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Planton M, Lemesle B, Cousineau M, Carlier J, Milongo-Rigal E, Carle-Toulemonde G, Salles J, Pariente J. The role of neuropsychological assessment in adults with attention deficit/hyperactivity disorders. Rev Neurol (Paris) 2021; 177:341-348. [PMID: 33618892 DOI: 10.1016/j.neurol.2021.01.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 01/02/2021] [Accepted: 01/14/2021] [Indexed: 12/01/2022]
Abstract
Attention-Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder characterized by inattention, hyperactivity and/or impulsivity. While ADHD was initially recognized as a childhood syndrome, scientific evidence accumulated to indicate that a significant proportion of ADHD children continue to experience symptoms of ADHD in adulthood. Moreover, the question of ADHD diagnosis can arise in adult patients who were not diagnosed in childhood. Currently, the diagnosis of ADHD in adulthood is based on the revised criteria described for children. However, their application for adults may be difficult for many reasons including compensation and comorbid disorders. To date, no clinical, neuropsychological, biological or imaging marker is available for the diagnosis of ADHD. Considering that ADHD is based on a neuropsychological model, in this article we will examine the usefulness of neuropsychological testing in the diagnosis in adults. We will first present diagnostic criteria of ADHD and the limits of their application in adults. We will then detail the neuropsychological data available in adult ADHD and the French and international clinical recommendations for neuropsychological assessment. Finally, we will explore the predictive value of neuropsychological scores in the diagnosis of ADHD and discuss key methodological points and perspectives for clinical research.
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Affiliation(s)
- M Planton
- Department of Neurology, Toulouse University Hospital, Toulouse, France; Inserm UMR1214, UPS, Toulouse NeuroImaging Center, Université de Toulouse, Toulouse, France.
| | - B Lemesle
- Department of Neurology, Toulouse University Hospital, Toulouse, France
| | - M Cousineau
- Department of Neurology, Toulouse University Hospital, Toulouse, France
| | - J Carlier
- Department of Neurology, Toulouse University Hospital, Toulouse, France
| | - E Milongo-Rigal
- Department of Neurology, Toulouse University Hospital, Toulouse, France
| | - G Carle-Toulemonde
- Department of Emergency Psychiatry and Consultation-Liaison Psychiatry, Toulouse University Hospital, Toulouse, France
| | - J Salles
- Department of Emergency Psychiatry and Consultation-Liaison Psychiatry, Toulouse University Hospital, Toulouse, France
| | - J Pariente
- Department of Neurology, Toulouse University Hospital, Toulouse, France; Inserm UMR1214, UPS, Toulouse NeuroImaging Center, Université de Toulouse, Toulouse, France
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Pistono A, Jucla M, Bézy C, Lemesle B, Le Men J, Pariente J. Discourse macrolinguistic impairment as a marker of linguistic and extralinguistic functions decline in early Alzheimer's disease. Int J Lang Commun Disord 2019; 54:390-400. [PMID: 30444044 DOI: 10.1111/1460-6984.12444] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Revised: 10/26/2018] [Accepted: 10/29/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Alzheimer's disease is characterized by macrolinguistic changes. This decline is often analyzed with quantitative scales. AIMS To analyze discourse production in early Alzheimer's disease (AD) and to identify qualitative markers of macrolinguistic decline. METHODS & PROCEDURES We analyzed macrolinguistic features of a clinical narrative task along with patients' cognitive changes. To do so, 17 early AD participants and 17 healthy controls were recruited and given a full neuropsychological and language assessment. Narrative discourses produced during the language assessment were transcribed and macrolinguistic features were qualitatively analyzed (i.e., local and global coherence marks and discourse informativeness). Inter-group comparison was complemented by intra-group correlation. As some inter-group comparisons revealed the existence of subgroups of patients, permutation tests were used to investigate how these subgroups differed vis-à-vis cognitive measures. OUTCOMES & RESULTS Overall, the results indicate that AD participants presented declines in informativeness and global coherence, correlated with declines in memory and executive functions. Permutation tests showed that participants with AD producing referential errors or misinterpretations had a deeper lexical-executive decline and a lower Mini-Mental State Evaluation (MMSE). CONCLUSIONS & IMPLICATIONS This study shows that two clinically relevant, qualitative signs differ in discourse production between typical ageing and early AD, namely information units and modalizing discourse. It also shows that macrolinguistic assessment is a useful tool for revealing impaired communication and cognition in early AD. Although lexical processing decline probably contributes to patients' macrolinguistic impairment, implications of extralinguistic functioning should be further investigated.
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Affiliation(s)
- Aurélie Pistono
- Octogone-Lordat Interdisciplinary Research Unit (EA 4156), University of Toulouse II-Jean Jaurès, Toulouse, France
- Toulouse NeuroImaging Center, Toulouse University, Inserm, UPS, France
| | - M Jucla
- Octogone-Lordat Interdisciplinary Research Unit (EA 4156), University of Toulouse II-Jean Jaurès, Toulouse, France
| | - C Bézy
- Neurology Department, Toulouse University Hospital, Toulouse, France
| | - B Lemesle
- Neurology Department, Toulouse University Hospital, Toulouse, France
| | - J Le Men
- Neurology Department, Toulouse University Hospital, Toulouse, France
| | - J Pariente
- Toulouse NeuroImaging Center, Toulouse University, Inserm, UPS, France
- Neurology Department, Toulouse University Hospital, Toulouse, France
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Salles J, Pariente J, Dimeglio C, Gandia P, Lemesle B, Giron A, Franchitto N, Schmitt L, Very E. Patient emergency assessment following deliberate self-poisoning with benzodiazepines: Can cognitive markers predict recall of the psychiatric interview? A pilot study. J Psychopharmacol 2017; 31:1362-1368. [PMID: 28441901 DOI: 10.1177/0269881117705088] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
STUDY HYPOTHESIS In cases of deliberate self-poisoning (DSP), patients often ingest benzodiazepines (BZDs), known to alter memory. Experts recommend recovery of the patient's cognitive capacity before psychiatric assessment. Unfortunately, there is no validated tool in common practice to assess whether sufficient cognitive recovery has occurred after DSP with BZDs to ensure patient memory of the assessment. OBJECTIVE The aim of the study was to identify cognitive functions and markers which predict preserved memory of the mental health care plan proposed at the emergency department after DSP. METHODS We recruited patients admitted for DSP with BZDs and control patients. At the time of the psychiatric assessment, we performed cognitive tests and we studied the relationship between these tests and the scores of a memory test performed 24 h after. RESULTS In comparison with the control group, we found memory impairment in the BZD group. We found significant impairment on the Trail Making Test A (TMT A) in the BZD group in comparison with the control group, while TMT A and Wechsler Adult Intelligence Scale (WAIS) Coding test scores were significantly correlated with memory scores. CONCLUSIONS Attentional functions tested by WAIS Coding test and TMT A were correlated with memory score. It could be profitable to assess it in clinical practice prior to a psychiatric interview.
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Affiliation(s)
- J Salles
- 1 Inserm, UMR 1214, Toulouse, France.,2 Université de Toulouse III, Toulouse, France.,3 CHU Toulouse, Service de Psychiatrie et Psychologie, Toulouse, France
| | - J Pariente
- 1 Inserm, UMR 1214, Toulouse, France.,2 Université de Toulouse III, Toulouse, France.,7 CHU Toulouse, Service de Neurologie, Neurosciences, Toulouse, France
| | - C Dimeglio
- 2 Université de Toulouse III, Toulouse, France.,4 CHU Toulouse, Service d'Épidémiologie, Santé Publique et Médecine Sociale, Toulouse, France.,5 Inserm, UMR 1027, Toulouse, France
| | - P Gandia
- 2 Université de Toulouse III, Toulouse, France.,6 CHU Toulouse, Service de Pharmacocinétique et Toxicologie, Institut Fédératif de Biologie, Toulouse, France
| | - B Lemesle
- 7 CHU Toulouse, Service de Neurologie, Neurosciences, Toulouse, France
| | - A Giron
- 2 Université de Toulouse III, Toulouse, France.,3 CHU Toulouse, Service de Psychiatrie et Psychologie, Toulouse, France
| | - N Franchitto
- 2 Université de Toulouse III, Toulouse, France.,8 CHU Toulouse, Service d'Addictologie Clinique, Urgences Réanimation Médecine, Toulouse, France.,9 CHU Toulouse, Service Urgences et Réanimation, Urgences et Réanimation Médecine, Toulouse, France
| | - L Schmitt
- 1 Inserm, UMR 1214, Toulouse, France.,2 Université de Toulouse III, Toulouse, France.,3 CHU Toulouse, Service de Psychiatrie et Psychologie, Toulouse, France
| | - E Very
- 1 Inserm, UMR 1214, Toulouse, France.,2 Université de Toulouse III, Toulouse, France.,3 CHU Toulouse, Service de Psychiatrie et Psychologie, Toulouse, France
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Lemesle B, Planton M, Pagès B, Pariente J. Accelerated long-term forgetting and autobiographical memory disorders in temporal lobe epilepsy: One entity or two? Rev Neurol (Paris) 2017; 173:498-505. [PMID: 28843413 DOI: 10.1016/j.neurol.2017.07.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Revised: 06/28/2017] [Accepted: 07/04/2017] [Indexed: 11/16/2022]
Abstract
Temporal lobe epilepsy (TLE) is a type of epilepsy that often has a negative impact on patients' memory. Despite the importance of patients' complaints in this regard, the difficulties described by these patients are often not easy to demonstrate through a standard neuropsychological assessment. Accelerated long-term forgetting and autobiographical memory disorders are the two main memory impairments reported in the literature in patients with TLE. However, the methods used by different authors to evaluate long-term memory and autobiographical memory are heterogeneous. This heterogeneity can lead to differences in the observed results as well as how they are interpreted. Yet, despite the methodological differences, objectification of such memory deficits appears to be both specific and robust within this patient population. Analysis of the literature shows that accelerated long-term forgetting and autobiographical memory disorders share the same clinical characteristics. This leads to the assumption that they are, in fact, only one entity and that their evaluation may be done through a single procedure. Our proposal is to place this evaluation within the context of memory consolidation disorders. With such a perspective, evaluation of accelerated forgetting in autobiographical memory should consist of identifying a disorder in the formation and/or recovery of new memory traces.
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Affiliation(s)
- B Lemesle
- Department of neurology, Toulouse university hospital, place du Dr-Baylac, 31059 Toulouse cedex, France; Toulouse neuroimaging center, université de Toulouse, Inserm, UPS, place du Dr-Baylac, 31059 Toulouse cedex, France.
| | - M Planton
- Department of neurology, Toulouse university hospital, place du Dr-Baylac, 31059 Toulouse cedex, France; Toulouse neuroimaging center, université de Toulouse, Inserm, UPS, place du Dr-Baylac, 31059 Toulouse cedex, France
| | - B Pagès
- Department of neurology, Toulouse university hospital, place du Dr-Baylac, 31059 Toulouse cedex, France; Toulouse neuroimaging center, université de Toulouse, Inserm, UPS, place du Dr-Baylac, 31059 Toulouse cedex, France
| | - J Pariente
- Department of neurology, Toulouse university hospital, place du Dr-Baylac, 31059 Toulouse cedex, France; Toulouse neuroimaging center, université de Toulouse, Inserm, UPS, place du Dr-Baylac, 31059 Toulouse cedex, France
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Planton M, Peiffer S, Albucher JF, Barbeau EJ, Tardy J, Pastor J, Januel AC, Bezy C, Lemesle B, Puel M, Demonet JF, Chollet F, Pariente J. Neuropsychological outcome after a first symptomatic ischaemic stroke with ‘good recovery’. Eur J Neurol 2011; 19:212-9. [DOI: 10.1111/j.1468-1331.2011.03450.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Planton M, Peiffer S, Albucher JF, Barbeau E, Tardy J, Pastor J, Januel AC, Bezy C, Lemesle B, Puel M, Demonet JF, Chollet F, Pariente J. Évaluation du fonctionnement cognitif et psychocomportemental après un premier infarctus cérébral symptomatique. Rev Neurol (Paris) 2010. [DOI: 10.1016/s0035-3787(10)70022-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Thomas-Antérion C, Regetti I, Lemesle B, Foyatier-Michel N, Laurent B, Michel D. [Specialized memory consultation and management of dementia syndrome]. Rev Med Interne 1995; 16:255-9. [PMID: 7746964 DOI: 10.1016/0248-8663(96)80704-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The specialized memory consultation is based on two successive examinations: one by a neurologist, the other by a psychologist, using standardized batteries of tests. In 200 consecutive subjects with 63.8 years mean age, the authors observe dementia syndromes (39%), age related disorders of memory (6.5%), psychiatric disorders (28.5%), disorders after brain injury or neurosurgery (18.5%) and medical neurological pathologies (5.5%). Patients are addressed by practician in 34.5%. In the group of 78 patients with dementia syndrome were studied the delay before consultation, familial story, memory complaints of patients and family and diagnosis. In subjects with memory complaints a psychometric evaluation performed by a team of specialists seems to be a mean of refining the diagnosis and to improve a personalized management.
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