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Cette etude utilise une methode constructiviste d’apprentissage « Hooks and Shifts », aupres des etudiants. Elle est centree sur la connaissance mathematique abstraite de moyenne et developpee en realite virtuelle. Elle etudie les associations entre « Shifts », situations d’abstraction, et sens de l’agentivite (SdA), caracteristique des apprenants. Une experience a mesure le gain d’apprentissage avec la methode ainsi que le SdA global. Les resultats montrent un gain d’apprentissage significatif, mais des liens equivoques avec le SdA global. Un fort SdA local aurait pu interferer avec cet apprentissage actif. Nous avons donc reproduit l’experience, mais par apprentissage passif et controlant les « Shifts ». Les resultats confirment un effet du SdA global sur l’apprentissage. Presentant des perspectives pratiques et theoriques, nous discutons egalement de pedagogie par la realite virtuelle.

Summary Objectives Evaluate demographic and aetiological characteristics of patients referred by specialist doctors (neurologists, geriatricians and psychiatrists) to an Academic Memory Clinic in Lyon, for the year 2008. These specialist-referred patients (SRP) constitute a specific mission of the French Academic Memory Clinics. Methods The outpatients consecutively referred in 2008 to our memory clinic by any persons (patients, families, general practitioners, specialist doctors) were all evaluated using clinical, neuropsychological and imaging information. We examined the distribution of patients diagnosis and differences in gender, education, and cognitive severity (MMSE). For each patient, diagnoses used clinical criteria at the first visit, and ranged from normal subjects to cognitive impaired patients with or without dementia. Results Among 384 patients, 160 (41.7%; 68 men and 92 women) were referred by specialist doctors. These 160 SRP were younger ( P P = 0.55) nor Mini Mental State Examination ( P = 0.15). SRP were more often demented than the non-referred patients (respectively, 64.4% vs 39.7%; P = 0.0001), and the demented SRP had less often Alzheimer's disease (AD) (30.1% vs 65.6%; P = 0,0001). Dementia was present in 64.4% of the 160 SRP: among the 160, AD was the most frequent cause (19.4%), followed by Lewy body dementia (11.3%), neurological diseases (12.5% – multiple sclerosis, vascular cognitive impairment, epilepsy) and Mild Cognitive Impairment (10%). Normal subjects were present in 8.1% of the SRP. Discussion As compared to non-SRP, SRP are younger, more demented (64,4%) and more prone to have non-AD dementia (69,9%). However, AD represented the most frequent diagnosis (19.4% of SRP). Conclusion SRP are an important part of the activity of an Academic Memory Clinic in Lyon. As compared to GPs, young and demented patients are more likely to be sent in a specialized referral center by specialist doctors.

Resume Objectif L’objectif etait d’analyser les caracteristiques demographiques et etiologiques de patients ayant debute une pathologie dementielle avant l’âge de 65 ans. Methodes L’etude a concerne 746 patients de la file active 2008 d’une consultation memoire (CM) neurologique du centre memoire de ressource et de recherche (CMRR) de Lyon. Les demences precoces correspondaient aux patients dont les symptomes cognitifs ou comportementaux etaient apparus avant 65 ans. Les diagnostics etiologiques des demences etaient portes selon les criteres cliniques internationaux habituels. Resultats Sur une file active de 746 patients atteints d’une pathologie dementielle (300 hommes, 446 femmes), 91 patients (12,2 %) avaient debute avant 65 ans (36,5 a 65 ans) et 655 patients apres 65 ans (66 a 92 ans). Les etiologies des 91 cas precoces etaient : Mild Cognitive Impairment (18,7 %), maladie d’Alzheimer (MA) (14,3 %), demences frontotemporales (14,3 %), atrophie corticale posterieure (14,3 %), aphasies progressives (11,0 %), demences a corps de Lewy (9,9 %), demences semantiques (8,8 %), autres demences (3,3 %), demences vasculaires (2,2 %), demences indeterminees (2,2 %), MA avec composante cerebrovasculaire (1,1 %). La MA constituait 57,4 % des demences ayant debute apres 65 ans. L’atrophie corticale posterieure avait la plus grande proportion de cas avant 65 ans (68,4 %). Les consultations de recours concernaient 50,5 % des cas precoces mais 12,7 % des cas tardifs ( p Conclusion Dans une CM neurologique de CMRR, les demences precoces representaient quatre fois plus de patients que les chiffres estimes en population generale. Les caracteristiques de notre CM expliquent la sur-representation de demences rares telles que les aphasies progressives primaires (5,2 % de la file active), les demences semantiques (3,6 %) et les atrophies corticales posterieures (2,5 %).

International audience; This article proposes a method based on wavelet transform and neural networks for relating pupillary behavior to psychological stress. The proposed method was tested by recording pupil diameter and electrodermal activity during a simulated driving task. Self-report measures were also collected. Participants performed a baseline run with the driving task only, followed by three stress runs where they were required to perform the driving task along with sound alerts, the presence of two human evaluators, and both. Self-reports and pupil diameter successfully indexed stress manipulation, and significant correlations were found between these measures. However, electrodermal activity did not vary accordingly. After training, the four-way parallel neural network classifier could guess whether a given unknown pupil diameter signal came from one of the four experimental trials with 79.2% precision. The present study shows that pupil diameter signal has good discriminating power for stress detection.

Evaluate demographic and aetiological characteristics of patients referred by specialist doctors (neurologists, geriatricians and psychiatrists) to an Academic Memory Clinic in Lyon, for the year 2008. These specialist-referred patients (SRP) constitute a specific mission of the French Academic Memory Clinics.The outpatients consecutively referred in 2008 to our memory clinic by any persons (patients, families, general practitioners, specialist doctors) were all evaluated using clinical, neuropsychological and imaging information. We examined the distribution of patients diagnosis and differences in gender, education, and cognitive severity (MMSE). For each patient, diagnoses used clinical criteria at the first visit, and ranged from normal subjects to cognitive impaired patients with or without dementia.Among 384 patients, 160 (41.7%; 68 men and 92 women) were referred by specialist doctors. These 160 SRP were younger (P0.0001) but did not differ from other patients on gender (P=0.55) nor Mini Mental State Examination (P=0.15). SRP were more often demented than the non-referred patients (respectively, 64.4% vs 39.7%; P=0.0001), and the demented SRP had less often Alzheimer's disease (AD) (30.1% vs 65.6%; P=0,0001). Dementia was present in 64.4% of the 160 SRP: among the 160, AD was the most frequent cause (19.4%), followed by Lewy body dementia (11.3%), neurological diseases (12.5% - multiple sclerosis, vascular cognitive impairment, epilepsy) and Mild Cognitive Impairment (10%). Normal subjects were present in 8.1% of the SRP.As compared to non-SRP, SRP are younger, more demented (64,4%) and more prone to have non-AD dementia (69,9%). However, AD represented the most frequent diagnosis (19.4% of SRP).SRP are an important part of the activity of an Academic Memory Clinic in Lyon. As compared to GPs, young and demented patients are more likely to be sent in a specialized referral center by specialist doctors.