Discrimination of facial identity and of emotions in Alzheimer's disease.

OBJECTIVE: To investigate processing of human faces identity and of emotional expressions in patients with Alzheimer's Disease (AD). BACKGROUND: Mechanisms responsible for discriminating facial identity may be dissociated from those involved in discriminating facial expressions. Patients with prosopagnosia often have preserved capacities for processing emotional facial expressions and occasionally, patients with focal lesions may recognize human faces without being able to recognize their facial expression. Such a dissociation has not been clearly shown in groups of AD patients. METHODS: Thirty-one probable AD patients and 14 control subjects were administered tasks of discrimination of faces and of emotions. RESULTS: AD patients were significantly impaired in discriminating facial identities and in naming and pointing to named emotions, but were comparable to controls in discriminating facial expressions of emotion. The deficits of facial discrimination and of identification of emotions were, on the whole, correlated with the MMS and Raven scores. Discrimination of emotions was not correlated to either test, suggesting that this ability is based on cognitive processes different from those underlying the MMS and the PM47. CONCLUSIONS: This dissociation implies two separate systems, one dedicated to discrimination of facial identities and the other to discrimination of emotions. This is compatible with the modular organization of cognitive deficits in AD and may explain the well known experience that nonverbal communication often remains effective even in patients with severe dementia.

Local immunotherapy of recurrent glioblastoma multiforme by intracerebral perfusion of interleukin-2 and LAK cells.

A non randomized pilot study has been undertaken to evaluate the feasibility of local immunotherapy (IT) of recurrent glioblastoma multiforme (GM) by continuous intracerebral perfusion of recombinant interleukin-2 (rIL-2, Eurocetus) with and without lymphokine activated killer (LAK) cells. At time of surgical removal of the tumor, a catheter was implanted in the cavity left by tumor debulking allowing continuous perfusion of rIL-2. Five patients received 18 x 10(6) IU/day or rIL-2 for five days. At days 1, 3, and 5 after surgery, rIL-2 perfusion was briefly interrupted for the injection of LAK cells. Eight other patients received rIL-2 alone, either 24 x 10(6) IU/day (five patients) or 54 x 10(6) IU/day (three patients). Capillary leak syndrome, which is the main side effect of systemic infusion of rIL-2, was never observed, but local immunotherapy induced fever, confusion, and cerebral edema in all patients. Despite local IT, tumor progression was diagnosed by CT scan 4 to 12 weeks after the treatment.

[Dietary intake recommended for elderly persons]. / Apports alimentaires à recommander aux personnes âgées.

Recommendations for dietary intake in elderly persons must account for wide interindividual variation. We propose different recommendations for: generally self sufficient elderly persons in good health. The recommended dietary intakes are very similar to those for adults, with a few exceptions (reduced calorie intake, the importance of protein and certain vitamins or minerals: vitamins B6, D, C, calcium, zinc ...); patients with an intercurrent disease or an event causing a loss of appetite and a reduction in dietary intake. Recommendations for these subjects should aim at correcting or preventing deficiencies by the use of supplementary and complementary nutritional products; subjects in a state of protein-calorie malnutrition. Recommended dietary intake should take into account the effect of malnutrition on the digestive functions of the pancreas and the intestine in the elderly. Such recommendations must be based on the findings of numerous studies now being carried out and of which we report here the first results.