Combining PET images and neuropsychological test data for automatic diagnosis of Alzheimer's disease

In recent years, several approaches to develop computer aided diagnosis (CAD) systems for dementia have been proposed. Some of these systems analyze neurological brain images by means of machine learning algorithms in order to find the patterns that characterize the disorder, and a few combine several imaging modalities to improve the diagnostic accuracy. However, they usually do not use neuropsychological testing data in that analysis. The purpose of this work is to measure the advantages of using not only neuroimages as data source in CAD systems for dementia but also neuropsychological scores. To this aim, we compared the accuracy rates achieved by systems that use neuropsychological scores beside the imaging data in the classification step and systems that use only one of these data sources. In order to address the small sample size problem and facilitate the data combination, a dimensionality reduction step (implemented using three different algorithms) was also applied on the imaging data. After each image is summarized in a reduced set of image features, the data sources were combined and classified using three different data combination approaches and a Support Vector Machine classifier. That way, by testing different dimensionality reduction methods and several data combination approaches, we aim not only highlighting the advantages of using neuropsychological scores in the classification, but also implementing the most accurate computer system for early dementia detention. The accuracy of the CAD systems were estimated using a database with records from 46 subjects, diagnosed with MCI or AD. A peak accuracy rate of 89% was obtained. In all cases the accuracy achieved using both, neuropsychological scores and imaging data, was substantially higher than the one obtained using only the imaging data.

Dorsomedial prefrontal metabolism and unawareness of current characteristics of personality traits in Alzheimer's disease

Anosognosia is a complex symptom corresponding to a lack of awareness of one's current clinical status. Anosognosia for cognitive deficits has frequently been described in Alzheimer's disease (AD), while unawareness of current characteristics of personality traits has rarely been considered. We used a well-established questionnaire-based method in a group of 37 AD patients and in healthy controls to probe self- and hetero-evaluation of patients' personality and we calculated differential scores between each participant's and his/her relative's judgments. A brain-behavior correlation was performed using 18-fluorodeoxyglucose positron emission tomography (FDG-PET) images. The behavioral data showed that AD patients presented with anosognosia for current characteristics of their personality and their anosognosia was primarily explained by impaired third perspective taking. The brain-behavior correlation analysis revealed a negative relationship between anosognosia for current characteristics of personality and dorsomedial prefrontal cortex (dMPFC) activity. Behavioral and neuroimaging data are consistent with the view that impairment of different functions subserved by the dMPFC (self-evaluation, inferences regarding complex enduring dispositions of self and others, confrontation of perspectives in interpersonal scripts) plays a role in anosognosia for current characteristics of personality in AD patients.

Genetic variance in micro-environmental sensitivity for milk and milk quality in Walloon Holstein cattle

Animals that are robust to environmental changes are desirable in the current dairy industry. Genetic differences in micro-environmental sensitivity can be studied through heterogeneity of residual variance between animals. However, residual variance between animals is usually assumed to be homogeneous in traditional genetic evaluations. The aim of this study was to investigate genetic heterogeneity of residual variance by estimating variance components in residual variance for milk yield, somatic cell score, contents in milk (g/dL) of 2 groups of milk fatty acids (i.e., saturated and unsaturated fatty acids), and the content in milk of one individual fatty acid (i.e., oleic acid, C18:1 cis-9), for first-parity Holstein cows in the Walloon Region of Belgium. A total of 146,027 test-day records from 26,887 cows in 747 herds were available. All cows had at least 3 records and a known sire. These sires had at least 10 cows with records and each herd × test-day had at least 5 cows. The 5 traits were analyzed separately based on fixed lactation curve and random regression test-day models for the mean. Estimation of variance components was performed by running iteratively expectation maximization-REML algorithm by the implementation of double hierarchical generalized linear models. Based on fixed lactation curve test-day mean models, heritability for residual variances ranged between 1.01×10(-3) and 4.17×10(-3) for all traits. The genetic standard deviation in residual variance (i.e., approximately the genetic coefficient of variation of residual variance) ranged between 0.12 and 0.17. Therefore, some genetic variance in micro-environmental sensitivity existed in the Walloon Holstein dairy cattle for the 5 studied traits. The standard deviations due to herd × test-day and permanent environment in residual variance ranged between 0.36 and 0.45 for herd × test-day effect and between 0.55 and 0.97 for permanent environmental effect. Therefore, nongenetic effects also contributed substantially to micro-environmental sensitivity. Addition of random regressions to the mean model did not reduce heterogeneity in residual variance and that genetic heterogeneity of residual variance was not simply an effect of an incomplete mean model.

Cognitive and neuroimaging evidence of impaired interaction between self and memory in Alzheimer's disease

In human cognition, self and memory processes strongly interact, as evidenced by the memory advantage for self-referential materials [Self-Reference Effect (SRE) and Self-Reference Recollection Effect (SRRE)]. The current study examined this interaction at the behavioural level and its neural correlates in patients with Alzheimer's disease (AD). Healthy older controls (HC) and AD patients performed trait-adjectives judgements either for self-relevance or for other-relevance (encoding phase). In a first experiment, the encoding and subsequent yes-no recognition phases were administrated in a Magnetic Resonance Imaging (MRI) scanner. Brain activation as measured by functional MRI (fMRI) was examined during self-relevance judgements and anatomical images were used to search for correlation between the memory advantage for self-related items and grey matter density (GMD). In a second experiment, participants described the retrieval experience that had driven their recognition decisions (familiarity vs recollective experience). The behavioural results revealed that the SRE and SRRE were impaired in AD patients compared to HC participants. Furthermore, verbal reports revealed that the retrieval of self-related information was preferentially associated with the retrieval of contextual details, such as source memory in the HC participants, but less so in the AD patients. Our imaging findings revealed that both groups activated the medial prefrontal cortex (MPFC) at encoding during self-relevance judgements. However, the variable and limited memory advantage for self-related information was associated with GMD in the lateral prefrontal cortex in the AD patients, a region supporting high-order processes linking self and memory. These findings suggest that even if AD patients engage MPFC during self-referential judgements, the retrieval of self-related memories is qualitatively and quantitatively impaired in relation with altered high-order processes in the lateral PFC.

Metabolic and structural connectivity within the default mode network relates to working memory performance in young healthy adults

Studies of functional connectivity suggest that the default mode network (DMN) might be relevant for cognitive functions. Here, we examined metabolic and structural connectivity between major DMN nodes, the posterior cingulate (PCC) and medial prefrontal cortex (MPFC), in relation to normal working memory (WM). DMN was captured using independent component analysis of [18F]fluorodeoxyglucose positron emission tomography (FDG-PET) data from 35 young healthy adults (27.1 ± 5.1 years). Metabolic connectivity, a correlation between FDG uptake in PCC and MPFC, was examined in groups of subjects with (relative to median) low (n=18) and high (n=17) performance on digit span backward test as an index of verbal WM. In addition, fiber tractography based on PCC and MPFC nodes as way points was performed in a subset of subjects. FDG uptake in the DMN nodes did not differ between high and low performers. However, significantly (p=0.01) lower metabolic connectivity was found in the group of low performers. Furthermore, as compared to high performers, low performers showed lower density of the left superior cingulate bundle. Verbal WM performance is related to metabolic and structural connectivity within the DMN in young healthy adults. Metabolic connectivity as quantified with FDG-PET might be a sensitive marker of the normal variability in some cognitive functions.

Associative memory in aging: the effect of unitization on source memory

In normal aging, memory for associations declines more than memory for individual items. Unitization is an encoding process defined by creation of a new single entity to represent a new arbitrary association. The current study tested the hypothesis that age-related differences in associative memory can be reduced by encoding instructions that promote unitization. In two experiments, groups of 20 young and 20 older participants learned new associations between a word and a background color under two conditions. In the item detail condition, they had to imagine that the item is the same color as the background-an instruction promoting unitization of the associations. In the context detail condition, which did not promote unitization, they had to imagine that the item interacted with another colored object. At test, they had to retrieve the color that was associated with each word (source memory). In both experiments, the results showed an age-related decrement in source memory performance in the context detail but not in the item detail condition. Moreover, Experiment 2 examined receiver operating characteristics in older participants and indicated that familiarity contributed more to source memory performance in the item detail than in the context detail condition. These findings suggest that unitization of new associations can overcome the associative memory deficit observed in aging, at least for item-color associations.

Item familiarity and controlled associative retrieval in Alzheimer's disease: an fMRI study

Typical Alzheimer's disease (AD) is characterized by an impaired form of associative memory, recollection, that includes the controlled retrieval of associations. In contrast, familiarity-based memory for individual items may sometimes be preserved in the early stages of the disease. This is the first study that directly examines whole-brain regional activity during one core aspect of the recollection function: associative controlled episodic retrieval (CER), contrasted to item familiarity in AD patients. Cerebral activity related to associative CER and item familiarity in AD patients and healthy controls (HCs) was measured with functional magnetic resonance imaging during a word-pair recognition task to which the process dissociation procedure was applied. Some patients had null CER estimates (AD-), whereas others did show some CER abilities (AD+), although significantly less than HC. In contrast, familiarity estimates were equivalent in the three groups. In AD+, as in controls, associative CER activated the inferior precuneus/posterior cingulate cortex (PCC). When performing group comparisons, no region was found to be significantly more activated during CER in HC than AD+ and vice versa. However, during associative CER, functional connectivity between this region and the hippocampus, the inferior parietal and dorsolateral prefrontal cortex (DLPFC) was significantly higher in HC than in AD+. In all three groups, item familiarity was related to activation along the intraparietal sulcus (IPS). In conclusion, whereas the preserved automatic detection of an old item (without retrieval of accurate word association) is related to parietal activation centred on the IPS, the inferior precuneus/PCC supports associative CER ability in AD patients, as in HC. However, AD patients have deficient functional connectivity during associative CER, suggesting that the residual recollection function in these patients might be impoverished by the lack of some recollection-related aspects such as autonoetic quality, episodic details and verification.

Differential effects of aging on the neural correlates of recollection and familiarity

The present experiment aimed to investigate age differences in the neural correlates of familiarity and recollection, while keeping performance similar across age groups by varying task difficulty. Twenty young and 20 older adults performed an episodic memory task in an event-related functional magnetic resonance imaging (fMRI) design. At encoding, participants were presented with pictures, either once or twice. Then, they performed a recognition task, with a Remember/Know paradigm. A similar performance was observed for the two groups in the Easy condition for recollection and in the Hard condition for familiarity. Imaging data revealed the classic recollection-related and familiarity-related networks, common to young and older groups. In addition, we observed that some activity related to recollection (left frontal, left temporal, left parietal cortices and left parahippocampus) and familiarity (bilateral anterior cingulate, right frontal gyrus and left superior temporal gyrus) was reduced in older compared to young adults. However, for recollection processes only, older adults additionally recruited the right precuneus, possibly to successfully compensate for their difficulties, as suggested by a positive correlation between recollection and precuneus activity.

Genetic correlations of days open with production traits and contents in milk of major fatty acids predicted by mid-infrared spectrometry

The objective of this study was to estimate the genetic relationships between days open (DO) and both milk production traits and fatty acid (FA) content in milk predicted by mid-infrared spectrometry. The edited data set included 143,332 FA and production test-day records and 29,792 DO records from 29,792 cows in 1,170 herds. (Co)variances were estimated using a series of 2-trait models that included a random regression for milk production and FA traits. In contrast to the genetic correlations with fat content, those between DO and FA content in milk changed considerably over the lactation. The genetic correlations with DO for unsaturated FA, monounsaturated FA, long-chain FA, C18:0, and C18:1 cis-9 were positive in early lactation but negative after 100 d in milk. For the other FA, genetic correlations with DO were negative across the whole lactation. At 5 d in milk, the genetic correlation between DO and C18:1 cis-9 was 0.39, whereas the genetic correlations between DO and C6:0 to C16:0 FA ranged from -0.37 to -0.23. These results substantiated the known relationship between fertility and energy balance status, explained by the release of long-chain FA in early lactation, from the mobilization of body fat reserves, and the consequent inhibition of de novo FA synthesis in the mammary gland. At 200 d in milk, the genetic correlations between DO and FA content ranged from -0.38 for C18:1 cis-9 to -0.03 for C6:0. This research indicates an opportunity to use FA content in milk as an indicator trait to supplement the prediction of genetic merit for fertility.

Verbal learning in Alzheimer's disease and mild cognitive impairment: fine-grained acquisition and short-delay consolidation performance and neural correlates

The aim of this study was to examine correlations between acquisition and short-delay consolidation and brain metabolism at rest measured by fluorodeoxyglucose positron emission tomography (FDG-PET) in 44 Alzheimer's disease (AD) patients, 16 patients with mild cognitive impairment (MCI) who progressed to dementia (MCI-AD), 15 MCI patients who remained stable (MCI-S, 4-8 years of follow-up), and 20 healthy older participants. Acquisition and short-delay consolidation were calculated respectively as mean gained (MG) and lost (ML) access to items of the California Verbal Learning Task. MG performance suggests that acquisition is impaired in AD patients even at predementia stage (MCI-AD). ML performance suggests that short-delay consolidation is deficient only in confirmed AD patients. Variations in acquisition performance in control participants are related to metabolic activity in the anterior parietal cortex, an area supporting task-positive attentional processes. In contrast, the acquisition deficit is related to decreased activity in the lateral temporal cortex, an area supporting semantic processes, in patients at an early stage of AD and is related to metabolic activity in the hippocampus, an area supporting associative processes, in confirmed AD patients.

Episodic autobiographical memory in amnestic mild cognitive impairment: what are the neural correlates?

Autobiographical memory in amnestic Mild Cognitive Impairment (aMCI) is characterized by impaired retrieval of episodic memories, but relatively preserved personal semantic knowledge. This study aimed to identify (via FDG-PET) the neural substrates of impaired episodic specificity of autobiographical memories in 35 aMCI patients compared with 24 healthy elderly controls. Significant correlations between regional cerebral activity and the proportion of episodic details in autobiographical memories from two life periods were found in specific regions of an autobiographical brain network. In aMCI patients, more than in controls, specifically episodic memories from early adulthood were associated with metabolic activity in the cuneus and in parietal regions. We hypothesized that variable retrieval of episodic autobiographical memories in our aMCI patients would be related to their variable capacity to reactivate specific sensory-perceptual and contextual details of early adulthood events linked to reduced (occipito-parietal) visual imagery and less efficient (parietal) attentional processes. For recent memories (last year), a correlation emerged between the proportion of episodic details and activity in lateral temporal regions and the temporo-parietal junction. Accordingly, variable episodic memory for recent events may be related to the efficiency of controlled search through general events likely to provide cues for the retrieval of episodic details and to the ability to establish a self perspective favouring recollection.

Frontal and posterior cingulate metabolic impairment in the behavioral variant of frontotemporal dementia with impaired autonoetic consciousness

Although memory dysfunction is not a prominent feature of the behavioral variant of frontotemporal dementia (bv-FTD), there is evidence of specific deficits of episodic memory in these patients. They also have problems monitoring their memory performance. The objective of the present study was to explore the ability to consciously retrieve own encoding of the context of events (autonoetic consciousness) and the ability to monitor memory performance using feeling-of-knowing (FOK) in bv-FTD. Analyses of the patients' cerebral metabolism (FDG-PET) allowed an examination of whether impaired episodic memory in bv-FTD is associated with the frontal dysfunction characteristic of the pathology or a dysfunction of memory-specific regions pertaining to Papez's circuit. Data were obtained from eight bv-FTD patients and 26 healthy controls. Autonoetic consciousness was evaluated by Remember responses during the recognition memory phase of the FOK experiment. As a group, bv-FTD patients demonstrated a decline in autonoetic consciousness and FOK accuracy at the chance level. While memory monitoring was impaired in most (seven) patients, four bv-FTD participants had individual impairment of autonoetic consciousness. They specifically showed reduced metabolism in the anterior medial prefrontal cortex, the left dorsolateral prefrontal cortex (near the superior frontal sulcus), parietal regions, and the posterior cingulate cortex. These findings were tentatively interpreted by considering the role of the metabolically impaired brain regions in self-referential processes, suggesting that the bv-FTD patients' problem consciously retrieving episodic memories may stem at least partly from deficient access to and maintenance/use of information about the self. Frontal and posterior cingulate metabolic impairment in the behavioral variant of frontotemporal dementia with impaired autonoetic consciousness

18F-flutemetamol amyloid imaging in Alzheimer disease and mild cognitive impairment: a phase 2 trial

OBJECTIVE

The most widely studied positron emission tomography ligand for in vivo beta-amyloid imaging is (11)C-Pittsburgh compound B ((11)C-PIB). Its availability, however, is limited by the need for an on-site cyclotron. Validation of the (18)F-labeled PIB derivative (18)F-flutemetamol could significantly enhance access to this novel technology.

METHODS

Twenty-seven patients with early-stage clinically probable Alzheimer disease (AD), 20 with amnestic mild cognitive impairment (MCI), and 15 cognitively intact healthy volunteers (HVs) above and 10 HVs below 55 years of age participated. The primary endpoint was the efficacy of blinded visual assessments of (18)F-flutemetamol scans in assigning subjects to a raised versus normal uptake category, with clinical diagnosis as the standard of truth (SOT). As secondary objectives, we determined the correlation between the regional standardized uptake value ratios (SUVRs) for (18)F-flutemetamol and its parent molecule (11)C-PIB in 20 of the AD subjects and 20 of the MCI patients. We also determined test-retest variability of (18)F-flutemetamol SUVRs in 5 of the AD subjects.

RESULTS

Blinded visual assessments of (18)F-flutemetamol scans assigned 25 of 27 scans from AD subjects and 1 of 15 scans from the elderly HVs to the raised category, corresponding to a sensitivity of 93.1% and a specificity of 93.3% against the SOT. Correlation coefficients between cortical (18)F-flutemetamol SUVRs and (11)C-PIB SUVRs ranged from 0.89 to 0.92. Test-retest variabilities of regional SUVRs were 1 to 4%.

INTERPRETATION

(18)F-Flutemetamol performs similarly to the (11)C-PIB parent molecule within the same subjects and provides high test-retest replicability and potentially much wider accessibility for clinical and research use.

Controlled memory processes in questionable Alzheimer's disease: a view from neuroimaging research

Alzheimer's disease (AD) is characterized by a progressive loss of controlled cognitive processes, and neuroimaging studies at early stages of AD provide an opportunity to tease out the neural correlates of controlled processes. Accordingly, controlled and automatic memory performance was assessed with the Process Dissociation Procedure in 50 patients diagnosed with questionable Alzheimer's disease (QAD). The patients' brain glucose metabolism was measured using FDG-PET. After a follow-up period of 36 months, 27 patients had converted to AD, while 23 remained stable. Both groups showed a similar decrease in controlled memory processes but preserved automatic processes at entry into the study. Voxel-based cognitive and metabolic correlations showed that a decrease in controlled memory processes was preferentially correlated with lower activity in the dorsomedial prefrontal and posterior cingulate cortices in very early AD patients. In stable QAD patients, reduced controlled performance in verbal memory correlated with impaired activity in the left anterior hippocampal structure. The results demonstrate the central role of a medial frontal-posterior cingulate network for controlled processing of episodic memory in the early stages of AD.

[Brain imaging of reflection on self]

Precise brain regions are activated when a subject gives a judgment on himself. Those are the medial parietal cortex, essentially related to episodic memory processing, and the ventromedial prefrontal cortex, recruited for evaluating the personal valence of an information. These regions are not activated in Alzheimer's disease. The decrease of awareness for own deficits in a patient with Alzheimer's disease would depend on a reduction of episodic memory capacities and a worsening of judgment for self significance.

Functional imaging of cognition in Alzheimer's disease using positron emission tomography

Positron emission tomography in Alzheimer's disease (AD) demonstrates a metabolic decrease, predominantly in associative posterior cortices (comprising the posterior cingulate cortex), and also involving medial temporal structures and frontal regions at a lesser degree. The level of activity in this wide network is roughly correlated with dementia severity, but several confounds (such as age, education or subcortical ischemic lesions) may influence the brain-behaviour relationship. Univariate analyses allow one to segregate brain regions that are particularly closely related to specific neuropsychological performances. For example, a relationship was established between the activity in lateral associative cortices and semantic performance in AD. The role of semantic capacities (subserved by temporal or parietal regions) in episodic memory tasks was also emphasized. The residual activity in medial temporal structures was related to episodic memory abilities, as measured by free recall performance, cued recall ability and recognition accuracy. More generally, AD patients' performance on episodic memory tasks was correlated with the metabolism in several structures of Papez's circuit (including the medial temporal and posterior cingulate regions). Multivariate analyses should provide complementary information on impaired metabolic covariance in functional networks of brain regions and the consequences for AD patients' cognitive performance. More longitudinal studies are being conducted that should tell us more about the prognostic value of initial metabolic impairment and the neural correlates of progressive deterioration of cognitive performance in AD.

The contribution of recollection and familiarity to recognition memory performance in chronic pain patients

This study examines the selective impact of chronic pain on memory functioning in a recognition task. Thirty chronic pain patients and 30 healthy control subjects performed a yes-no word recognition test. The contribution of recollection and familiarity to both groups' performance was compared by means of the Remember/Know (R/K) procedure, which distinguishes recognition based on the recollection of the encoding episode (R responses) and recognition accompanied by a feeling of familiarity (K responses). Chronic pain patients showed a decrease in recollection together with an increase in familiarity: indeed, they reported less R and more K responses than control subjects. This pattern of performance was not related to the overall recognition ability. These findings are consistent with the hypothesis of the attentional cost of chronic pain, suggesting a selective impact of chronic pain on the most attention-demanding cognitive processes, such as recollection. This study emphasises the relevance of specific procedures distinguishing the underlying components of memory functioning rather than solely global indicators.

The Effects of Aging on the Recognition of Different Types of Associations

The present study examined how aging influences item and associative recognition memory, and compared memory for two types of associations: associations between the same kinds of information and associations between different kinds of information. A group of young adults and a group of older adults performed a forced-choice face recognition task and two multitrial forced-choice associative recognition tasks, assessing memory for face-face and face-spatial location associations. The results showed disproportionate age-related decline of associative recognition compared to intact item recognition. Moreover, aging affected both types of associative tasks in the same way. The findings support an associative deficit hypothesis (Naveh-Benjamin, Journal of Experimental Psychology: Learning, Memory and Cognition, 26, 1170-1187, 2000), which attributes a substantial part of the age effect on episodic memory tasks to difficulty with binding individual components into a cohesive memory trace. This associative deficit seems to affect same-information associations, as well as different-information associations.

Variability in the Impairment of Recognition Memory in Patients with Frontal Lobe Lesions

Fourteen patients with frontal lobe lesions and 14 normal subjects were tested on a recognition memory task that required discriminating between target words, new words that are synonyms of the targets and unrelated distractors. A deficit was found in 12 of the patients. Moreover, three different patterns of recognition impairment were identified: (I) poor memory for targets, (II) normal hits but increased false recognitions for both types of distractors, (III) normal hit rates, but increased false recognitions for synonyms only. Differences in terms of location of the damage and behavioral characteristics between these subgroups were examined. An encoding deficit was proposed to explain the performance of patients in subgroup I. The behavioral patterns of the patients in subgroups II and III could be interpreted as deficient post-retrieval verification processes and an inability to recollect item-specific information, respectively.

Memory for temporal context: Effects of ageing, encoding instructions, and retrieval strategies

Young and older adults were compared on a list discrimination task. In Experiment 1, performance declined with ageing after incidental and intentional encoding of the temporal context. Moreover, there was no benefit for intentional encoding in either group. In Experiment 2, each list was associated with a different encoding context. There were age differences in performance when participants tried to retrieve the encoding context of the items as a cue for their list of occurrence, but not when participants evaluated temporal distance from the strength of the memory trace. This suggests that the age-related decrease in list discrimination could be at least partly due to a difficulty in inferring strategically the temporal context of the items from information encoded in the same time.

Dissociation between recall and recognition memory performance in an amnesic patient with hippocampal damage following carbon monoxide poisoning

Some patients with relatively selective hippocampal damage have shown proportionate recall and recognition deficits. Moreover, familiarity as well as recollection have been found to be impaired in some of these patients. In contrast, other patients with apparently similar damage presented with relatively preserved recognition despite having severely impaired recall, and some of these patients have been shown to have preserved familiarity. We report here the case of an amnesic patient who suffered bilateral hippocampal damage and temporoparietal atrophy after carbon monoxide poisoning. On tests matched for difficulty, his recall performance was more severely impaired than his recognition memory, for verbal as well as for visual materials. Moreover, he performed within the range of healthy matched subjects on nine recognition tests out of ten. In a task using the process dissociation procedure, the patient's familiarity was preserved although his recollection was impaired. These findings indicate that recall and recognition memory can be dissociated in amnesic patients with hippocampal lesions even when temporoparietal cortical atrophy is also present.

The effects of aging on location-based and distance-based processes in memory for time

Retrieving when an event occurred may depend on an estimation of the age of the event (distance-based processes) or on strategic reconstruction processes based on contextual information associated with the event (location-based processes). Young and older participants performed a list discrimination task that has been designed to dissociate the contribution of both types of processes. An adapted Remember/Know/Guess procedure [Can. J. Exp. Psychol. 50 (1996) 114] was developed to evaluate the processes used by the participants to recognize the stimuli and retrieve their list of occurrence. The results showed that aging disrupts location-based processes more than distance-based processes. In addition, a limitation of speed of processing and working-memory capacities was the main predictor of age-related differences on location-based processes, whereas working-memory capacities mediated partly age differences on distance-based processes.

The contribution of recollection and familiarity to recognition memory: a study of the effects of test format and aging

Whether the format of a recognition memory task influences the contribution of recollection and familiarity to performance is a matter of debate. The authors investigated this issue by comparing the performance of 64 young (mean age = 21.7 years; mean education = 14.5 years) and 62 older participants (mean age = 64.4 years; mean education = 14.2 years) on a yes-no and a forced-choice recognition task for unfamiliar faces using the remember-know-guess procedure. Familiarity contributed more to forced-choice than to yes-no performance. Moreover, older participants, who showed a decrease in recollection together with an increase in familiarity, performed better on the forced-choice task than on the yes-no task, whereas younger participants showed the opposite pattern.

A biomechanical study of the ulnar nerve at the elbow

The relative elongation with elbow flexion of the ulnar nerve, proximal and distal to the cubital tunnel, and of the cubital tunnel retinaculum, was measured in cadaver specimens by stereophotogrammetry. The proximal part of the ulnar nerve elongated significantly with full elbow flexion. No significant change of length was measured in the distal part of the nerve. The length of the cubital tunnel retinaculum increased by an average of 45% from full elbow extension to full flexion.

Hepatitis B virus-specific cytotoxic T lymphocyte responses in patients with acute and chronic hepatitis B virus infection

An in vitro model was developed that allowed the analysis of hepatitis B virus-specific cytotoxic T lymphocyte responses in patients suffering from acute and chronic hepatitis B virus infections. Since virus-specific cytotoxic T lymphocytes recognize endogenously synthesized and processed antigen only when it is presented in the context of autologous HLA class I molecules and since hepatitis B virus does not infect human cells in vitro, a panel of recombinant vaccinia viruses was constructed to induce the expression of hepatitis B virus envelope and nucleocapsid proteins in cultured primary cells or cell lines derived from the patients to be studied. In order for a cytotoxic T lymphocyte response to be detectable with the currently available techniques, a sufficient number of activated cytotoxic T lymphocytes is required. To meet this requirement, lymphocytes freshly isolated from venous blood were stimulated in vitro with recombinant vaccinia-infected and formaldehyde-fixed autologous T lymphoblasts. The presence of hepatitis B virus-specific cytotoxic T lymphocytes, amplified and activated during this induction culture, was demonstrated in a microcytotoxicity assay using 51Cr-labeled, recombinant vaccinia-infected Epstein-Barr virus-immortalized, autologous B lymphocytes as target cells. Using this in vitro model, we were able to demonstrate the presence of hepatitis B virus envelope- and nucleocapsid-specific cytotoxic T lymphocytes in venous blood from one subject who had recently recovered from an acute hepatitis B virus infection and in three patients suffering from chronic hepatitis B virus infections. No hepatitis B virus-specific cytotoxic T lymphocytes activity was discernible in the venous blood from two vaccine recipients.(ABSTRACT TRUNCATED AT 250 WORDS)

[Psychological profile with Cushing disease (author's transl)]

Fifty-six patients with clinically and biologically unequivocal Cushing disease underwent psychological evaluation including at least one interview, a graphological test, a tree test, and a Szondi test. Patients were found to be hyperadapted, with a rigid repressive system, concealing major anxiety. These patients are closely dependent on their familial and professional affective relationships. This probably establishes the intensity of their repressive system. They need approval, appreciation, and recognition. Obsessional features are found (scrupulous conscience, compulsive activity) as well as manic-depressive features (fluctuations between depression and euphoric activity acting as a defense against depression). During the interviews it was established that onset of Cushing disease occurred a few months after prolonged stress; this stress dealt electively with the patients affective relationships.