High frequency of potentially pathogenic SORL1 mutations in autosomal dominant early-onset Alzheimer disease

Performing exome sequencing in 14 autosomal dominant early-onset Alzheimer disease (ADEOAD) index cases without mutation on known genes (amyloid precursor protein (APP), presenilin1 (PSEN1) and presenilin2 (PSEN2)), we found that in five patients, the SORL1 gene harbored unknown nonsense (n=1) or missense (n=4) mutations. These mutations were not retrieved in 1500 controls of same ethnic origin. In a replication sample, including 15 ADEOAD cases, 2 unknown non-synonymous mutations (1 missense, 1 nonsense) were retrieved, thus yielding to a total of 7/29 unknown mutations in the combined sample. Using in silico predictions, we conclude that these seven private mutations are likely to have a pathogenic effect. SORL1 encodes the Sortilin-related receptor LR11/SorLA, a protein involved in the control of amyloid beta peptide production. Our results suggest that besides the involvement of the APP and PSEN genes, further genetic heterogeneity, involving another gene of the same pathway is present in ADEOAD.

[Anterograde declarative memory and its models]

INTRODUCTION

Patient H.M.'s recent death provides the opportunity to highlight the importance of his contribution to a better understanding of the anterograde amnesic syndrome. The thorough study of this patient over five decades largely contributed to shape the unitary model of declarative memory. This model holds that declarative memory is a single system that cannot be fractionated into subcomponents. As a system, it depends mainly on medial temporal lobes structures. The objective of this review is to present the main characteristics of different modular models that have been proposed as alternatives to the unitary model. It is also an opportunity to present different patients, who, although less famous than H.M., helped make signification contribution to the field of memory.

STATE OF THE ART

The characteristics of the five main modular models are presented, including the most recent one (the perceptual-mnemonic model). The differences as well as how these models converge are highlighted.

PERSPECTIVES

Different possibilities that could help reconcile unitary and modular approaches are considered.

CONCLUSION

Although modular models differ significantly in many aspects, all converge to the notion that memory for single items and semantic memory could be dissociated from memory for complex material and context-rich episodes. In addition, these models converge concerning the involvement of critical brain structures for these stages: Item and semantic memory, as well as familiarity, are thought to largely depend on anterior subhippocampal areas, while relational, context-rich memory and recollective experiences are thought to largely depend on the hippocampal formation.

Carotidynia: a new case for an old controversy

Whereas International Headache society (IHS) criteria of carotidynia were defined in 1988, its validity as a distinct nosological entity has recently been questioned, leading this entity to be removed from the second IHS classification in 2004. We report the case of a 30-year-old woman who developed a pain located at the left carotid bulb, associated with typical findings on ultrasonography and MRI. We discuss new criteria and denomination of this clinical entity.

Adrénoleucodystrophie liée à l’X, forme cérébrale de l’adulte

The authors report a case of an X-linked-adrenoleukodystrophy (ALD) in a young adult presenting with hemianopsia. Adult onset cerebral ALD is rare and represents only 3% of cases of ALD. The observation describes clinical data, as well as conventional and spectroscopic MR imaging and related value in prognosis evaluation.

[Consensus statement on severe dementia]

Under the auspices of the French Society of Gerontology and Geriatrics, a multidisciplinary group of experts, including geriatricians, neurologists, epidemiologists, psychiatrists, pharmacologists, and public health specialists developed consensus recommendations about care for patients with severe dementia. They defined 21 recommendations for general practitioners, long-term care physicians, and specialists, based on the knowledge currently available (2005). The aim of care at all stages is to mitigate the quality-of-life of patient, caregiver, and family insofar as possible, combining care and future planning until the end of life. Management, to take into account problems including nutritional status, behavior disorders, and ability (or inability) to perform activities of daily living, must be global, multidisciplinary, and coordinated and must optimize use of local medical and social resources. The group also stressed the importance of clinical research to improve knowledge of disease course and assess management strategies and recommended specific area for research.

Consensus sur la démence de type Alzheimer au stade sévère

Under the auspices of the French Society of Gerontology and Geriatrics, a multidisciplinary team including geriatritians, neurologists, epidemiologists, psychiatrists, pharmacologists and public health specialists developed a consensus on care for patients with severe dementia. They defined 21 recommendations for general practitioners, long-term care physicians and specialists based on knowledge available in 2005. At all stages of the disease, the objective of care is to improve as much as possible quality-of-life for the patient and his/her family, including a life project until the end of life. It is always possible to do something for these patients and their family: nutritional status, behavior disorders, and incapacities to deal with basic activities of daily life have to be taken in consideration. Resource allocation and proximity care have to be targeted. Research areas necessary to improve the care of patients with severe dementia has been selected.

Investigating acupuncture using brain imaging techniques: the current state of play

We have systematically researched and reviewed the literature looking at the effect of acupuncture on brain activation as measured by functional magnetic resonance imaging and positron emission tomography. These studies show that specific and largely predictable areas of brain activation and deactivation occur when considering the traditional Chinese functions attributable to certain specific acupuncture points. For example, points associated with hearing and vision stimulates the visual and auditory cerebral areas respectively. Pain, however, is a complex matrix that is intimately intertwined with expectation. Acupuncture clearly affects this matrix in both specific and non-specific manner that is consistent with its specific clinical effects, as well as the effects of expectation on pain relief. This article summarizes the current imaging literature.

Fluoxetine modulates motor performance and cerebral activation of patients recovering from stroke

In order to determine the influence of a single dose of fluoxetine on the cerebral motor activation of lacunar stroke patients in the early phase of recovery, we conducted a prospective, double-blind, crossover, placebo-controlled study on 8 patients with pure motor hemiparesia. Each patient underwent two functional magnetic resonance imaging (fMRI) examinations: one under fluoxetine and one under placebo. The first was performed 2 weeks after stroke onset and the second a week later. During the two fMRI examinations, patients performed an active controlled motor task with the affected hand and a passive one conducted by the examiner with the same hand. Motor performance was evaluated by motor tests under placebo and under fluoxetine immediately before the examinations to investigate the effect of fluoxetine on motor function. Under fluoxetine, during the active motor task, hyperactivation in the ipsilesional primary motor cortex was found. Moreover, fluoxetine significantly improved motor skills of the affected side. We found that a single dose of fluoxetine was enough to modulate cerebral sensory-motor activation in patients. This redistribution of activation toward the motor cortex output activation was associated with an enhancement of motor performance.

Effects of cefmetazol, cefoxitin and imipenem on polymorphonuclear leukocytes

1. We have investigated the effects produced in vitro by Cefmetazol, Cefoxitin and Imipenem on the chemotaxis, spontaneous mobility, adherence, phagocytosis and candidicide power of human polymorphonuclear neutrophils (PMNs). 2. The three antibiotics tested significantly stimulated the adherence of neutrophils to nylon fibre at doses either equal (50 mg/l) or superior (500 mg/l) to the therapeutic one. 3. Cefmetazol, Cefoxitin and Imipenem bring about a maximum increase of chemotaxis at the therapeutic dose, whereas the spontaneous mobility diminishes with any one of the doses used. 4. The capacity of the PMNs to phagocytize and produce lysis of Candida albicans is increased in Cefmetazol with therapeutic doses. Cefoxitin produced an increased lysis of candidas.

[The patella and the femoro-patellar joint during rheumatoid polyarthritis]

The authors report 2 series of cases of rheumatoid arthritis, one prospective of 115 cases, the other retrospective of 72 cases, and note the frequency of clinical and radiological patellar and femoro-patellar involvement during this disease. Signs of active rheumatoid disease in the patella were present in 31 cases. The most common lesions of the femoro-patellar joint space are narrowing and lateral dislocation of the patella. The femoro-patellar lesions evolve in parallel to the femoro-tibial lesions, but dissociation is possible. The early detection of a femoro-patellar syndrome permits effective treatment by isometric rehabilitation of the quadriceps. On the most advanced lesions, and when pain is limited to the femur and patella, an operation of reaxation of the patella may provide remarkable functional improvement.