[Pure progressive amnesia, isolated for 16 years with focal hippocampus atrophy]

INTRODUCTION

Pure progressive amnesia is a rare and unusual syndrome involving long preservation of autonomy and absence of progression in other cognitive domains.

CASE REPORT

We report a case which remained quiescent for 16 years characterized by severe isolated episodic amnesia and preservation of spatial, semantic and implicit memory and autonomy. MRI revealed bilateral focal atrophy of the hippocampus.

CONCLUSION

This specific pattern of impairment differs from other types of amnesic syndromes. It is important to identify this kind of amnesia because of its specific course. Studying the topography of the brain lesions may contribute to a better understanding of the neural systems involved in declarative memory.

[Memory complaints and anxiety. Apropos of 40 patients attending a specialized memory consultation]

This study reports results of the specialized memory consultation based on 2 successive examinations, one by a neurologist, the other by a psychologist, of 40 anxious subjects with or without social phobias. Traumatic events were frequent and we observed Alzheimer's disease in the family of 41.9% of subjects. Anxious subjects obtained a high score in Mac Nair questionnaire [44.05 (16,49)]. Their principal complaints were attentional difficulties. They obtained normal but low performances for free recall of 10 pictures, logical memory (QM), and inverse span. Mac Nair score was only correlated with logical memory score. Standardized psychometric evaluation showed short-term memory difficulties. Attention seems to be unstable and anxious individuals have relatively limited attentional resources. They are preoccupied by their anxiety and thus have less ability to focus on tasks.

Procedural memory: computer learning in control subjects and in Parkinson's disease patients

We used perceptual motor tasks involving the learning of mouse control by looking at a Macintosh computer screen. We studied 90 control subjects aged between sixteen and seventy-five years. There was a significant time difference between the scales of age but improvement was the same for all subjects. We also studied 24 patients with Parkinson's disease (PD). We observed an influence of age and also of educational levels. The PD patients had difficulties of learning in all tests but they did not show differences in time when compared to the control group in the first learning session (Student's t-test). They learned two or four and a half times less well than the control group. In the first test, they had some difficulty in initiating the procedure and learned eight times less well than the control group. Performances seemed to be heterogeneous: patients with only tremor (seven) and patients without treatment (five) performed better than others but learned less. Success in procedural tasks for the PD group seemed to depend on the capacity to initiate the response and not on the development of an accurate strategy. Many questions still remain unanswered, and we have to study different kinds of implicit memory tasks to differentiate performance in control and basal ganglia groups.

[Specialized memory consultation and management of dementia syndrome]

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.

[Spelling impairments. Neuropsychological study in two adolescents with developmental dysgraphia]

Two adolescents 14 and 16 years of age presented with isolated developmental agraphia. The spelling errors were correlated with the degree of orthographic ambiguity and with the word frequency as in acquired agraphia. Patients used to simplify the words spelling and to follow the phoneme-grapheme conversion. The deficit is interpreted as a failure of a selective visual memory for irregular words, representing a developmental graphemic logogene impairment. The better performance of reading is interpreted in relation to phonological system integrity which could better supply the grapheme phoneme conversion of reading even for irregular words. The ambiguous and irregular words recognition during reading appeared easier than their spelling during writing. Short term and working memory for irregular words appeared normal; the deficit occurred only for the long term recall after 20 minutes. Learning of 20 irregular words was made possible in one case by selective reminding of the errors. In spite of normal MRI, a developmental disorder involving the angular gyrus is proposed as for acquired lexical agraphia in adults.

[Aging and procedural memory. Study of a series of tests on microcomputers]

The authors have assessed perceptual motor tasks involving the learning of the mouse control by locking at a Macinthosh computer screen during three consecutive sessions. Tests were performed by 102 control subjects aged between 16 and 85 years. Concerning age, there was a significant time difference (ANOVA) but improvement was the same for all subjects. Educational level and IQP results didn't influence procedural performance. Men were faster in three tasks. We can argue that implicit learning abilities appear before explicit memory and within the adult life span there appears to be little significant deterioration in implicit memory abilitie.