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| Name | Class |
|---|---|
| University Grenoble Alps | OTHER |
| Université Savoie Mont Blanc | OTHER |
| Centre National de la Recherche Scientifique, France | OTHER |
| Laboratoire de Psychologie et NeuroCognition |
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The aim of the present study is to investigate potential cognitive mechanisms contributing to working memory impairment in Alzheimer's disease and vascular dementia. The investigators consider a new hypothesis suggesting that difficulties in mobilizing maintenance strategies of information could explain this working memory deficit. More specifically, the investigators assume that patient groups will have difficulties in employing both refreshing and elaborative strategies during a working memory task (i.e., complex span task), as compared to a control group.
Working memory is considered as a central hub in human cognition. Good working memory capacities are fundamental for daily life. However, previous research has indicated that patients with Alzheimer's disease or vascular dementia have significant working memory impairment. Currently, there is no consensus on the cognitive mechanisms responsible for this deficit. Prior findings have highlighted that patients with Alzheimer's disease and/or vascular dementia demonstrate specific difficulties in dual-task situations. In this context, the investigators hypothesize that the continuous alternation between maintenance and processing phases involved in working memory could be impaired for these patients. Thus, the aim of the present study is to investigate if patients with Alzheimer's disease and/or vascular dementia can use maintenance strategies of information in working memory, as typically observed in individuals without cognitive impairments.
To this end, the investigators propose a short working memory task in which they manipulate the opportunities to use refreshing strategies and elaborative strategies. The investigators expect that patients with Alzheimer's disease, vascular dementia, or mixed dementia will benefit less than healthy older adults from the increased opportunities to employ refreshing and elaboration. These difficulties could account for the impaired working memory performance associated with these diseases.
In a second step, the investigators formulate distinctive hypotheses between patient sub-groups:
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Alzheimer disease | Alzheimer's disease is define on the basis of the medical diagnostic. As part of routine care, they undergo a standardized clinical neuropsychological assessment that evaluates several cognitive functions. For the study and during the day of medical consultations, each patient will perform a working memory task, lasting approximately 30 minutes. If the patient is accompanied by a family member, the investigators ask the latter to complete a questionnaire on patient's daily executive functioning (French version of the Behavior rating inventory of executive function [BRIEF-A]). |
| |
| Vascular dementia | Vascular dementia is define on the basis of the medical diagnostic. As part of routine care, they undergo a standardized clinical neuropsychological assessment that evaluates several cognitive functions. For the study and during the day of medical consultations, each patient will perform a working memory task, lasting approximately 30 minutes. If the patient is accompanied by a family member, the investigators ask the latter to complete a questionnaire on patient's daily executive functioning (French version of the Behavior rating inventory of executive function [BRIEF-A]). |
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| Mixed dementia | Mixed dementia (i.e., Alzheimer's disease and vascular dementia) is define on the basis of the medical diagnostic. As part of routine care, they undergo a standardized clinical neuropsychological assessment that evaluates several cognitive functions . For the study and during the day of medical consultations, each patient will perform a working memory task, lasting approximately 30 minutes. If the patient is accompanied by a family member, the investigators ask the latter to complete a questionnaire on patient's daily executive functioning (French version of the Behavior rating inventory of executive function [BRIEF-A]). |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Complex span task | Behavioral | The intervention consists in a computerized working memory task. This task follows the design of a complex span task, involving alternation between memorization and processing steps. For each trial, participants have to memorize French words. These words are sequentially displayed on the screen. Between each word, participants perform a processing task consisting in a spatial location task: They have to determine if a shape is at the top or at the bottom of the screen. After each processing episode, participants have a free time (i.e., available time to maintain information in WM). At the end of each trial, participants perform an orally immediate recall. This experimental task involves several conditions in order to manipulate the opportunities for the spontaneous use of refreshing and elaborative strategies. |
| Measure | Description | Time Frame |
|---|---|---|
| Memory performance in the Working memory task | Percentage of correct immediate recall, computed with strict serial recall criterion (item identity + correct position) and computed with item recall criterion (item identity only). | 15 minutes |
| Processing performance in the Working memory task | Percentage of correct response in the spatial part of working memory task | 15 minutes |
| Reaction time | Reaction time for each distractor (in ms) in the spatial part of working memory task | 30 minutes |
| Measure | Description | Time Frame |
|---|---|---|
| Mini-Mental State Examination (MMSE) | MMSE is a test evaluate global cognitive functioning Score from 0 to 30 A higher score mean a better cognitive efficiency | 15 minutes |
| Digit span forward WAIS IV (digit number) |
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Inclusion Criteria:
Exclusion Criteria:
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The population of this study will consist of patients performing a neuropsychological assessment at Grenoble-Alpes University Hospital. These patients consult because of cognitive disorders. The patients are dividied into these three subgroups according to their medical diagnosis of Alzheimer's disease, vascular dementia, or mixed dementia (diagnostic criteria : Dubois et al. (2021) for Alzheimer's disease; VASCOG diagnostic criteria : Sachdev et al., 2015 for vascular dementia; and diagnostic criteria : DSM-V (APA, 2013) for mixed dementia due to Alzheimer and vascular etiology). The population of this study will also include healthy participants (carers/visitors of patients at the Gerontology centre or volunteers at Gerontology centre).
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Amelie Bichon | Contact | 0476728161 | abichon@chu-grenoble.fr |
| Name | Affiliation | Role |
|---|---|---|
| Benoit Lemaire | Laboratoire de Psychologie et NeuroCognition | Study Chair |
| Sophie Portrat | Laboratoire de Psychologie et NeuroCognition | Study Chair |
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 29557069 | Background | Bartsch LM, Singmann H, Oberauer K. The effects of refreshing and elaboration on working memory performance, and their contributions to long-term memory formation. Mem Cognit. 2018 Jul;46(5):796-808. doi: 10.3758/s13421-018-0805-9. | |
| 17605579 | Background | Belleville S, Chertkow H, Gauthier S. Working memory and control of attention in persons with Alzheimer's disease and mild cognitive impairment. Neuropsychology. 2007 Jul;21(4):458-69. doi: 10.1037/0894-4105.21.4.458. |
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| ID | Term |
|---|---|
| D000544 | Alzheimer Disease |
| D015140 | Dementia, Vascular |
| D000093902 | Mixed Dementias |
| ID | Term |
|---|---|
| D003704 | Dementia |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
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| OTHER |
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|
| Control group | Control group includes healthy older adults (without cognitive impairment). As patient group, control group will perform the working memory task. However, control group does not undergo the clinical neuropsychological assessment. |
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| Clinical neuropsychological assessment | Diagnostic Test | As part of routine care, participants in the patient group undergo a standardized clinical neuropsychological assessment that evaluates several cognitive functions. The investigators hypothesize correlations between working memory performance during the experimental task and the results of neuropsychological tests. Thus, the investigators consider the results to several French versions of neuropsychological tests:
|
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| Clinical neurospychological assessement | Diagnostic Test | Participants in the control group undergo 2 tests clinical that evaluate cognitive functioning. The investigators consider the results to French versions of these neuropsychological tests:
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The participant's span is noted, corresponding to the longest number of sequential digits that can be repeated forward.
| 5 minutes |
| Digit span forward WAIS IV (standard note) | This scale permitted to obtain a standard note from 0 to 19 A higher score means a better performance | 5 minutes |
| Digit span backward WAIS IV (digit number) | The participant's span is noted, corresponding to the longest number of sequential digits that can be repeated backward. | 5 minutes |
| Digit span backward WAIS IV (standard note) | This scale permitted to obtain a standard note from 0 to 19 A higher score means a better performance | 5 minutes |
| Stroop Test - denomination part | the denomination part of stroop test measures processing speed time is taken, in seconds | 30 secondes |
| Stroop Test - minor interference part (Time) | this part of stroop test measures low inhibition process time is taken, in seconds | 30 secondes |
| Stroop Test - minor interference part (errors) | this part of stroop test measures low inhibition process number of errors is noted, from 0 to 24 | 30 secondes |
| Stroop Test - major interference part (time) | this part of stroop test measures strong inhibition process time is taken, in seconds | 90 secondes |
| Stroop Test - major interference part (errors) | this part of stroop test measures strong inhibition process number of errors is noted, from 0 to 24 | 90 secondes |
| Trail Making Test - Part A (time) | This test evaluate motor speed processing Time in seconds | 2 minutes |
| Trail Making Test - Part A (errors) | This test evaluates motor speed processing Number of errors is noted | 2 minutes |
| Trail Making Test - Part B (time) | This test evaluates mental flexibility Time in seconds | 5 minutes |
| Trail Making Test - Part B (errors) | This test evaluates mental flexibility Number of errors is noted | 5 minutes |
| Category fluences | Number of correct words is noted | 5 minutes |
| Memory evaluation (16-item Free and Cued Recall, or GERIA-12) | These tests evaluate verbal episodic memory Scores are noted for each trail, from 0 to 16 (RL-RI/16) or 0 to 12 (Geria-12) A higher score means a better performance | 40 minutes |
| Naming task | This test evaluate the capacity to correctly name a picture Score is noted, from 0 to 40 A higher score means a better performance | 40 minutes |
| Behavior rating inventory of executive function | Questionnaire (french version) on patient's daily executive functioning, completed by a relative of the patient, if present Global score from 75 to 225, composing by several composite scores. A higher score means a more severe executive dysfonctionning in daily life | 10 minutes |
| Instrumental Activities of Daily Living | Questionnaire completed by a professional (nurse or doctor) with the patient and an accompagniant if present Score from 0 to 8 A higher score mean a better autonomy in daily life | 5 minutes |
| Activities of Daily Living | Questionnaire completed by a professional (nurse or doctor) with the patient and an accompagniant if present Score from 0 to 6 A higher score mean a better autonomy in daily life | 5 minutes |
| 29542133 | Background | Camos V, Johnson M, Loaiza V, Portrat S, Souza A, Vergauwe E. What is attentional refreshing in working memory? Ann N Y Acad Sci. 2018 Jul;1424(1):19-32. doi: 10.1111/nyas.13616. Epub 2018 Mar 15. |
| 16523997 | Background | Conway AR, Kane MJ, Bunting MF, Hambrick DZ, Wilhelm O, Engle RW. Working memory span tasks: A methodological review and user's guide. Psychon Bull Rev. 2005 Oct;12(5):769-86. doi: 10.3758/bf03196772. |
| 20543458 | Background | Inasaridze K, Foley JA, Logie RH, Sala SD. Dual task impairments in vascular dementia. Behav Neurol. 2010;22(1-2):45-52. doi: 10.3233/BEN-2009-0252. |
| 34675799 | Background | Zheng C, Zhang RS, Wan T, Zhao JS. Topological Alterations of Working Memory Impairment in Aged Patients With Vascular Dementia. Front Aging Neurosci. 2021 Oct 4;13:741445. doi: 10.3389/fnagi.2021.741445. eCollection 2021. |
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| 22575403 | Background | Korczyn AD, Vakhapova V, Grinberg LT. Vascular dementia. J Neurol Sci. 2012 Nov 15;322(1-2):2-10. doi: 10.1016/j.jns.2012.03.027. Epub 2012 May 8. |
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| D024801 |
| Tauopathies |
| D019636 | Neurodegenerative Diseases |
| D019965 | Neurocognitive Disorders |
| D001523 | Mental Disorders |
| D002561 | Cerebrovascular Disorders |
| D002537 | Intracranial Arteriosclerosis |
| D020765 | Intracranial Arterial Diseases |
| D056784 | Leukoencephalopathies |
| D001161 | Arteriosclerosis |
| D001157 | Arterial Occlusive Diseases |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |