Par Editorial La Presse de la Manche
Published on 22 Sep 23 at 9:05 p.m. See my news Follow La Presse de la Manche September 21 is World Alzheimer’s Day. (©Archives / Jean-Paul BARBIER)
On the occasion of the World Alzheimer’s DayThursday September 21, 2023, Francis Eustache, neuropsychologist at the University of Caen, originally from Virandeville, agreed to answer our questions.
This professor at the Practical School of Advanced Studies (EPHE), at Parishas been one of the pioneers in France use brain imaging to better understand Alzheimer’s disease.
Actu : Your career and your work on memory have been vectors for understanding the origins of Alzheimer’s. Can you tell us what you went through?
Francis Eustache: After secondary studies in Cherbourg, I went to Paris and Caen for my higher studies. Director from 2013 to 2016 of the Cyceron biomedical imaging center in Caen (the first in France and in the world to use brain imaging to study cognitive functioning and human memory), I started working on the subject in 1979. When this center was created in the 1980s, when I was working, we understood that memory loss was not due to old age, but rather an illness. An extraordinary leap forward.
225 000 cas
In France, 225,000 new cases of Alzheimer’s disease are detected each year.
Can we say that a person with Alzheimer’s disease has lost their identity?
F.E. : Thank you for this question which is quite fundamental. I sometimes read things, and often I don’t agree with them. I think a person will maintain their identity even if they are sick. In our identity, there are things that are relatively fixed. For example, I am from Cotentin. When I was 15, I already had ideas that I still have today because I benefited from a certain education and a certain number of values. I kept these values, but today, at 65, I have changed. People who have a brain disease will also be changed, but that does not mean that they no longer have an identity. What I feel most about these people, and what we have also been able to measure, is that they are attached to a very characteristic moment in their lives.
Neuropsychologist Francis Eustache comes from Virandeville, in Manche. (©Inserm / Mehrak)
“Attach to a characteristic moment in life”, can you elaborate?
F.E. : I remember a woman who was a farmer. I was doing a neuropsychological exam, then all of a sudden, she said to me: “We have to cut it short, because I have to take care of my cows. » Even though it was a woman who no longer had her farm. This moment was part of his life. We have to be careful when we talk about loss of identity, it’s not nothing. It’s terrible if you take it literally. For me, an affected person (even with very significant disorders) always keeps their identity. It reveals itself in moments of exchange with a loved one, during a particular activity… You must take advantage of these moments.
Brain imaging has been a key element in understanding this disease. What did it actually enable?
F.E. : What we were able to show initially were maps of the brain. The evolution of atrophic lesions and, especially in Cyceron using positron emission tomography (PET Scan), the repercussions of these lesions on the functioning of the brain. At the time, this provided extremely strong scientific rationale.
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You also concluded, through research and understanding the dynamics of disease, that the brain can adapt. Hence the importance of staying active…
F.E. : The brain is very malleable and can create compensatory mechanisms to counteract disease and delay it. And there is a way to amplify them with a certain lifestyle, favoring social relationships, intellectual and physical activity. All these notions, which have now become part of everyday language, did not exist three or four decades ago.
Alcohol, the scourge of memory problems
Alcohol consumption, a social fact seen as festive for most French people, also leads to serious memory problems. Ingested excessively, alcohol is associated with a tripling of the risk of dementia and a doubling of the risk of developing Alzheimer’s disease. Amnesia, difficulty creating new memories, concentration problems…
At the Pasteur hospital in Cherbourg-en-Cotentin, “the cases are numerous, too numerous,” assures Damien Caronnet, neurologist. It is the leading cause of dementia in young people.”
Thiamine (vitamin B1), present in our foods, is essential for the proper functioning of our neurons. However, alcohol reduces its absorption. And it suppresses hunger, especially when combined with sugary drinks.
“Whiskey, coke and rum are a scourge among young people. With the sugar they assimilate, malnutrition can appear, because they no longer feel the need to eat,” says the neurologist from the neuro-geriatric evaluation unit. This deficiency is called Korsakoff syndrome, a neurodegenerative disease.
Recently, a 23-year-old was admitted to Pasteur Hospital after drinking excessively for three to four months. “His Papez circuit, a set of connections in our brain, had become necrotic. » This degeneration is based on the same principle as Alzheimer’s disease. And the brain damage is irreversible.
Pharmacological progress is now expected. Where we are ?
F.E. : We are at a pivotal time. At least four or five drugs are currently being tested in the United States. They act on the amyloid plaques that form in the brain by erasing them and delaying the deleterious effects on cognition. Unfortunately, there are a large number of side effects, and they have not yet arrived in Europe. We must therefore be careful and not give false hope to patients.
Francis Eustache participated, with six other authors, in the writing of the book “Memory and Trauma” released in early September 2023 by Dunod. Price: 24 euros.
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