RESUMEN

INTRODUCTION AND OBJECTIVES: Early dementia diagnosis in low and middle-income countries (LMIC) is challenging due to limited availability of brief, culturally appropriate, and psychometrically validated tests. Montreal Cognitive Assessment (MoCA) is one of the most widely used cognitive screening tests in primary and secondary care globally. In the current study, we adapted and validated MoCA in five Indian languages (Hindi, Bengali, Telugu, Kannada, and Malayalam) and determined the optimal cut-off points that correspond to screening for clinical diagnosis of dementia and MCI. METHODS: A systematic process of adaptation and modifications of MoCA was fulfilled. A total of 446 participants: 214 controls, 102 dementia, and 130 MCI were recruited across six centers. RESULTS: Across five languages, the area under the curve for diagnosis of dementia varied from 0.89 to 0.98 and MCI varied from 0.73 to 0.96. The sensitivity, specificity and optimum cut-off scores were established separately for five Indian languages. CONCLUSIONS: The Indian adapted MoCA is standardized and validated in five Indian languages for early diagnosis of dementia and MCI in a linguistically and culturally diverse population.

RESUMEN

Objectives: The growing prevalence of dementia, especially in low- and middle-income countries (LMICs), has raised the need for a unified cognitive screening tool that can aid its early detection. The linguistically and educationally diverse population in India contributes to challenges in diagnosis. The present study aimed to assess the validity and diagnostic accuracy of the Indian Council of Medical Research-Neurocognitive Toolbox (ICMR-NCTB), a comprehensive neuropsychological test battery adapted in five languages, for the diagnosis of dementia. Methods: A multidisciplinary group of experts developed the ICMR-NCTB based on reviewing the existing tools and incorporation of culturally appropriate modifications. The finalized tests of the major cognitive domains of attention, executive functions, memory, language, and visuospatial skills were then adapted and translated into five Indian languages: Hindi, Bengali, Telugu, Kannada, and Malayalam. Three hundred fifty-four participants were recruited, including 222 controls and 132 dementia patients. The sensitivity and specificity of the adapted tests were established for the diagnosis of dementia. Results: A significant difference in the mean (median) performance scores between healthy controls and patients with dementia was observed on all tests of ICMR-NCTB. The area under the curve for majority of the tests included in the ICMR-NCTB ranged from 0.73 to 1.00, and the sensitivity and specificity of the ICMR-NCTB tests ranged from 70 to 100% and 70.7 to 100%, respectively, to identify dementia across all five languages. Conclusions: The ICMR-NCTB is a valid instrument to diagnose dementia across five Indian languages, with good diagnostic accuracy. The toolbox was effective in overcoming the challenge of linguistic diversity. The study has wide implications to address the problem of a high disease burden and low diagnostic rate of dementia in LMICs like India.

RESUMEN

Many jobs like outdoor work and emergency rescue have to be exposed to extremely cold environments. The combined effects of the cold exposure and work intensity on human cognitive performance remain unclear. In this paper, the experiments of six Chinese young men exposed to an extremely cold environment (-10 °C) were conducted in a climatic chamber. The work intensity level was graded according to the metabolic rate corresponding to three walking speeds. Nine cognitive functions and one perceived were recorded to evaluate the subjects' cognitive performance, including NCTB (seven items), Stroop, and RPE were measured. The increase of workload from moderate to high could lead to the acceleration of fatigue speed and the aggravation of fatigue degree 5 min earlier. Moderate work intensity is a noteworthy work level in extremely cold environment, which is an inflection point in the impact of fatigue and cognitive levels. The manual dexterity significantly increases by the workload intensity, and the high work intensity makes the hands more dexterous (29% increase). Extremely cold environment has a significant effect on short-term memory (decreased 33%). The selective attention was reduced by 16% in the extremely cold environment. With the moderate work intensity in extremely cold environment, the perceived judgment response speed would decrease. The combined effects of the extremely cold environment and the workload on the cognitive functions of psychomotor ability and attention or sensorimotor speed should be paid more attention to.

Asunto(s)

RESUMEN

An expanded GGGGCC hexanucleotide (G4C2) repeat within the non-coding region of C9ORF72 gene has been identified as the most common genetic cause of FTD/ALS kindred, and synthetic ligand targeting this pathological expansion sequence holds a promising approach for the disease interference. We here describe the naphthyridine carbamate tetramer, p-NCTB, as a binding ligand to hairpin G4C2 repeat. p-NCTB simultaneously recognizes two distal CGGG/CGGG sites in G4C2 repeat DNA and RNA leading to the formation of the interhelical (inter- and intrastrand) binding complexes. The intrastrand binding was predominant when p-NCTB bound to long repeat sequence that accommodates multiple binding sites by folding into hairpins, while the interstrand binding was exclusive for short repeat sequence. The binding of p-NCTB showed repeat-length selectivity: the longer repeat sequence is a better target for p-NCTB. p-NCTB demonstrated inhibition of transcription against G4C2 repeat template in vitro in a repeat length-dependent manner.

Asunto(s)

RESUMEN

OBJECTIVES: Epidemiology studies indicated that coke-oven workers with long-term exposure to polycyclic aromatic hydrocarbons (PAHs) often have some neurobehavioral abnormalities especially impairment for cognitive function, while the underlying mechanisms are not fully understood. Numerous studies have indicated the antioxidant and anti-apoptosis roles of heat shock protein 70 (Hsp70). The genetic polymorphisms in HSP70 genes are associated with multiple diseases including neurotoxicity. However, it is unclear whether HSP70 polymorphisms are related to the neurotoxicity of PAH. We, therefore, investigate the possible association between HSP70 polymorphisms and neurobehavioral abnormalities. METHODS: 188 coke-oven workers and 137 control workers were recruited in this study. Emotional and cognitive function was assessed using the WHO/NCTB. HSP70 polymorphisms (HSP70-1 G190C, HSP70-2 G1267 A and HSP70-hom T2437C) were checked by PCR-RFLP. RESULTS: The results indicated that HSP70-1 CC genotypes in coke-oven workers were associated with poor neurobehavioral performance such as the attention /response speed and visual perception/memory, while the HSP70-2 AA genotypes were associated with lower short-term auditory memory. CONCLUSIONS: HSP70-1 CC and HSP70-2 AA genotypes in coke-oven workers may increase the risk for neurobehavioral damage, especially attention, learning and memory.

Asunto(s)

RESUMEN

BACKGROUND: Minimal hepatic encephalopathy (MHE) may adversely affect driving skills. AIMS: To compare the driving performance of cirrhotic patients with and without prior HE as well as controls using a driving stimulator and to correlate psychometric testing with driving performance. METHODS: Adult patients with cirrhosis, who drove to the outpatient clinic for their routine appointments underwent a battery of driving and psychometric tests including number connection tests A & B (NCT-A and NCT-B), digit symbol test (DST) and critical flicker and fusion frequency (CFF) testing. RESULTS: Cirrhotics had significantly higher NCT-A (39.3 s vs. 31.2 s, P = 0.006) and DST scores (317 s vs. 245 s, P = 0.012), and lower CFF scores Fusion (33 vs. 36 Hz, P = 0.05), Flicker (35 vs. 42 Hz, P = 0.007) than controls. There was no difference in NCT-A, DST and CFF scores between patients with and without HE. Ten (22%) patients, 7 (27%) with prior HE and 3 (15%) without prior HE, had abnormal NCT-A scores (i.e. >control mean ± 2SD), and 12% of patients with prior HE had one or more driving test accidents, while controls and patients without prior HE had none. Patients with cirrhosis were more likely to hit pedestrians compared to controls (P = 0.05). There was no correlation between CFF, DST and NCTB scores with driving performance test results. CONCLUSIONS: Unlike previous reports, no significant differences were noted between the patients with and without prior HE on psychometric testing, and on the driving simulator, but driving accidents were seen in only those with previous history of HE.

RESUMEN

Pesticides remain an integral part of agricultural activities worldwide. Although there have been a number of studies over the last two decades concerning the adverse effects of pesticide poisoning and chronic long term exposures on neurobehavioral function, the impact of recent pesticide poisoning and long term pesticide exposure on neurobehavioral function in Chinese farm workers has not been reported. China is the largest user of pesticides worldwide and figures suggest 53,300-123,000 Chinese people are poisoned every year. A case control study was conducted to examine the impact of recent pesticide poisoning on neurobehavioral function and the relationship between years worked in agriculture and lower performance on neurobehavioral tests. A total of 121 farm workers who self-reported recent pesticide poisonings within the previous 12 months (case group) and 80 farm workers who reported no pesticide poisoning in the previous 12 months (control group) were recruited from three areas of Jiangsu Province, China. The World Health Organization (WHO) recommended neurobehavioral core test battery (NCTB) was used to assess neurobehavioral functioning among cases and controls. Student's t tests and two-way covariance analysis (ANCOVA) were used to test for significant differences in the neurobehavioral test results between the groups. Scores on the Profile of Mood States (POMS) in the recently poisoned group were significantly higher for anger-hostility, depression-dejection, tension-anxiety and lower for vigor-activity compared to controls (p < .05). Digit span, digit symbol, Benton visual retention and pursuit aiming scores were all significantly lower among the recently poisoned group compared to the controls (p < .05). Two-way ANCOVA indicated significantly lower performance in correct pursuit aiming and higher error pursuit aiming amongst the recently poisoned group and those who had worked for more than 30 years in agriculture (p < .05). These findings provide important preliminary epidemiological evidence regarding the association between occupational pesticide exposure and neurobehavioral functioning in Chinese farm workers.

Asunto(s)

RESUMEN

Hepatic encephalopathy is a reversible progressive neuropsychiatric disorder that encompasses a wide clinical spectrum. Covert hepatic encephalopathy is defined as patients with minimal hepatic encephalopathy and Grade I encephalopathy by West-Haven Criteria. Terminology such as "sub-clinical", "latent", and "minimal" appear to trivialize the disease and have been replaced by the term covert. The lack of clinical signs means that covert hepatic encephalopathy is rarely recognized or treated outside of clinical trials with options for therapy based on patients with episodic hepatic encephalopathy. This review discusses the current available options for therapy in covert hepatic encephalopathy and focuses on non-absorbable disacharides (lactulose or lactitol), antibiotics (rifaximin), probiotics/synbiotics and l-ornithine-l-aspartate.

RESUMEN

The World Health Organization-recommended neurobehavioral core test battery (NCTB) became the international standard for identifying adverse human behavioral effects due to neurotoxic chemical exposure when it was first proposed in 1983. Since then the WHO NCTB has been repeatedly cited as the basis for test selection in human neurotoxicology research. A discussion group was held before the International Symposium on Neurobehavioral Methods and Effects in Occupational and Environmental Health to review the NCTB and reconsider its tests. The workshop made three consensus recommendations to the International Congress on Occupational Health (ICOH) Scientific Committee on Neurotoxicology and Psychophysiology (SCNP):. 1. A 'screening' battery of broadly sensitive tests is needed as guidance to the field of human neurotoxicology 2. The SCNP should convene a panel to reconsider the functions measured and the tests in the WHO NCTB 3. Three disciplines should be represented in the panel recommending a revised NCTB: neuropsychology; experimental psychology; neurology. This recommendation will be pursued at the next meeting of the International Congress on Occupational Health (ICOH) Scientific Committee on Neurotoxicology and Psychophysiology (SCNP).

Asunto(s)

RESUMEN

BACKGROUND AND STUDY AIMS: Minimal hepatic encephalopathy (MHE) is diagnosed when hepatic patients perform worse on psychometric tests compared to healthy controls. This study aimed to evaluate probiotics as alternative therapy in MHE. PATIENTS AND METHODS: This is an open-label randomised controlled trial, performed in the Department of Tropical Medicine and Infectious Diseases, Tanta University Hospitals, from March 2010 to January 2012. A total of 90 patients with MHE were allocated by simple randomisation to three parallel equal groups. Group A received lactulose, group B a probiotic (Lactobacillus acidophilus) and group C served as the control. After informed consent, patients were tested for gut micrecology, fasting blood ammonia, liver functions and magnetic resonance spectroscopy (MRS) examination to study brain metabolites, mainly choline (Cho), myo-inositol (mI), glutamine+glutamate (Glx) and creatinin (Cre). Patients who developed overt encephalopathy were excluded from analysis. The whole battery of investigations was repeated in the same order after 4weeks. RESULTS: The probiotic was better tolerated than lactulose. The relative risk reduction (RRR) of developing overt encephalopathy was 60% in the case of lactulose and 80% in the case of probiotic, with a number needed to treat (NNT) of 2.4 and 2.3, respectively. The differential but not total microecology count was significantly shifted towards saccharolytic rather than proteolytic bacteria. The mI/Cre and (Cho+mI)/Glx ratios were significantly increased and the Glx/Cre ratio was significantly reduced after 1month-follow-up in the probiotic group compared to the lactulose group and in both treatment groups compared to the control group. CONCLUSION: Both probiotic and lactulose therapy can improve blood ammonia and psychometric tests in MHE and reduce the risk of developing overt encephalopathy. MRS showed more improvement in the levels of brain neurometabolites in the probiotic group.

Asunto(s)

RESUMEN

BACKGROUND: Neurotoxicants present in water supply may affect human functions in terms of attention, response speed and perceptual motor speed. Neurobehavioural performance can be influenced by gender, age and education levels. This study aims to assess the neurobehavioral performance of palm oil estate residents with private water supply in southern Peninsular of Malaysia. METHODS: A total of 287 and 246 participants from estates with private (PWS) and public water supply (PUB) were recruited to complete a demographic and subjective symptom questionnaire followed by the Neurobehavioral Core Test Battery (NCTB). RESULTS: PWS participants who consumed privately-treated water performed poorly in all NCTB tests compared to PUB participants except for Santa Ana test. Significant group differences in neurobehavioral performance were found for Digit Span Backward (P=0.047), Benton Visual Retention (P=0.006) and Trail Making B tests (P<0.05); which measures the function of memory, attention and visual perception-conceptual. Gender, age and years of education influenced the NCTB scores (P<0.05). Female participants performed poorly in tests measuring latency but excellently tackled those tests that determined association. Younger participants from both PWS and PUB performed better on NCTB tests when compared to other age groups (P<0.05). PWS and PUB participants in this study who received a longer duration of education excelled in the NCTB tests (P=0.000). CONCLUSION: Poor neurobehavioral performance is associated with low water supply quality which affects neurofunctions in terms of attention, memory, response and perceptual motor speed.

RESUMEN

Simple reaction time, digit span, digit symbol, Santa Ana dexterity test, Benton visual retention test, and pursuit aiming of the WHO NCTB (neurobehavioral core test battery) were administered to the 96 males occupationally non-exposed to neurotoxic chemicals. All subjects do not have any disease and head trauma and do not take medicine recently. Multiple regression analysis was done for establishing predict equation to estimate normal ranges of tests for males. Age was main independent variable affected all tests except for simple reaction time. Digit symbol was affected by educational level. Santa Ana dexterity, non-preferred hand was affected by alcohol drinking. Santa Ana dexterity, preferred hand and wrong dot of pursuit aiming were affected by smoking.

Asunto(s)

RESUMEN

Ethylene oxide is widely used to sterilize heat-sensitive materials in hospital. Previous reports for neurotoxic effects of ethylene oxide have been described in animals and humans. To assess the exposure level and neurobehavioral effect of ethylene oxide, a cross-sectional study was performed to 27 nurses from central supply unit at hospital, exposed to ethylene oxide and 32 nurses as reference. Ethylene oxide was collected with using a personal air sampler and analyzed by gas chromatography for the determination of exposure level, and five items among Neurobehavioral Core Test Battery (NCTB) of World Health Organization, including Digit Span, Benton visual retention. Santa Ana dexterity, Digit Symbol and Simple reaction time, were administered to the exposed and reference group. The mean exposure level was 0.63 ppm in the exposed group and six subjects were exposed above the level of 1 ppm, which is currently regulated by the Korean Ministry of Labor. The results of neurobehavioral test in the exposed group showed significantly poorer performances in Digit Span forward and backward, Benton visual retention and Simple reaction time, comparing with the reference group. When the exposure level was divided into below and above the level of 1 ppm, there were significant differences in performance on Benton visual retentions, Digit Symbol and Simple reaction time. Also, Digit Span forward and backward showed significantly poorer performances below the level of 1 ppm, compared with reference group. Simple reaction time was still significantly delayed by the exposure level after controlling the confounding factors with multiple regression analysis. The results suggest that the periodic measurement of ethylene oxide in hospital and health care program is needed.

Asunto(s)

RESUMEN

This study was performed to see whether neurobehavioral tests was affected by the exposure-free time in the workers chronically exposed to organic solvents. Thirty-four female workers were participated and four items among neurobehavioral core test battery of World Health Organization, including digit span, Santa Ana Dexterity, digit symbol, Benton Visual Retention, were administered to the workers. Test was conducted three times-preshift on Monday, preshift on Weekday and during shift on Weekday-per person and the interval of tests was 2 weeks. Digit span forward, Santa Ana Dexterity, digit symbol, and Benton Visual Retention showed significant decrements by performing time, especially during shift on Weekday versus preshift on Monday and preshift on Weekday. In addition, the score at preshift on Weekday was significantly lower than preshift on Monday, in preferred Santa Ana Dexterity and digit symbol. Generally, those who were exposed to high concentration, over 50 years and under 6 years of education showed marked decrease of score at during shift. So, it would be desirable that neurobehavioral test is conducted at preshift on Monday and items related to short term memory could be considerable to be done at preshift on Weekday.

Asunto(s)

RESUMEN

With increased use of neurotoxic agents in manufacturing industries, hazardous effects of neurotoxic agents pose significant problems in protecting health of workers who work in these industries. A normal range of neurobehavioral performance is required 10 study hazardous effects of neurotoxic agents among workers. However, such reference for Korean population is not available yet. The objective of this study is to estimate a normal range of neurobehuvioral test performance of female workers in Korea. Data for neurobehavioral test performance developed by the world Health organization were obtained from 165 female workers. Study Subjects, 140 production workers and 25 clerks, who voluntarily participated in this study were not occupationally exposed to neurotoxic agents. The mean age and the mean education years of them were 32 years and 10.9 years, respectively. Santa Ana dexterity, pursuit aiming, digit symbol, simple reaction time, and Benton visual retention tests among the Neurobehavioral Core Test Battery(NCTB) were included in the evaluation. Subjects were interviewed by a trained interviewer for their detailed occupational history. Mean(+/-SD) performance of the participants were: 45.7+/-7.1 and 41.9+/-6.4 in the Santa Ana dexterity test of the preferred and non-preferred hands; 191.9+/-38.6 in correct dot of the pursuit aiming test; 57.7+/-16.0 in the digit symbol test; 274.8+/-44.6 msec in the mean simple reaction time and 70.5+/-69.0 msec in the mean standard deviation of it; and 7.8+/-1.7 in the Benton visual retention test. Most neurobehavioral performance scores were correlated significantly with age and educational level. Educational level was found to be a significant independent variable which was associated with all test scores. Age was significantly associated with scores of pursuit aiming and digit symbol tests.

Asunto(s)

RESUMEN

It is known that there appear some nonspecific and delicate changes in neuropsychiatric aspect on the workers when they are exposed for a long period to low concentrated organic solvents in the work places. Therefore, it give rise to the necessity of developing a program for the health supervisor stationed in the work place to supervise these neurobehavioral health affection. In addition to the questionnaire posed to the workers exposed to organic solvents, the study team conducted NCTB(Neurobehavioral Core Test Battery) respectively on an exposed group and a non-exposed group to organic solvents. The study team compared the results and decided whether or not to apply the results to the evaluation program of health affection. The study team divided 132 workers in 6 car repairing factories and 2 textile printing factories into exposed group and non-exposed group, pairing them off into 66 research objects according to their age, sex, and job. Neurobehavioral test was conducted on 6 items, except the POMS test, of NCTB developed by the World Health 0rganization (WHO) . The study team conducted examinations of working environment on the exposed and non-exposed groups of each work place. The analysis of the collected materials for examinations were conducted with GC-MS. The concentration of the mix-ture in the air, relative to their respective threshold limit values (TLV) was calculated according to the formula of the ACGIH and the Korean threshold limits. The results indicated that for two of eight factories samples the recommended concentration limits for mixtures was exceeded. Of the six tests, the'digit span forward','digit span backward'and'digit symbol' produced conspicuous statistical differences between the two groups (p<0.1) as a result of compairing the test values by means of paired t-test. The results of respective analysis of the car repairing factories and textile printing factories revealed that the textile printing factories had greater differences between the exposed and the non-exposed than in the car repairing factories. It is presumably because the textile printing workers are continuously exposed to the organic solvents during working hours, whereas the car repairing workers are exposed only when they are doing painting works. The NCTB is assessed very useful in examining the neurobehavioral health affection under the exposure to organic solvents, and, therefore, the study team expects that the NCTB will play an important part in the course of developing a health program for the workers exposed to organic solvents.

Asunto(s)

RESUMEN

No abstract available.

RESUMEN

A cross sectional study was performed to evaluate the neurobehavioral effects of chronic exposure of complex organic solvents, using NCTB(Neurobehavioral Core Test Battery) recommended by WHO(World Health organization). Forty female shoe factory workers and twenty-two controls matched with age were participated. The tests were performed in the morning before start of work, to exclude the effects of acute exposure. Workers were exposed mainly to toluene, methyl ethyl ketone, n-hexane, cyclo-hexane, dichloroethylene, trichloroethylene, benzene, xylenes etc. The ranges of present solvent exposure of hygienic effect were 0.46~0.71 in the process using adhesives indirectly, and 1.83-2.39 in the process using it directly. We reclassified the subjects, according to cumulative exposure. It showed significantly poorer performances in high exposed group on Santa Ana Dexterity and Benton visual Retention, compared with control group. After controlling confounder, the significances were still remained. But, further cohort studies, having the information of personal exposure dose from entering a factory, are required to clarify the effects of chronic exposure of complex organic solvents in relation to dose and duration of exposure.

Asunto(s)

RESUMEN

In order to evaluate the confounding factors of neurobehavioral tests and the neurobehavioral effects in the workers exposed to organic solvents, NCTB was carried out on 100 workers. 46 workers had never been exposed to neurotoxic substances, and the others were being exposed to the solvents, mainly toluene. Simple reaction time, digit symbol, Santa Ana dexterity test and persuit aiming were different with age in non exposure group. Simple reaction time was carried out well in males, and digit symbol and persuit aiming were in females. There was no difference at educational level when the subject was educated over 12 years. Santa Ana dexterity and Benton visual test differed according to exposure level to toluene, however simple reaction time didn't. The acute neurotoxic effect was not excluded in this study. But, NCTB could be used to evaluate and prevent neurobehavioral changes in workers exposed to neurotoxic solvents in Korea.

Asunto(s)