[Effects of physostigmine on amnesic syndromes (author's transl)]

Eserine sulphate (physostigmine) tests were conducted in 23 patients with amnesia due to cerebral lesions. Psychometric examinations were performed before and after treatment. Results were analysed statistically for the whole group, and after distribution of patients as a function of the etiology, of the mechanism involved, and of the presumed lesions: 1) amnesias related to lesions along Papez' circuit as shown on CT scans were compared with those with normal CT scans; 2) amnesias of the "hippocampic" types were compared with other neuropsychological types. After eserine sulphate learning ability rapidly improved, in all cases, whereas spontaneous or assisted recall was only slightly improved. No significant differences in learning or recall were noted between the group with normal CT scans and that with evidence of bilateral lesions. In contrast, the efficiency of physostigmine was clearly related to the nature of neuropsychological disorders both for learning and recall of verbal material : a positive effect occurred only in the group with obvious evocation and recall disorders (mamillary, thalamic, or cingular lesions). For improvement to occur the product had be be injected before learning. The role of cholinergic mediators in memory is discussed with regard to these observations. Overall benefit was poor since lasting improvement in fixation was noted in one case only. Thus eserine sulphate appears of little value for prolonged therapy. It may be useful for a functional test during neuropsychological investigations.