Magali Volteau

Unité Inserm U1077, Caen, Lower Normandy, France

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Publications (13)43.52 Total impact

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    ABSTRACT: The present study investigates the impact of unawareness of deficit (anosognosia) in patients with Alzheimer's disease upon professional health care burden. Cross-sectional study with a consecutive clinical sample from an Alzheimer day-care hospital in France. 65 patients with probable AD, aged from 75 to 94 years old, consecutively admitted at the Alzheimer Day Hospital to complete a program of cognitive stimulation and psychosocial rehabilitation. Each patient was submitted to a standardized evaluation including clinical investigation, cerebral imagery, and neuropsychological assessment. Anosognosia of memory deficit and anosognosia of behavioral disturbances were measured as the "discrepancy scores" between patients' self-reports and family member ratings of patient memory performance and behavioral disturbances. Professional health care burden was assessed with the Professional Health Care Dementia Burden Index (PCDBI; maximal score: 12), designed for this study. Multiple linear regressions were used to examine the correlations between the PCDBI and the severity of anosognosia. The findings showed a significant positive correlation between the PCDBI and both anosognosia of memory impairment and behavioral abnormalities (both p at least less than 0.05). However, there was no significant correlation between the severity of the burden and the severity of cognitive decline or functional impairment (both p at least>0.05). Anosognosia in Alzheimer disease patients has a negative impact upon the professional caregivers' burden over and above the cognitive deficit and the functional impairments.
    The Journal of Nutrition Health and Aging 05/2011; 15(5):356-60. · 2.39 Impact Factor
  • J Nutr Health Aging. 01/2009; 13(1):21-26.
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    ABSTRACT: The aim of the Pre-Al study is to evaluate and compare the predictive value of different tools for an early identification of Alzheimer's disease. Patients coming for consultation to memory clinics without dementia were included if they had an objective memory or attention trouble assessed by a MMSE score > 25 (with at least one missing item at the words recall) and / or an Isaac set test score < 28. All were examined by a neuropsychological battery (Free and Cued Selective Reminding Test, digit ordering test, WAIS-R digit symbol, Trail making test, Benton visual retention test, verbal fluency, confrontation naming and Baddeley's double task test). A subpopulation received an MRI and SPECT assessment. 251 patients were included (mean age: 72.0 years; mean education duration: 10.9 years). Validation of the predictive tests will be based on the comparison of these tests in patients developing dementia and others, after a follow-up of at least 3 years. This paper presents methodology of the study and the population description.
    The Journal of Nutrition Health and Aging 01/2009; 13(1):21-6. · 2.39 Impact Factor
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    ABSTRACT: The objective of this study is to identify the cerebral regions that are assessed by the Frontal Assessment Battery (FAB). Using SPM voxel-based analysis, we looked for correlations between FAB performance and brain SPECT perfusion in 47 patients with the frontal variant of frontotemporal dementia (fv-FTD) recruited by the French FTD research network, a multicentre initiative of French University hospitals with expertise in the field of dementia. A significant correlation was found between FAB performance and perfusion in the medial and dorsolateral frontal cortex bilaterally, independently of age, gender and MMSE. No correlations were observed with orbital frontal or parietal perfusion, in spite of the presence of hypoperfusion in these areas, or with perfusion of any other cortical or subcortical region. These findings confirm that the FAB is an adequate tool for assessing functions related to the dorsolateral and medial frontal cortex, and is thus useful for the evaluation of diseases associated with frontal dysfunction.
    Journal of the Neurological Sciences 11/2008; 273(1-2):84-7. · 2.24 Impact Factor
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    ABSTRACT: Apathy is one of the most common behavioral symptoms in mild cognitive impairment (MCI). The aim of the authors' study was to examine the influence of the apathy dimensions, i.e., emotional blunting, lack of initiative, and lack of interest, on the risk of developing of Alzheimer disease (AD) in patients with MCI. Longitudinal study. Fourteen French memory clinics. Apathy was assessed in 214 MCI patients. The main endpoint considered was the development of AD during the 3-year follow-up. The neuropsychiatric evaluation included the Goldberg anxiety scale and the Montgomery and Asberg Depression Rating Scale; apathy was assessed with the Apathy Inventory. After 3 years, 59 patients (27.2%) had developed AD. The risk of conversion to AD was significantly higher for patients with lack of interest. Using Cox analyses, controlling for age, gender and education, the difference between survival curves was significant for lack of interest. Lack of interest, a mild behavioral sign, could be an indicator of potential decline in MCI patients and underlines the importance of checking the cognitive status of these patients.
    The American journal of geriatric psychiatry: official journal of the American Association for Geriatric Psychiatry 10/2008; 16(9):770-6. · 3.35 Impact Factor
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    ABSTRACT: To compare the power of tests assessing different cognitive domains for the identification of prodromal Alzheimer disease (AD) among patients with mild cognitive impairment (MCI). Given the early involvement of the medial temporal lobe, a precocious and specific pattern of memory disorders might be expected for the identification of prodromal AD. A total of 251 patients with MCI were tested at baseline by a standardized neuropsychological battery, which included the Free and Cued Selective Recall Reminding Test (FCSRT) for verbal episodic memory; the Benton Visual Retention Test for visual memory; the Deno 100 and verbal fluency for language; a serial digit learning test and the double task of Baddeley for working memory; Wechsler Adult Intelligence Scale (WAIS) similarities for conceptual elaboration; and the Stroop test, the Trail Making test, and the WAIS digit symbol test for executive functions. The patients were followed at 6-month intervals for up to 3 years in order to identify those who converted to AD vs those who remained stable over time. Statistical analyses were based on receiver operating characteristic curve and Cox proportional hazards models. A total of 59 subjects converted to AD dementia. The most sensitive and specific test for diagnosis of prodromal AD was the FCSRT. Significant cutoff for the diagnosis was 17/48 for free recall, 40/48 for total recall, and below 71% for index of sensitivity of cueing (% of efficacy of semantic cues for retrieval). The amnestic syndrome of the medial temporal type, defined by the Free and Cued Selective Recall Reminding Test, is able to distinguish patients at an early stage of Alzheimer disease from mild cognitive impairment non-converters.
    Neurology 12/2007; 69(19):1859-67. · 8.25 Impact Factor
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    Neurology 08/2007; 69(5):488-90. · 8.25 Impact Factor
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    ABSTRACT: To evaluate the relation between apathy and development of dementia in patients with amnestic mild cognitive impairment (MCI). Two hundred and fifty-one French-speaking outpatients fulfilling the criteria of amnestic MCI were enrolled. Apathy was assessed with the Apathy Inventory (IA). Neuropsychiatric evaluation also included the Goldberg anxiety scale and the Montgomery and Asberg Depressive Rating Scale (MADRS). The main end point considered after a 1-year follow-up was the development of dementia of Alzheimer type (DAT). At baseline there were 86 (39.8%) subjects presenting at least one symptom of apathy among the 216 included in analysis. After a 1-year follow-up, 22 patients developed DAT. Of the patients with apathy at baseline 13 (15.1%) developed DAT in comparison with 9 (6.9%) of the non-apathetic patients. At the 1-year follow-up, patients developing DAT had a significantly higher frequency of apathetic symptoms (91.7%) than patients without DAT (26.9%). Taking into account that apathy is one of the most frequently observed neuropsychiatric symptoms in MCI and in DAT the present study suggests that patients with MCI and apathy should be more closely observed.
    Clinical Neurology and Neurosurgery 01/2007; 108(8):733-6. · 1.23 Impact Factor
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    ABSTRACT: We conducted a French multicentric cross-sectional study to describe in detail the demographic, neurological and behavioural characteristics of the frontal variant of frontotemporal dementia (fvFTD) and to characterize the pattern of brain perfusion SPECT in comparison to a healthy control group. A total of 68 fvFTD patients had technetium-99m-ECD brain perfusion SPECT at inclusion, 61 of which also underwent an in-depth evaluation including 70 items assessing behaviour, language and affect/emotion at onset and at inclusion. The mean age-at-onset was 60.4 +/- 7.8 years (35-75). Twenty-six per cent of the patients were older than 65 at onset. A positive familial history consistent with an autosomal dominant inheritance was found in 18% of the patients. At onset, the behavioural profile was predominantly inert in 25% of the patients, disinhibited in 18% and mixed in others. The behavioural features progressed to predominantly mixed or inert forms. Although, inertia was associated with predominant medial frontal and cingulate hypoperfusion, and patients with disinhibition exhibited predominant ventromedial prefrontal and temporal hypoperfusion, there were no major clinical differences between disinhibited and inert patients. Forty-five per cent of the deceased patients survived <6 years (short survival), and 34% of the patients survived >8 years (long survival). This shows that the final outcome of fvFTD is highly variable. No clinical factors predictive of short or long survival were identified. Unexpected, however, was the finding that brainstem hypoperfusion distinguished patients with a short survival from patients with long survival. In conclusion, this study shows that fvFTD is clinically a rather homogeneous entity. It also provides evidence that different behavioural presentations at onset are related to different anatomical localizations of degenerative damage. Finally, it demonstrates the prognostic value of brainstem hypoperfusion in a subgroup of patients with a short survival.
    Brain 11/2006; 129(Pt 11):3051-65. · 10.23 Impact Factor
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    ABSTRACT: To investigate the neuropsychological characteristics of patients diagnosed with mild cognitive impairment (MCI) with and without apathy. A cohort of 245 MCI patients (mean age = 72 +/- 5.5 years; mean MMSE = 27.5 +/- 1.3) was divided into two subgroups according to their Apathy Inventory score and underwent an extensive neuropsychological battery. There were 94 (38.4%) patients with and 151 (61.6%) patients without apathy. At baseline the apathetic subgroup had a significantly lower total score on the free and cued selective reminding test (FCSR). Furthermore, the apathetic subgroup showed a significant deterioration in FCSR total recall score between baseline and the 1-year assessment. In conclusion, the presence of apathy in MCI patients is not associated with frontal task performance but with a higher degree of memory impairment.
    Dementia and Geriatric Cognitive Disorders 02/2006; 21(3):192-7. · 2.79 Impact Factor
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    ABSTRACT: Corrélations anatomo-fonctionnelles chez des malades d'Alzheimer (MA): entre Voxel- based morphometry (VBM) et tests psychométriques. L. Hugonot-Diener (1,5), M. Sarazin (1,2), S. Kinkingnéhun (1,5), E. Guichard (1), T. Herguetta (1,5), M. Volteau (1), G. Dalla Barba (1,5), B. Dubois (1,2,4). (1) INSERM U610, (2) Fédération de Neurologie, (3) Service de Neuroradiologie, (4) IFR-NS, Groupe Hospitalier Pitié-Salpêtrière, Paris 75013, France (5) IFR-49, SHFJ, Orsay 91401, France Objectif : Analyser les corrélations entre les performances neuropsychologiques et l’atrophie corticale dans la maladie d’Alzheimer débutante (MA)en IRM par la méthode de la voxel-based morphometry (VBM). Population et méthode : Vingt patients ayant une maladie d’Alzheimer légère ont été inclus (âge moyen : 73,1 ± 5,0 ans, MMS : 24± 2,6, NSC : 5 ± 1,5). Tous les patients ont eu (1) une évaluation clinique incluant une échelle de dépression et comportementale ; (2) une évaluation incluant l’épreuve de rappel libre, rappel indicé (mémoire épisodique), la batterie de Montanes (mémoire sémantique), la BREF et la CANTAB (attention et shifting en modalité visuelle) et une évaluation des praxies gestuelles ; (3) une IRM cérébrale. L’atrophie corticale mesurée en VBM selon la méthode de Good, était corrélée aux scores neuropsychologiques (corrélations linéaires). Les corrélations ont été analysées en SPM2 après application d’un masque, pour dégager le lobe temporal. Résultats : Une corrélation (seuillage p< 0,01 non corrigé) a été observé : entre (1) le score total de l’épreuve de rappel libre et indicé et l’atrophie du lobe temporal inférieur gauche et du gyrus fusiforme gauche, (2) entre les temps de réponse à la CANTAB Simple Reverse Latency avec le lobe temporal moyen et inférieur droit et le gyrus fusiforme gauche, et pour le temps de latence de shifting avec le lobe temporal inférieur droit, le gyrus fusiforme droit et l’hippocampe droit. Aucune corrélation n’a été montrée avec les tests de mémoire sémantique, les tests des fonctions exécutives et l’apraxie gestuelle probablement parce que les performances n’étaient que très légèrement altérées à ce stade débutant de la maladie. Conclusion. Les performances en mémoire épisodique verbales sont associées au degré d’atrophie temporale et du gyrus fusiforme gauche, alors que le maintien de l’attention et du shifting en modalité visuelle, sont associées au degré d’atrophie temporale droite. La technique de la VBM permet d’identifier les substrats neuronaux qui sous -tendent les troubles cognitifs dès les stades débutants de la maladie d’Alzheimer..
    Revue Neurologique - REV NEUROL. 01/2005; 161(12):120-120.
  • Revue Neurologique - REV NEUROL. 01/2005; 161(12):99-100.
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    ABSTRACT: ObjectivesThe present study investigates the impact of unawareness of deficit (anosognosia) in patients with Alzheimer’s disease upon professional health care burden. DesignCross-sectional study with a consecutive clinical sample from an Alzheimer day-care hospital in France. Subjects65 patients with probable AD, aged from 75 to 94 years old, consecutively admitted at the Alzheimer Day Hospital to complete a program of cognitive stimulation and psychosocial rehabilitation. MeasurementsBach patient was submitted to a standardized evaluation including clinical investigation, cerebral imagery, and neuropsychological assessment. Anosognosia of memory deficit and anosognosia of behavioral disturbances were measured as the “discrepancy-scores” between patients’ self-reports and family member ratings of patient memory performance and behavioral disturbances. Professional health care burden was assessed with the Professional Health Care Dementia Burden Index (PCDBI; maximal score: 12), designed for this study. Multiple linear regressions were used to examine the correlations between the PCDBI and the severity of anosognosia. ResultsThe findings showed a significant positive correlation between the PCDBI and both anosognosia of memory impairment and behavioral abnormalities (both p at least less than 0.05). However, there was no significant correlation between the severity of the burden and the severity of cognitive decline or functional impairment (both p at least>0.05). ConclusionAnosognosia in Alzheimer disease patients has a negative impact upon the professional caregivers’ burden over and above the cognitive deficit and the functional impairments. Key wordsAnosognosia–Alzheimer–professional health care burden
    The Journal of Nutrition Health and Aging 15(5):356-360. · 2.39 Impact Factor