient populations.

Although executive function disorders are among the most prevalent cognitive impairments a consensus on diagnostic criteria has yet to be reached. With a view to harmonizing these criteria, the present position paper (i) focuses on the main dysexecutive disorders, (ii) examines recent approaches in both the behavioral and cognitive domains, (iii) defines diagnostic boundaries for frontal syndrome, (iv) reports on the frequency and profile of the executive function disorders observed in the main brain diseases, and (v) proposes an operationalization of diagnostic criteria. Future work must define the executive processes involved in human adaptive behavior, characterize their impairment in brain diseases, and improve the management of these conditions (including remediation strategies and rehabilitation).

The present study aimed at validating the Memory Associative Test of the district of Seine-Saint-Denis (TMA)-93, a new test of episodic memory. The TMA-93 was proposed to mostly less educated and multicultural elderly population composed of 376 healthy controls (HC) and 94 patients with Alzheimer’s disease (AD). The construct validity was checked by studying correlations with a widely used memory test (the Free and Cued Selective Reminding Test [FCSRT]) in the subsample of literate patients. Results showed that (i) all the TMA-93 scores of the patients with AD were lower than those of the HC, (ii) the TMA-93 total score identified patients with AD with a high sensitivity (88%) and very high specificity (97%), and (iii) the TMA-93 total score was strongly correlated with both free recall and total recall scores of the FCSRT. Taken together, results showed that the TMA-93 is a reliable tool to assess episodic memory in a multicultural, less educated, or illiterate population, with good construct validity for AD diagnostic accuracy.

Normal aging affects explicit memory while leaving implicit memory relatively spared. Normal aging also modifies how emotions are processed and experienced, with increasing evidence that older adults (OAs) focus more on positive information than younger adults (YAs). The aim of the present study was to investigate how age-related changes in emotion processing influence explicit and implicit memory. We used emotional melodies that differed in terms of valence (positive or negative) and arousal (high or low). Implicit memory was assessed with a preference task exploiting exposure effects, and explicit memory with a recognition task. Results indicated that effects of valence and arousal interacted to modulate both implicit and explicit memory in YAs. In OAs, recognition was poorer than in YAs; however, recognition of positive and high-arousal (happy) studied melodies was comparable. Insofar as socioemotional selectivity theory (SST) predicts a preservation of the recognition of positive information, our findings are not fully consistent with the extension of this theory to positive melodies since recognition of low-arousal (peaceful) studied melodies was poorer in OAs. In the preference task, YAs showed stronger exposure effects than OAs, suggesting an age-related decline of implicit memory. This impairment is smaller than the one observed for explicit memory (recognition), extending to the musical domain the dissociation between explicit memory decline and implicit memory relative preservation in aging. Finally, the disproportionate preference for positive material seen in OAs did not translate into stronger exposure effects for positive material suggesting no age-related emotional bias in implicit memory. (PsycINFO Database Record

BACKGROUND Quality of life (QoL) is an important area of clinical neuro-oncology, especially in glioblastoma patients. Although previous studies showed an association between QoL and anxiety, few studies have focused on the anxiety level throughout the disease progression (Bunevicius et al., 2017; Kilbride et al., 2007). Underestimating anxiety may have several consequences: a low treatment compliance, exacerbation of somatic symptoms or side effects of treatment, difficulties with understanding medical information and lower cooperation with the medical staff (Spencer, 2010). In the present study, we aimed assessing the current state of anxiety in a prospective cohort of patients treated for glioblastoma. We also investigated potential correlations with other clinical and psychological variables to better understand determinants of anxiety in this population. MATERIAL AND METHODS At the beginning of their cycle of temozolomide cure and after radio-chemotherapy, 30 patients with glioblastoma were included. Inclusion criteria were: Karnofsky index (IK) ≥ 70% and absence of cognitive disorder that could interfere with the completion of questionnaires. The characteristics of patients were as follows: mean age of 56.6 years ± 12.5 (70% were more than 50 years old); 20% were women; 50% had a university degree and IK of 87% ± 5. Anxiety level was assessed using the State-Trait Anxiety Inventory. This scale consists of 40 items on a self-report basis measuring how patients feel right now (“state”) and how they generally feel (“trait”). We also assessed (i) QoL using the Cancer Quality of Life Questionnaire 30 and the Brain Cancer Module-20; (ii) the presence of depressive symptoms using the Hospital Anxiety and Depression Scale; (iii) the self-esteem using the Rosenberg self-esteem scale and (iv) memory complains using the Prospective and Retrospective Memory Questionnaire. RESULTS The preliminary results showed that - at baseline - 21% of our sample reported high levels of anxiety. Correlation analyses showed that state anxiety was correlated with trait anxiety (rho=0.799, p< .001), QoL (rho=0.678, p< .001), level of self-esteem (rho=-0.514, p=0.004) and memory complains (rho=0.618, p< .001). Any correlation was found with age, education level, lesional lateralization or depressive symptoms. Women had higher state anxiety scores than men (t(27)=-2.4, p=0.02). CONCLUSION These preliminary results suggest that higher current state of anxiety is associated with lower QoL and lower self-esteem, regardless the presence of depressive symptoms, age, education level or lesional lateralization. Anxiety level at the follow-up (4 and 6 months after the baseline) and determinants of its progression will also be presented and might help health professionals to understand patients’ experience and better meet their needs.

Introduction: Music is increasingly used to improve cognition in clinical settings. However, it remains unclear whether its use as a mnemonic strategy is effective in Alzheimer’s disease (AD). The ...

Few neuropsychological tests are available to assess executive dysfunction in low-educated and multicultural populations. To address this issue, the TFA-93, a switching verbal fluency test to assess cognitive flexibility, was administered to 70 healthy controls, 57 patients with a clinical diagnosis of Alzheimer’s disease, and 21 with a clinical diagnosis of a neurodegenerative disease associated with frontal disorders. Most of the participants were low-educated and nonnative French speakers. The TFA-93 comprises 2 categorical fluency tasks (animals and fruits) and a fluency task in which participants have to switch between animals and fruits. Correct responses and errors were collected, and a flexibility index expressed the switching cost. Results showed that correct responses were lower, and the switching cost was greater in both patient groups. In low-educated and multicultural populations, the TFA-93 seems to be a good alternative to assess flexibility compared to the standard neuropsychological tools based on academic abilities.

The objectives of this study were to characterize the frequencies and profiles of behavioral and cognitive dysexecutive syndromes in PD (based on validated battery and diagnostic criteria) and to develop a shortened diagnostic battery. Eighty-eight non-demented patients with a diagnosis of PD were examined with an executive validated battery. Using a validated framework, the patients' test results were interpreted with respect to normative data from 780 controls. A dysexecutive syndrome was observed in 80.6% of the patients [95% confidence interval: 71.1-90.1]. The dysexecutive profile was characterized by prominent impairments in deduction, flexibility, inhibition and initiation in the cognitive domain, and by global hypoactivity with apathy and hyperactivity in the behavioral domain. This finding implies that patients with PD should be assessed with cognitive tests and a validated inventory for behavioral dysexecutive syndromes. A shortened battery (based on three cognitive tests and three behavioral domains) provided high diagnostic accuracy.

Behavioral dysexecutive disorders are highly prevalent in patients with neurological diseases but cannot be explained by cognitive dysexecutive impairments. In fact, the underlying mechanisms are poorly understood. Given that socioemotional functioning underlies appropriate behavior, socioemotional impairments may contribute to the appearance of behavioral disorders. To investigate this issue, we performed a transnosological study. Seventy-five patients suffering from various neurological diseases (Alzheimer's disease (AD), Parkinson's disease (PD), frontotemporal lobar degeneration, and stroke) were included in the study. The patients were comprehensively assessed in terms of cognitive and behavioral dysexecutive disorders and socioemotional processes (facial emotion recognition and theory of mind). As was seen for cognitive and behavioral dysexecutive impairments, the prevalence of socioemotional impairments varied according to the diagnosis. Stepwise logistic regressions showed that (i) only cognitive executive indices predicted hypoactivity with apathy/abulia, (ii) theory of mind impairments predicted hyperactivity-distractibility-impulsivity and stereotyped/perseverative behaviors, and (iii) impaired facial emotion recognition predicted social behavior disorders. Several dysexecutive behavioral disorders are associated with an underlying impairment in socioemotional processes but not with cognitive indices of executive functioning (except for apathy). These results strongly suggest that some dysexecutive behavioral disorders are the outward signs of an underlying impairment in socioemotional processes.

Objectives Although relationships between empathy and burnout have been reported, it remains unclear whether empathy should be considered as a predictive or a protective factor. A multidimensional approach towards empathy was selected to determine whether cognitive and emotional aspects might differently contribute to the burnout (first study). In a second study, we aimed at investigating the effect of empathy-based training program on empathic skills and burnout. Methods The first survey was conducted among 124 nursing staff from 10 geriatric residential facilities. They filled out (i) the Maslach burnout inventory (assessing emotional exhaustion, depersonalization and personal accomplishment); (ii) two empathy questionnaires assessing both cognitive (perspective-taking, i.e. the tendency to adopt another person's point of view) and emotional empathy (compassionate care, i.e. the propensity to take patients' feelings into account; and personal distress, i.e. feelings of discomfort in relationships). In the second study, questionnaires were filled out by 41 caregivers before and after an empathy-based training program (Validation®). Results results showed that higher personal distress predicted higher burnout scores while higher compassionate care predicted lower emotional exhaustion and higher perspective-taking predicted lower depersonalization as well as higher accomplishment. Results from the second study showed that personal distress decreased after the Validation training and nursing staffs reported lower depersonalization and higher accomplishment. Conclusion The first study suggests that, in predicting the decrease of burnout symptomatology, perspective-taking and the propensity for compassionate care should be considered as protective factors, whereas personal distress can be considered as a predictive factor. Moreover, empathy-based training programs such as Validation® could contribute to the prevention of burnout by decreasing signs of personal distress. The nature of this component (empathy or sympathy) is discussed.

Age-related differences in episodic memory have been explained by a decrement in strategic encoding implementation. It has been shown in clinical populations that music can be used during the encoding stage as a mnemonic strategy to learn verbal information. The effectiveness of this strategy remains equivocal in older adults (OA). Furthermore, the impact of the emotional valence of the music used has never been investigated in this context. Thirty OA and 24 young adults (YA) learned texts that were either set to music that was positively or negatively valenced, or spoken only. Immediate and delayed recalls were measured. Results showed that: (i) OA perform worse than YA in immediate and delayed recall; (ii) sung lyrics are better remembered than spoken ones in OA, but only when the associated music is positively-valenced; (iii) this pattern is observed regardless the retention delay. These findings support the benefit of a musical encoding on verbal learning in healthy OA and are consistent with the positivity effect classically reported in normal aging. Added to the potential applications in daily life, the results are discussed with respect to the theoretical hypotheses of the mechanisms underlying the advantage of musical encoding.

Although previous studies suggest that music may facilitate verbal learning in a healthy population, such a mnemonic effect has seldom been investigated in Alzheimer's disease (AD). Moreover, memorization of texts was generally compared when either sung or spoken. In the present study, it was examined whether the benefit observed on verbal learning was specific to music or whether an associative context binding items together led to similar benefits, regardless of the nature of the association.Twelve patients with mild AD and 15 healthy controls learned texts presented with either a musical (sung) or a nonmusical association (spoken associated to a silent movie sequence) or without association (spoken alone). Immediate and delayed (after a 5-min delay) recall was measured.Main results showed that (a) sung texts were better remembered than spoken texts, both immediately and after a retention delay, for both groups; (b) the musical benefit was robust, being observed in most AD patients; (c) the nonmusical association may also facilitate verbal learning but to a lesser extent.A musical association during the encoding stage facilitates learning and retention in AD. Furthermore, this advantage seemed quite specific to music. The results are discussed with respect to the clinical applications in AD; theoretical implications are highlighted to explain the power of music as a mnemonic technique.

The management of patients with Alzheimer's disease is a significant public health problem given the limited effectiveness of pharmacological therapies combined with iatrogenic effects of drug treatments in dementia. Consequently, the development of nondrug care, such as musical interventions, has become a necessity. The experimental rigor of studies in this area, however, is often lacking. It is therefore difficult to determine the impact of musical interventions on patients with dementia. As part of a series of studies, we carried out randomized controlled trials to compare the effectiveness of musical activities to other pleasant activities on various functions in patients with severe Alzheimer's disease. The data obtained in these trials are discussed in light of the methodological constraints and requirements specific to these clinical studies. Although the results demonstrate the power of music on the emotional and behavioral status of patients, they also suggest that other pleasant activities (e.g., cooking) are also effective, leaving open the question about the specific benefits of music in patients with dementia. All these findings highlight the promising potential for nonpharmacological treatments to improve the well-being of patients living in residential care and to reduce caregiver burden.

Given the increasing prevalence of dementia and the limited efficacy of pharmacological treatments, it is crucial to improve the knowledge of the factors that might delay the onset of dementia for developing non-pharmacological interventions. Recent studies have provided evidence that game-based interventions, especially the practice of video games, could improve the cognitive functioning (e.g. executive functions) in older adults and in demented patients. The positive effects of these games have also been demonstrated on physical health (e.g. improvement of balance and gait). Video gamed-based interventions may also alleviate mood or behavioral disorders, and increase interactions with friends, family, caregivers or other patients. The positive impact of games on these domains (cognitive and physical decline, social isolation) suggests that game-based interventions might contribute to delay the onset of dementia. Thus, playing games might be considered as a protective factor in dementia and even more as a potential non-pharmacological strategy in dementia rather than leisure activity.

Introduction Bien que l’atteinte cognitive des patients atteints de glioblastome soit frequente et s’associe a une perte d’autonomie et des difficultes familiales et professionnelles [1] , [2] , il n’existe pas de test specifiquement valide. Objectifs Etudier l’interet du TNI-93 [3] qui a l’avantage d’etre simple a administrer, peu anxiogene, rapide et sensible pour detecter les troubles mnesiques [3] . Patients et methodes Population : 10 patients ayant un glioblastome (37 a 72 ans, moyenne d’âge : 52,5 ans ± 15,2) et 16 sujets controles (30 et 72 ans, 49,3 ans ± 13,5). N’ont pas ete inclus les patients presentant un indice de Karnofsky inferieur a 70 %. Une batterie de test a ete proposee, dont le MMSE et le TNI-93, auquel un rappel differe libre et indice a ete ajoute. Resultats Les resultats des patients et des controles ne differaient pas pour l’âge (p = 0,561), le niveau de scolarite (p = 0,452) ou le score au MMSE (p = 0,193). En revanche, les performances etaient significativement differentes pour le rappel total a 20 minutes du TNI-93 (p = 0,016). Discussion Le rappel differe du TNI-93 semble discriminer les patients des sujets controles. Il parait important de pouvoir augmenter le nombre d’inclusion pour effectuer cette analyse selon la topographie lesionnelle des patients. Par ailleurs, l’aspect peu anxiogene du test semble adapte a sa passation a differents moments de l’evolution des symptomes. Conclusion La validation d’une batterie d’evaluation neuropsychologique complete dans le glioblastome avec des tests presentant les memes caracteristiques que le TNI-93 semble necessaire.

International audience; Although musical interventions have recently gained popularity as a non-pharmacological treatment in dementia, there is still insufficient evidence of their effectiveness. To investigate this issue, a single-center randomized controlled trial was conducted with forty-eight patients with Alzheimer's disease or mixed dementia to compare the effects of music versus cooking interventions in the emotional, cognitive, and behavioral domain, as well as on professional caregiver distress. Each intervention lasted four weeks (two one-hour sessions a week). Multi-component evaluations (with blind assessors) were conducted before, during, and after the interventions to assess their short and long-term effects (up to four weeks post interventions). Analyses revealed that both music and cooking interventions led to positive changes in the patients' emotional state and decreased the severity of their behavioral disorders, as well as reduced caregiver distress. However, no benefit on the cognitive status of the patients was seen. While results did not demonstrate a specific benefit of music on any of the considered measures, the present study suggests the efficacy of two pleasant non-pharmacological treatments in patients with moderate to severe dementia. Our findings highlight the potential of such interventions in improving the well-being of patients living in residential care, as well as reducing caregiver distress.

International audience; On account of the limited effectiveness of pharmacological treatments in Alzheimer's disease (AD), there is a growing interest on nonpharmacological treatments, including musical intervention. Despite the large number of studies showing the multiple benefits of music on behavioral, emotional and cognitive disorders of patients with AD, only a few of them used a rigorous method. Finally, the specificity of musical as compared to non-musical and pleasant interventions has rarely been addressed. To investigate this issue, two randomized controlled trials were conducted contrasting the effects of musical to painting (Study 1) or cooking (Study 2) interventions on emotional state of 33 patients with AD. The patients' emotional state was assessed by analyzing professional caregivers' judgments of the patient's mood, then facial expressions and valence of the discourse from short-filmed interviews. In the first study (n=22), each intervention lasted 3 weeks (two sessions per week) and the patients' emotional state was assessed before, during and after intervention periods. After the interventions, the results showed that facial expression, discourse content and mood assessment improved (more positive than negative expressions) as compared to pre-intervention assessment. However, musical intervention was more effective and had longer effects as compared with painting. In the second study (n=11), we further examined long lasting effects of music as compared to cooking by adding evaluation of the patients' emotional state 2 and 4 weeks after the last intervention. Again, music was more effective to improve the emotional state. Music had positive effects that remained significant up to 4 weeks after the intervention, while cooking only produced short-term effect on mood. In both studies, benefits were significant in more than 80% of patients. Taken together, these findings show that music intervention has specific effects on patients' emotional well being, offering promising methods to improve the quality of life of patients with AD.

Introduction L’evaluation neuropsychologique des sujets peu scolarises et/ou peu francophones dispose de peu d’outils normalises hormis deux tests de memoire, le TNI-93 et le TMA-93. Il n’existe pas de tests des fonctions executives adaptes pour ces populations. Objectifs Elaboration d’un test, le TFA-93, afin de pouvoir evaluer les capacites de flexibilite mentale chez des sujets de faible niveau d’etude et/ou de maitrise du francais. Methodes Le TFA-93, inspire de la methodologie d’une etude bresilienne de Paula et al. [4], se deroule en 3 phases : deux epreuves de fluence verbale categorielle en 1 minute (« animaux » puis « fruits ») et une epreuve de flexibilite mentale demandant d’evoquer alternativement un item de chaque categorie « animaux » et « fruits ». Le nombre de reponses correctes est note ainsi que le nombre de perseverations. Un indice de « flexibilite mentale » est calcule a l’issue de l’epreuve (plus l’indice est faible, plus le cout lie a l’alternance est eleve). Resultats Cent quarante huit participants de plus 50 ans : 70 controles, 78 patients dements (73 % Alzheimer, 27 % demences frontales), toutes langues maternelles confondues (37 % francais), apparies en termes de sexe, d’âge et de niveau scolaire. Les sujets sains produisent plus d’exemplaires que les patients dans les trois phases (tous les p Discussion Le TFA-93 discrimine les patients des sujets controles dans cet echantillon de sujets de faible niveau d’etude et/ou de faible maitrise du francais. La passation s’est deroulee sans difficulte pour l’ensemble des participants, sans probleme de comprehension des consignes. Conclusion Le TFA-93 semble adapte a l’evaluation de la flexibilite mentale des sujets de faible niveau d’etude et/ou de faible maitrise du francais. Informations complementaires L’etude n’a pas beneficie de financement particulier, public ou prive.

International audience; Introduction:La Haute autorité de santé recommande le développement des thérapies non médicamenteuses. Si les interventions musicales connaissent un succès grandissant, les études rigoureuses sur le plan méthodologique sont rares.Objectifs: L’objectif de cette étude était de tester l’efficacité et la spécificité des interventions musicales en les comparant à une autre intervention.Méthodes: Trente-sept patients avec DTA ont été répartis aléatoirement dans un atelier musical (n = 18) ou culinaire (n = 19), pendant quatre semaines (2 × 1 h/semaine). L’état émotionnel (hétéro-questionnaire de l’humeur ; valence du discours et des expressions faciales mesurées à partir d’entretiens filmés), le fonctionnement cognitif, les troubles du comportement et le retentissement sur la charge de travail des soignants ont été évalués avant, pendant (après le quatrième et huitième atelier) et à distance (deux et quatre semaines) de l’intervention.Résultats: Les résultats ont montré :– que les deux ateliers amélioraient à court terme (pendant l’intervention) l’état émotionnel, la sévérité des troubles du comportement et la charge de travail des soignants ;– que seul le bénéfice des ateliers musicaux sur les troubles comportementaux et sur la charge de travail des soignants persistait jusqu’à un mois après l’intervention.Aucune amélioration n’était retrouvée sur les mesures cognitives.Discussion: Bien que les deux prises en charge permettent des bénéfices relativement comparables à court terme, les bénéfices semblent plus durables suite aux interventions musicales. Toutefois, la spécificité de la musique est donc moins nette que dans nos précédents travaux, ce qui peut être expliqué au regard des divergences méthodologiques (e.g. durée de l’intervention ; évaluations en aveugle).Conclusion: Comme attendu, les résultats de cette étude ont montré l’efficacité des thérapies non médicamenteuses de la démence, avec des effets plus durables suite aux interventions musicales.

International audience; Objective: Parkinson's disease (PD) is associated with behavioral disorders that can affect social functioning but are poorly understood. Since emotional and cognitive social processes are known to be crucial in social relationships, impairment of these processes may account for the emergence of behavioral disorders. Method: We used a systematic battery of tests to assess emotional processes and social cognition in PD patients and relate our findings to conventional neuropsychological data (especially behavioral disorders). Twenty-three PD patients and 46 controls (matched for age and-educational level) were included in the study and underwent neuropsychological testing, including an assessment of the behavioral and cognitive components of executive function. Emotional and cognitive social processes were assessed with the Interpersonal Reactivity Index caregiver-administered questionnaire (as a measure of empathy), a facial emotion recognition task and two theory of mind (ToM) tasks. Results: When compared with controls, PD patients showed low levels of empathy (p = .006), impaired facial emotion recognition (which persisted after correction for perceptual abilities) (p = .001), poor performance in a second-order ToM task (p = .008) that assessed both cognitive (p = .004) and affective (p = .03) inferences and, lastly, frequent dysexecutive behavioral disorders (in over 40% of the patients). Overall, impaired emotional and cognitive social functioning was observed in 17% of patients and was related to certain cognitive dysexecutive disorders. In terms of behavioral dysexecutive disorders, social behavior disorders were related to impaired emotional and cognitive social functioning (p = .04) but were independent of cognitive impairments. Conclusions: Emotional and cognitive social processes were found to be impaired in Parkinson's disease. This impairment may account for the emergence of social behavioral disorders.

International audience; We explored the value of a battery of socioemotional tasks for differentiating between frontotemporal lobar degeneration (FTLD) and Alzheimer's disease (AD). Patients with FTLD (n = 13) or AD (n = 13) and healthy controls (n = 26) underwent a neuropsychological assessment and the socioemotional battery (an empathy questionnaire, an emotion recognition task, and theory of mind tasks). Socioemotional processes were markedly impaired in FTLD but relatively unaffected in mild AD. The computed Socioemotional Index discriminated more accurately between FTLD from AD than behavioral and executive assessments did. Furthermore, impairments in socioemotional processes were correlated with indifference to others.

Introduction Les troubles executifs sont frequents dans la maladie de Parkinson. Cependant, des incertitudes demeurent en raison de l’heterogeneite de l’evaluation de ces troubles et la variabilite du critere de deficit. Objectifs L’objectif de cette etude etait de caracteriser la frequence et le profil des troubles executifs a partir d’une batterie et d’une methodologie validee [1] , [2] et proposer une batterie reduite adaptee a la clinique courante. Patients et methodes Quatre-vingt-huit patients non dements avec un diagnostic de MP ont ete examines. La batterie GREFEX incluait 7 tests (Trail Making Test (TMT), Stroop, Brixton, six elements, tâche double, fluences verbales, Wisconsin Card Sorting Test) et un questionnaire comportemental explorant principalement :reduction d’activite avec apathie, hyperactivite, euphorie, perseveration, conduites sociales et sexuelles. Les resultats des tests des patients ont ete interpretes par rapport a des donnees normatives de 780 temoins. Resultats Un syndrome dysexecutif etait observe chez 80,6 % des patients (IC95 % : 71,1–90,1). Le profil etait caracterise par un trouble de deduction, flexibilite, inhibition et initiation et par une hypoactivite avec apathie et une hyperactivite pour le comportement. L’analyse de regression a selectionne 3 tests (TMT, Brixton, WCST) et 3 domaines comportementaux (hypoactivite, hyperactivite, conduites sexuelles) offrant une precision diagnostique [AUC : 0,838 (cognitif) ; AUC : 0,783 (comportemental)] comparable a celle de la batterie totale (p > 0,25). Discussion Ces resultats montrent une frequence elevee de troubles dysexecutifs cognitifs mais aussi comportementaux chez les patients Parkinson. Ils montrent egalement qu’une batterie reduite basee sur 3 tests cognitifs et 3 domaines comportementaux dysexecutifs peut permettre de fournir un diagnostic fiable de troubles dysexecutifs. Conclusion Ces resultats impliquent de realiser une evaluation des fonctions executives tant sur le plan cognitif que comportemental et ce, a partir d’un inventaire valide. Une batterie reduite issue de la batterie GREFEX peut permettre de fournir un diagnostic fiable de troubles dysexecutifs.

International audience; Problems with face recognition are frequent in older adults. However, the mechanisms involved have only been partially discovered. In particular, it is unknown to what extent these problems may be related to changes in configural face processing. Here, we investigated the face inversion effect (FIE) together with the ability to detect modifications in the vertical or horizontal second-order relations between facial features. We used a same/different unfamiliar face discrimination task with 33 young and 33 older adults. The results showed dissociations in the performances of older versus younger adults. There was a lack of inversion effect during the recognition of original faces by older adults. However, for modified faces, older adults showed a pattern of performance similar to that of young participants, with preserved FIE for vertically modified faces and no detectable FIE for horizontally modified faces. Most importantly, the detection of vertical modifications was preserved in older relative to young adults whereas the detection of horizontal modifications was markedly diminished. We conclude that age has dissociable effects on configural face-encoding processes, with a relative preservation of vertical compared to horizontal second-order relations processing. These results help to understand some divergent results in the literature and may explain the spared familiar face identification abilities in the daily lives of older adults.

The ability to recognize facial identity and emotional facial expression is central to social relationships. This paper reviews studies concerning face recognition and emotional facial expression during normal aging as well as in neurodegenerative diseases occurring in the elderly. It focuses on Alzheimer's disease, frontotemporal and semantic dementia, and also Parkinson's disease. The results of studies on healthy elderly individuals show subtle alterations in the recognition of facial identity and emotional facial expression from the age of 50 years, and increasing after 70. Studies in neurodegenerative diseases show that - during their initial stages - face recognition and facial expression can be specifically affected. Little has been done to assess these difficulties in clinical practice. They could constitute a useful marker for differential diagnosis, especially for the clinical differentiation of Alzheimer's disease (AD) from frontotemporal dementia (FTD). Social difficulties and some behavioural problems observed in these patients may, at least partly, result from these deficits in face processing. Thus, it is important to specify the possible underlying anatomofunctional substrates of these deficits as well as to plan suitable remediation programs.

L'empathie, definie comme la capacite a comprendre et ressentir les emotions d'autrui, a un role central dans les interactions sociales. Malgre les confusions terminologiques heritees de nombreuses conceptions theoriques, l'empathie serait un phenomene non unitaire, compose de l'empathie emotionnelle, reflet d'une resonance affective entre l'observateur et la cible, dont la base cerebrale serait le systeme neurone miroir ; et de l'empathie cognitive impliquant la conscience de soi, les capacites de prise de perspective, d'inhibition et de regulation. L'interaction de ces processus pose encore question, rendant difficile une modelisation de l'empathie. Neanmoins, l'observation d'une double dissociation entre l'empathie emotionnelle et l'empathie cognitive suggere l'existence de troubles d'empathie d'origines differentes. Il existe certains arguments en faveur d'une atteinte de l'empathie ou d'un de ses processus sous-jacents dans differentes pathologies degeneratives, justifiant une evaluation de ces capacites. Celle-ci pourrait permettre de rendre compte de troubles comportementaux. Or, en pratique courante, il existe encore peu d'outils cliniques adaptes. Finalement, le phenomene complexe d'empathie pourrait offrir de nouvelles perspectives quant au diagnostic, bien que de tels benefices restent a explorer.

International audience