Cognitive emotion regulation questionnaire: Psychometric properties of the Tunisian version.

OBJECTIVES: This study investigated the psychometric properties of the Cognitive Emotion Regulation Questionnaire in a Tunisian Arabic-Speaking population. METHOD: The CERQ original version was translated and back-translated and then administrated to 360 participants. Afterwards, using the explanatory and confirmatory factor analysis, we studied the latent factor structure for CERQ. The internal consistency of the subscales was assessed by Cronbach's alfa coefficients, and the test-retest and interscale reliability were assessed with Pearson correlations. The criterion validity was also examined using correlations between the CERQ subscales and both the Beck Depression Inventory (BDI) and State-Trait Anxiety Inventory (STAI) scales at first evaluation and at a one year follow-up. RESULTS: The Tunisian version was quite satisfactory with the nine-factor structure, as in the original CERQ. Moreover, all validity and reliability measures were comparable to the original CERQ. CONCLUSION: The present study is the first work devoted to a Tunisian adaptation of the CERQ. Our findings highlight that the Tunisian version is both reliable and valid for the measurement of cognitive emotion regulation strategies.

Gestural apraxia.

Gestural apraxia was first described in 1905 by Hugo Karl Liepmann. While his description is still used, the actual terms are often confusing. The cognitive approach using models proposes thinking of the condition in terms of production and conceptual knowledge. The underlying cognitive processes are still being debated, as are also the optimal ways to assess them. Several neuroimaging studies have revealed the involvement of a left-lateralized frontoparietal network, with preferential activation of the superior parietal lobe, intraparietal sulcus and inferior parietal cortex. The presence of apraxia after a stroke is prevalent, and the incidence is sufficient to propose rehabilitation.

Within-population Y-linked genetic variation for lifespan in Drosophila melanogaster.

The view that the Y chromosome is of little importance for phenotypic evolution stems from early studies of Drosophila melanogaster. This species' Y chromosome contains only 13 protein-coding genes, is almost entirely heterochromatic and is not necessary for male viability. Population genetic theory further suggests that non-neutral variation can only be maintained at the Y chromosome under special circumstances. Yet, recent studies suggest that the D. melanogaster Y chromosome trans-regulates hundreds to thousands of X and autosomal genes. This finding suggests that the Y chromosome may play a far more active role in adaptive evolution than has previously been assumed. To evaluate the potential for the Y chromosome to contribute to phenotypic evolution from standing genetic variation, we test for Y-linked variation in lifespan within a population of D. melanogaster. Assessing variation for lifespan provides a powerful test because lifespan (i) shows sexual dimorphism, which the Y is primarily predicted to contribute to, (ii) is influenced by many genes, which provides the Y with many potential regulatory targets and (iii) is sensitive to heterochromatin remodelling, a mechanism through which the Y chromosome is believed to regulate gene expression. Our results show a small but significant effect of the Y chromosome and thus suggest that the Y chromosome has the potential to respond to selection from standing genetic variation. Despite its small effect size, Y-linked variation may still be important, in particular when evolution of sexual dimorphism is genetically constrained elsewhere in the genome.

Assessment of everyday executive functioning in children with frontal or temporal epilepsies.

Executive functions are particularly vulnerable in case of brain disruption during childhood, when the brain is not fully mature. Some studies showed impairments of executive functions in children with epilepsy, but only a few of them investigated the impact of executive dysfunctions on daily life. The aim of this study was to understand the everyday executive functioning of children with epilepsy both at home and in school. We administered the Behavior Rating Inventory of Executive Function to parents and teachers of 53 children (7-16 years of age) with structural epilepsies or epilepsies of unknown cause of temporal lobe (n=25) or frontal lobe (n=28). The results indicated a global executive impairment in the whole group of patients, compared with normative data, with no difference between the group with temporal lobe epilepsy (TLE) and that with frontal lobe epilepsy (FLE), except for monitor domain, which seemed more frequently impaired in the group with FLE. Congruence between parent and teacher ratings was found. The frequency of seizures was not related to executive dysfunction, whereas the number of antiepileptic drugs tended to positively correlate with working memory impairment. Onset of epilepsy at a younger age was also related to more executive difficulties but only according to teacher ratings. Lastly, duration of epilepsy was strongly associated with executive deficits reported in the context of school. Our results support the executive dysfunction hypothesis in daily life of children with structural focal epilepsy or focal epilepsy of unknown cause and are consistent with the early brain vulnerability hypothesis currently prevalent in the context of child neuropsychology. The BRIEF appears to be a clinically useful tool for assessing executive function impairment in this clinical population.

Utilization behavior: clinical and theoretical approaches.

Lhermitte (1983) coined the term "utilization behavior" (UB) to define a neurobehavioral syndrome in which the visuo-tactile presentation of objects compels patients to grasp and use them, despite the fact that they have not been instructed to do so. The author suggested that UB was the consequence of frontal lobe damage. Thereafter, Shallice, Burgess, Schon, and Baxter (1989) questioned Lhermitte's (1983) procedure for eliciting UB, putting forward an alternative research methodology that led to differentiate two forms of UB: "induced" and "incidental." To date, there has been no direct comparison between these two procedures, nor have any other methodologies been used to explore this clinical sign, which is related to fundamental concepts such as free will and human autonomy. We investigated UB in 70 subjects (25 patients with frontal lobe lesions, 10 patients with posterior brain damage and 35 control subjects) using the methodologies of Lhermitte (1983) and Shallice et al. (1989), as well as an original "verbal generation" procedure. Our results show that the verbal generation procedure reveals UB efficiently and that elicitation of this sign appears to be directly linked to the content of the task. We discuss the interpretation of UB in terms of an executive control deficit.

Psychosocial quality of life in patients after total laryngectomy.

OBJECTIVES: To examine Psychosocial Quality-of Life (PSQL) changes occurring over time among patients treated for laryngeal carcinoma by total laryngectomy. METHODS: A retrospective, observational transversal study was performed on PSQL changes over time in laryngeal carcinoma patients having undergone total laryngectomy. Patients were interviewed using a questionnaire developed by two sociologists and a head and neck surgeon. Changes over time were assessed according to information with regards to smoking, alcohol consumption, psychological well-being, social life, family support, occupation and medical and demographic data regarding age, gender, verbal communication and patient appearance. POPULATION: 150 patients completed the questionnaire. All were aged over 50 years at the time of surgery (total laryngectomy). Eighty-five percent of patients were smokers and 81% drinkers. On average, the questionnaires were completed by patients 6 years after surgery. RESULTS: Before and after total laryngectomy, no statistical differences were noted for marital status (p = 1.000), frequency of dining at home with friends (p = 0.175), frequency of weekend outings (p = 0.092) or frequency of holidays (p = 0.565). A significant decrease was noted for smoking and drinking (p < 0.001), frequency of going to a café (p < 0.001), frequency of dinner outings at friends' homes (p = 0.032) and frequency of going out to a restaurant (p < 0.001). A significant increase was observed in: owning a pet (p = 0.02) and time spent watching television (p < 0.001). CONCLUSION: The two latter results are indicative of feelings of solitude among total laryngectomees. Tracheostoma and voice deprivation are limiting factors in social relationships, hence pushing individuals into withdrawal.

[Frontal lobe, executive functions and cognitive control]. / Lobe frontal, fonctions exécutives et controle cognitif.

The approach of executive functions began with the early description of behavioural disorders induced by frontal damage. The development of neuropsychology has led to the description of a large variety of cognitive disorders. The interpretation in cognitive terms of these disorders has emphasized the critical impairment of executive functions which are involved in non-routine situations. The role of working memory, initially suggested by animal studies, has also largely influenced theoretical approaches. Numerous studies have been interpreted within the theoretical frameworks developed by Shallice and by Baddeley. A large amount of studies have allowed the specification of control processes (initiation, inhibition...). Recent studies are beginning to investigate cognitive disorders underlying behavioural changes such as deficits of emotional, social and metacognitive processes. In addition these studies seriously question the assumption of a unique central control system. These studies have deeply influenced the clinical approach, the assessment and the diagnosis of executive syndrome. For clinical practice, these data lead to favour specific assessment of some key behavioural and cognitive deficits based on a battery of tests and structured interview of an informant.

Cognitive changes in asymptomatic carriers of the Huntington disease mutation gene.

Huntington disease (HD) is a neurodegenerative disorder due to an excessive number of CAG repeats in the IT15 gene on chromosome 4. Studies of cognitive function in asymptomatic gene carriers have yielded contradictory results. This study compared cognitive performance in 44 subjects with the HD mutation (group of carriers) who had no clinical signs of HD and 39 at-risk individuals without HD mutation (group of non-carriers). Neuropsychological evaluation focused on global cognitive efficiency, psychomotor speed, attentional, executive and memory functions. Significant differences, with lower performances in the group of gene carriers, were detected for some measures of psychomotor speed, attention and executive functioning (all P < 0.01). More differences between groups were observed for memory measures, in particular on the California Verbal Memory Test. Complementing these observations, cognitive scores were correlated with age in the group of gene carriers, but not in the group of non-carriers. This suggests that the cognitive changes precede the appearance of the motor and psychiatric symptoms in HD and that tests proved to be sensitive to early HD deficiencies are better suited than global cognitive efficiency scales to observe them.

[A study of action planning in patients with Alzheimer's disease using the zoo map test]. / Etude de la planification de l'action au moyen du test du plan du zoo dans la maladie d'Alzheimer.

INTRODUCTION: Executive dysfunction is regularly reported in patients with Alzheimer's disease. Nevertheless few studies have focused on planning ability in this neurodegenerative disease. OBJECTIVES: This study aimed to investigate the formulation and the execution of plans in Alzheimer's disease using an ecological planning subtask derived from the Behavioural Assessment of the Dysexecutive Syndrome test battery, the "Zoo Map Test". There are two trials. The first trial consists of a "high demand" version of the subtask in which the subjects must plan in advance the order in which they will visit designated locations in a zoo (formulation level). In the second, or "low demand" version, the subject is simply required to follow a concrete externally imposed strategy to reach the locations to visit (execution level). The test was given to 16 patients with Alzheimer's disease and 13 normal elderly subjects. RESULTS: The two way ANOVAs mainly showed more difficulties in patients with Alzheimer's disease than in healthy elderly in both conditions. The difference between formulation and execution was greater in patients with Alzheimer's disease than in healthy elderly. Planning impairments mainly correlated with behavioural changes (in particular motivational changes) observed by patient's relatives. CONCLUSION: These results suggest that patients with Alzheimer's disease have some problems to mentally develop logical strategies and to execute complex predetermined plans, which are partially related to behavioural changes.

[Eating behavior in pediatric obesity: Of the advantages of combining the neurobiological and neuropsychological approaches]. / Comportement alimentaire de l'enfant et de l'adolescent souffrant d'obésité : intérêt d'un couplage des approches neurobiologique et neuropsychologique.

Obesity is currently considered a major public health concern, as shown by the growing number of people with excess weight, alarmingly in infants, and despite medical care. Many studies have underlined the reasons for medical care failure caused by an inability to sustain a resistant behavior towards palatable food (high sugar and fat content). Hence, previous research has highlighted connections between excessive eating behavior and the activity of neurotransmitters in brain areas involved in affective behavior and the reward circuit. Reduction of the dopaminergic activity in the prefrontal orbital and limbic cortex may raise the question of executive skills, which play a major role in social adaptation and behavior control. These findings remind us of the need to grasp environmental and behavioral factors to better identify cognitive and affective profiles and improve childhood obesity treatment.

Discrepancy between social and nonsocial decision-making under uncertainty following prefrontal lobe damage: the impact of an interactionist approach.

Deficits in decision-making are thought to contribute significantly to socio-behavioral impairments of patients with frontal lobe damage. The purpose of this study was to test the hypothesis of whether the inappropriate social behavior of patients with frontal lesions can be viewed as the product of a general failure of decision-making ability or as the result of socio-cognitive impairment. We studied a group of patients with prefrontal lesions (FL patients, n = 15) and a group of matched healthy controls (n = 30) on the Iowa Gambling task (IGT) of nonsocial decision-making, environmental dependency phenomena (EDP) during social interaction, and the "reading the mind in the eyes" and "character intention task" of theory of mind (TOM) tasks. The FL patients were impaired in both TOM and EDP protocols but, surprisingly, they behaved appropriately in the IGT. In addition, FL patients with EDP did not differ in executive functioning, IGT and TOM measures from those who did not demonstrate these behavioral disorders. The right orbitofrontal cortex was associated with social decision-making deficits. By adopting an interactionist approach, this study raises the possibility of identifying components of social and nonsocial decision-making, which could be helpful in understanding the behavioral disorders of FL patients.

Cognitive functions in chronic locked-in syndrome: a report of two cases.

We describe a 38-year-old woman and a 38-year-old man who have been living in a "locked-in" condition 3 and 2 years, respectively. Extensive neuropsychological testing, carried out with a communication aid system (writing apparatus) which exploited the patients residual eye movements, showed preserved cognitive abilities in spite of the long standing de-efferentation.

[Obsessive-compulsive behavior (arithmomania). Atrophy of the caudate nuclei]. / Comportement compulsif d'allure obsessionnelle (arithmomanie). Atrophie des noyaux caudés.

We report the case of a 56-year-old woman who died after a 2.5 years progressive course of behavioral disorders associating severe obsessive-compulsive counting with disinhibition. Neuropathological examination showed severe gliosis of the caudate nuclei whereas the lentiform nuclei and frontal cortex were not involved. In contrast with previous reports, this case lacked psychic akinesia which is usually combined with obsessive-compulsive behavior. It is a further illustration of how subcortical lesions can produce a frontal like syndrome. It suggests a fundamental role of the caudate nuclei in the control of behavior.

[Clinico-pathologic case of slowly progressive herpes simplex encephalitis without temporal necrosis]. / Un cas clinico-pathologique d'encéphalite herpétique lentement progressive sans nécrose temporale.

A case of herpes simplex encephalitis (HSE) is reported. The patient experienced short term memory disorders and irritability progressing over 3 months, without seizures or fever. The CSF was normal. CT showed a small low density area in the right posterior orbito-frontal region. At post-mortem examination, one month later, the temporal cortex appeared largely spared by necrosis, which involved the posterior orbito-frontal areas. Cowdry type A inclusions, herpes virus like particles and fluorescent reaction with HSV1 monoclonal antibodies strongly supported the diagnostic. Such atypical cases of long duration have apparently seldom been reported. They suggest that HSE should be considered in the differential diagnosis of a subacute encephalopathy.

[Intellectual and mood disorders in multiple sclerosis]. / Troubles intellectuels et thymiques dans la sclérose en plaques.

Reports of frequency and interpretation of intellectual and mood disorders differ in multiple sclerosis (MS). Forty-one patients with MS defined according to MacAlpine's criteria were evaluated by psychometric tests (WAIS) and neuropsychologic examinations (study of language, gnosic and praxic activities, dynamic gestural organization, memory and learning) together with, in 24 of them, the AMDP psychopathologic rating scale. Intellectual disorders were noted in 65 p. 100 of patients. Although more frequent in severe and chronic forms they were nevertheless of early onset since more than a half of the patients with onset of disease less than 5 years ago were affected. Their semiology was fairly homogeneous, combining disturbances of dynamic gestural organization (decomposition or simplification) and memory and learning deficiencies without anomalies of instrumental functions or usual psychometric mental deterioration. Application of the AMDP scale failed to reveal any psychotic type of disorders. Mood disturbances were predominant, affecting 60 p. 100 of the subpopulation studied (24 cases) and combining, in an unexpected manner: dysphoria, euphoria and depression. Only euphoria appeared to be correlated with intellectual disorders. Frequency of both intellectual and mood disorders was similar to that reported in other series published. The relative homogeneity of semiology, seen by the correlation between the different disturbances (decomposition and simplification, plateau learning curve and euphoria) and the unusual grouping of these effects, is suggestive of their organic basis. In addition, signs and symptoms resemble the neuropsychological expression of frontal lobe lesions and certain lesions of central grey nuclei.(ABSTRACT TRUNCATED AT 250 WORDS)

[Incidence of grasping and its relationship to cerebral lesions]. / Comportement de grasping: incidence clinique et corrélations anatomo-cliniques.

Grasping is associated with frontal lobe pathology. Nevertheless, there is lack of precise anatomical correlations and very few studies are published. The aim of the study was to determine the incidence of the grasping and its relationship to cerebral lesions. We studied 236 patients admitted to the Neurology Department (108 women and 128 men; mean age 65.3), and tested with a standardized procedure (De Renzi and Barbieri, 1992). A score of grasping was determined for each patient. The locations of the cerebral lesions were assessed by two neurologists using the method of Damasio and Damasio (1989). Grasping was found in 38 patients (16.1p.100) with dementia or cerebral damage. In all cases, the lesion affected the frontal lobe. The patients with grasping showed a significant higher number of lesioned areas particularly for the frontal and the parietal regions. The score of right grasping was significantly higher with a lesion in the right paraventricular frontal and in the left parietal paraventricular areas. The score of left grasping was significantly higher with a lesion in the left frontal paraventricular area. These results are discussed in relationship with motor control.

[Processing of "scripts" and frontal lobe function in Huntington's disease]. / Arrangement de scripts dans la maladie de Huntington.

According to Norman and Shallice, the basal ganglia are involved in the activation and maintenance of overlearned or routine scripts in action planning. This study aimed to investigate how patients with Huntington disease manipulate scripts. Ten patients with Huntington's disease and 12 normal control subjects matched by age and education were asked to re-establish the sequential order of series of script actions which were given with or without distractor elements (i.e. with or without actions belonging to trivial scripts). Compared with normal controls, patients with Huntington disease made significantly more errors in script sequencing. However there was no significant difference in performance between patients with Huntington disease and normal control subjects in inhibiting irrelevant actions. These results suggest that early Huntington's disease patients exhibit early impairment in their ability to produce temporally coherent sequences without deficit in their ability to eliminate distractors in the action domain. These results support in part the predictions of Norman and Shallice's model. From a neuroanatomical point of view, this dissociation of performance fits with what is known about the neuropathological progression of Huntington's disease in which neuronal loss progresses in a dorsal-to-ventral direction and with what was shown in patients with circumscribed frontal lobe damage. In these patients, impairment in script sequencing is related to lesions in the lateral prefrontal regions.

[Value of the neuropsychological evaluation in cerebral arterial aneurysms surgically treated]. / Intérêt du bilan neuropsychologique dans les anévrysmes artériels cérébraux opérés.

Early examination (3 months) of 81 patients, operated on for ruptured cerebral aneurysms, by neurosurgeons and neuropsychologists show significant differences between them both; the neuropsychological evaluation has the best predictive value as far as the outcome is concerned especially regarding the return to their initial job (69% after a year in this series). The outcome also depends on the age, the preoperative grade, and the professional qualification. The aneurysm location and the date of the operation are not so important. Early neuropsychological evaluation enable us to start a rehabilitation program for socio professional reinsertion and to improve the quality of life.