A man in his 80s gradually began to feel that he was experiencing the same events over and over again. This troubling symptom, somewhat reminiscent of the 1993 movie “Groundhog Day,” likely emerged as a rare complication of Alzheimer’s diseaseaccording to a new report of the case.
According to the report, published May 16 in the journal BMJ case reportsthe man once complained to his e-book manufacturer because he thought it kept showing the same material, and he also contacted a technician because his television repeatedly showed the same news.
Describing his predicament in his own words, he said, “Wherever I go, the same people are on the side of the road, the same cars behind me with the same people in them… the same person gets out of the cars with wearing the same clothes, carrying the same bags, saying the same things… nothing is new.”
This condition, called deja vecu with recollective confabulation (DVRC), is sometimes seen in neurodegenerative diseases such as Alzheimer’s, according to the report. Neurodegenerative diseases are diseases in which cells of the central nervous system stop working and eventually die. These conditions worsen over time and there are no cures yet.
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Deja vecu differs from the more famous deja vu, the transient and strange feeling that you have experienced the present before. While deja vu describes a fleeting sensation, deja vecu is the persistent perception that new encounters are repetitions of previous experiences.
Those with deja vecu often lack insight into their condition and develop disabling, delusional false beliefs and behaviors to justify their abnormal perceptions, the case report authors wrote. Collectively, this false perception coupled with the production of false evidence to support it is known as recollective confabulation.
DVRC has been described in a handful other patients with neurodegeneration, including some with Alzheimer’s disease. The exact cause of DVRC remains elusive, but some have suggested that dysfunction of the hippocampus, a part of the brain that helps convert short-term memories into long-term memories, may give rise to a “false sense of memory,” the authors say. noted.
Deja vecu without memory confabulation has also been observed in some neurological disorders, including temporal lobe epilepsy And traumatic brain damageand in psychiatric disorders, such as schizophrenia. This was the case in one reported case linked to a person taking 5-hydroxytryptophana compound that is converted into the chemical messenger serotonin in the body.
A neuropsychological assessment of the man in the recent case revealed memory loss, impulsive behavior and cognitive decline, and he often confused two separate stories as one. Brain scans revealed unusually low activity in the left temporal lobe, an area of the wrinkled outer layer of the brain behind the left ear, and the frontal lobes, with abnormalities more pronounced on the right than the left.
Doctors also examined the man’s cerebrospinal fluid (CSF), the fluid that surrounds and protects the brain and spinal cord. They found that in the CSF, the level of the protein amyloid beta-42 was reduced, while the tau protein level was borderline elevated. These are signs of Alzheimer’s disease.
The man was treated with immunotherapy, probably because his doctors had also found antibodies in his CSF, but this treatment was stopped due to a lack of clinical improvement. Four years after the onset of his symptoms, the man scored worse on cognitive tests than during his initial assessment.
“His recollective confabulation symptoms remain pervasive and bothersome,” the case report authors wrote. Still, “he continued to live at home and remained independent with self-care.”
The largest case series that DVRC documented included reports from 13 patients, nine of whom were likely to have Alzheimer’s disease. Three of the patients had mild cognitive impairment and one had frontotemporal dementia, the authors of the case report wrote. They noted that their case report is unique in that it is DVRC’s first report to analyze brain activity with scans, evaluate the patient’s CSF, and include repeated neuropsychological testing.