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1.
Neurologia (Engl Ed) ; 38(4): 246-255, 2023 May.
Artigo em Inglês | MEDLINE | ID: mdl-35668009

RESUMO

INTRODUCTION: Population ageing poses a challenge for countries in preventing and detecting neurodegenerative disorders. The Montreal Cognitive Assessment (MoCA), a short, simple, valid, and reliable screening test, assesses general cognitive status, and is useful in public health contexts. This study aims to normalise and standardise the MoCA test for the Chilean population. METHOD: We performed a descriptive, correlational validation study of the MoCA test, using a sample including 526 healthy individuals of both sexes, aged between 18 and 90 years, from the north, centre, and south of Chile. We analysed the effects of age, education level, and sex on MoCA performance. RESULTS: Age and education level had a significant impact on general cognitive performance, as determined by MoCA score. Age, education, and sex account for 1%-7% of variance. The mean (standard deviation) score for the total sample was 24.04 (3.22), whereas the normal range originally defined for the instrument is 26-30 points. Older adults with less formal education presented poorer results and lower cognitive performance. We propose a protocol for evaluating results by percentiles and scores for different age ranges, and an individual normalised scalar score. DISCUSSION: We present normative data for the MoCA test in the Chilean population, and propose cut-off points for different age ranges to discriminate normal cognitive performance from neurocognitive disorders; results are adjusted for education level. This proposal would assist in the use of the test and reduce the rate of false positives.


Assuntos
Disfunção Cognitiva , Masculino , Feminino , Humanos , Idoso , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso de 80 Anos ou mais , Chile , Testes de Estado Mental e Demência , Disfunção Cognitiva/diagnóstico , Cognição , Envelhecimento
2.
Ter. psicol ; 40(3): 367-395, dic. 2022. ilus, tab
Artigo em Espanhol | LILACS | ID: biblio-1424679

RESUMO

La planificación es definida como la habilidad de desarrollar un plan secuenciado de pasos conductuales para alcanzar una meta y forma parte de un conjunto de funciones cognitivas de alto orden denominadas funciones ejecutivas. Esta función se ve afectada en diversas situaciones de la vida cotidiana y en una variedad de trastornos neuropsiquiátricos (por ej., depresión, ansiedad, déficit atencional, esquizofrenia, etc.). Tanto el diseño de pruebas cognitivas para evaluar planificación en el contexto clínico, como también el diseño de paradigmas experimentales de evaluación de la planificación en el contexto de investigación, continúa siendo un desafío para la neuropsicología clínica y para las neurociencias. En este artículo de revisión sistemática que sigue las direcciones PRISMA, revisamos la teoría e investigación en relación con la evaluación clínica y la investigación de las bases neurobiológicas de la planificación y los aportes a la comprensión de los mecanismos de su implementación. Se reportan medidas metodológicas comunes y se resumen las aproximaciones teóricas que contribuyen en su comprensión. Nuestros hallazgos muestran la implicancia de la corteza prefrontal en el rendimiento en planificación, en particular el área dorsolateral, corteza cingulada anterior y frontopolar. Mayores estudios clínicos, instrumentales y experimentales son necesarios para comprender mejor la planificación en el contexto de una teoría integrativa de las funciones ejecutivas y del rol de la corteza prefrontal.


Planning is defined as the ability to develop a sequenced plan of behavioral steps to achieve a goal and is part of a set of high-order cognitive functions called executive functions. This function is affected in various daily life situations and in a variety of neuropsychiatric disorders (e.g., depression, anxiety, attention deficit disorder, schizophrenia, etc.). Both the design of cognitive tests to assess planning in the clinical context, as well as the design of experimental paradigms for evaluating planning in research context, continues to be a challenge for clinical neuropsychology and neurosciences. In this PRISMA systematic review article, we review theory and research regarding clinical assessment and research into the neurobiological bases of planning and contributions to understanding the mechanisms of its implementation. Common methodological measures are reported and the theoretical approaches that contribute to their understanding are summarized. Our findings show the involvement of the prefrontal cortex in planning performance, particularly the dorsolateral area, the anterior cingulate cortex, and the frontopolar cortex. Further clinical, instrumental, and experimental studies are needed to better understand planning in the context of an integrative theory of executive functions and the role of the prefrontal cortex.


Assuntos
Humanos , Córtex Pré-Frontal/fisiologia , Função Executiva , Testes Neuropsicológicos
3.
Rev. CES psicol ; 15(2): 1-22, mayo-ago. 2022. tab, graf
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1387203

RESUMO

Resumen Los pacientes diagnosticados con Enfermedad de Parkinson (EP) presentan alteraciones motoras concomitantes a otras alteraciones de tipo cognitivo, conductual o emocional. Una de las alternativas al tratamiento farmacológico es la estimulación cerebral profunda (ECP). Existen reportes de alteraciones en el rendimiento de tareas cognitivas tras procedimiento de ECP, lo que podría sugerir que el procedimiento es responsable de estos cambios cognitivos. El objetivo del estudio fue comparar los resultados del rendimiento en pruebas cognitivas de pacientes con EP de dos grupos (con ECP y sin ECP). Se recolectaron los resultados de 47 pacientes (n = 16 ECP; n = 31 sin ECP) durante los años de 2011 hasta 2015. Dentro de las funciones y variables evaluadas se encuentran: categorización visual, flexibilidad cognitiva, solución de problemas, atención selectiva, velocidad de procesamiento, inhibición conductual y calidad de vida. En general, no se encontraron diferencias significativas entre los grupos en las funciones evaluadas. En el grupo de participantes con ECP, se encontró mayor cantidad de correlaciones entre las pruebas de semejanzas y las de dígitos inversos, listas de palabras, búsqueda de símbolos y las subpruebas del Wisconsin Card Sorting Test. Así mismo, en los pacientes con ECP se presentó una percepción menor de calidad de vida asociada al tiempo de la enfermedad en comparación con el grupo sin ECP. En conclusión, estos resultados son congruentes con estudios similares de evaluación neuropsicológica y se discute el papel del tratamiento de estimulación en los pacientes, los cuales no siempre tienen un impacto positivo sobre la calidad de vida percibida.


Abstract Patients diagnosed with Parkinson's disease show motor alterations together to cognitive, behavioral, and emotional disturbances. An alternative treatment to the exclusive pharmacological medication is the Deep Brain Stimulation procedure (DBS). Some studies have shown altered behavioral patterns after DBS device implantation, suggesting a relationship between a particular performance in cognitive tests derived from the DBS procedure. Our study aimed to compare the performance of cognitive tests in Parkinson's disease patients with and without DBS. Results were analyzed from 47 patients (n = 16 DBS; n = 31 without DBS) in a range since 2011 to 2015. Functions tested were visual categorization, cognitive flexibility, problem solutions, selective attention, cognitive processing speed, behavioral inhibition, and quality of life. In general, there are non-significative differences between groups in functions tested. However, correlations were found depending on the group (DBS or without DBS patients), with more positive correlations inside the DBS group between the similarity test and inversed digits, list of words, symbol search and the sub-test of the Wisconsin Card Sorting Test. In addition, the DBS group showed a low perception of the quality of life associated with the disorder´s time compared to the without DBS group. In conclusion, these results are congruent with similar studies of neuropsychological evaluation, and the role of treatment is discussed below the perception of the quality of life.

4.
J. bras. psiquiatr ; J. bras. psiquiatr;71(3): 241-246, July-set. 2022. tab, graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1405460

RESUMO

ABSTRACT Objective To report the case of a teenager (12 years old) diagnosed with a brain tumor in the right frontal-parietal region emphasizing the main characteristics observed in neuropsychological examinations. Methods In the pre-surgical evaluation, the patient presented behavioral alterations, including deficits in verbal comprehension, perceptual organization, working memory, processing speed, and slight alterations regarding constructive praxis. Results A reevaluation after two years surgery revealed significant improvement in verbal and perceptual comprehension and constructive praxis while remaining a slight change in processing speed. These results suggest that the tumor's surgical resection produced significant improvements in the patient's neurocognitive context, especially in executive functions. This study also indicates that Neuropsychological evaluation are useful for pre- and post- surgical evaluation of cognitive functioning and its evolution. Conclusion Brain tumor causes cognitive and behavioral changes and its resection can result in improvements in the patient's quality of life.


RESUMO Objetivo Relatar o caso de uma adolescente (12 anos de idade) diagnosticada com tumor cerebral na região frontoparietal direita, enfatizando as principais características observadas em exames neuropsicológicos. Métodos Na avaliação pré-cirúrgica, a paciente apresentou alterações comportamentais, incluindo déficits na compreensão verbal, organização perceptual, memória de trabalho, velocidade de processamento e pequenas alterações na praxia construtiva. Resultados Uma reavaliação dois anos após a cirurgia revelou melhora significativa na compreensão verbal e perceptiva e na práxis construtiva, permanecendo uma ligeira alteração na velocidade de processamento. Esses resultados sugerem que a ressecção cirúrgica do tumor produziu melhoras significativas no contexto neurocognitivo da paciente, sobretudo nas funções executivas. Este estudo também indica que a avaliação neuropsicológica é útil para avaliação pré e pós-cirúrgica do funcionamento cognitivo e sua evolução. Conclusão O tumor cerebral causa alterações cognitivas e comportamentais e a sua ressecção pode resultar em melhorias na qualidade de vida do paciente.

5.
Front Neurol ; 13: 796846, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35280275

RESUMO

A comparative analysis of the targets for deep brain stimulation (DBS) to treat refractory temporal lobe epilepsy and the rationale for its use is presented, with an emphasis on the latency to obtain the significant antiepileptic effect and the long-term seizure control. The analysis includes consideration of surgical techniques currently used to optimize antiseizure effects and decrease surgical risks. Seizure control is similar for programed DBS and DBS responsive to abnormal cortical or subcortical electroencephalogram (EEG) activity. There is no difference in the long-term seizure control between programmed and responsive and intermittent or continuous DBS. However, intermittent programed DBS may have a significant antiseizure effect starting in the first month when applied to a non-sclerotic tissue such as the parahippocampal cortex. DBS induces no neuropsychological deterioration.

6.
Rev. chil. neuropsicol. (En línea) ; 16(1): 23-27, ene. 2022. tab
Artigo em Espanhol | LILACS | ID: biblio-1362142

RESUMO

La neuropsicología está desarrollándose y migrando a otras áreas tales como la judicial, en donde el neuropsicólogo forense ayuda al juez a tomar decisiones ecuánimes e imparciales, sin embargo, nace como problemática el fenómeno de la simulación de déficits neurocognitivos con el propósito de obtener ganancias secundarias. Este artículo tiene como objetivo abordar dicho fenómeno mediante una sistematización bibliográfica, estableciendo un marco teórico-comprensivo del fenómeno, así como también identificando las principales herramientas para su detección. Se esquematizan apartados que forman un hilo conductor que arrojan como resultado que la detección de la simulación de déficits neurocognitivos es una tarea compleja, multidimensional y que debería tener un enfoque holístico, por lo tanto, es necesario seguir investigando al respecto para perfeccionar sus métodos de identificación.


Neuropsychology is developing and migrating to other areas such as the judicial, where the forensic neuropsychologist helps the judge to make fair and impartial decisions, however, the phenomenon of the simulation of neurocognitive deficits with the purpose of obtaining secondary gains is born as a problem. This article aims to address this phenomenon through a bibliographic systematization, establishing a theoretical-comprehensive framework of the phenomenon, as well as identifying the main tools for its detection. Thus, sections are outlined that form a common thread that show as a result that the detection of the simulation of neurocognitive deficits is a complex, multidimensional task and that it should have a holistic approach, therefore, it is necessary to continue researching in this regard. to perfect its results identification methods.


Assuntos
Humanos , Transtornos Neurocognitivos/diagnóstico , Simulação de Doença , Testes Neuropsicológicos
7.
Rev. cuba. med. mil ; 50(3): e1036, 2021. graf
Artigo em Espanhol | CUMED, LILACS | ID: biblio-1357317

RESUMO

Introducción: La riqueza de las manifestaciones neuropsicológicas de la demencia frontotemporal, ha permitido la identificación de diferentes variantes de la enfermedad, sin embargo, existen pacientes en los que se entrelazan las características clínicas de más de una variante, lo que ha llevado a cuestionar lo relativo de las clasificaciones vigentes. Objetivo: Caracterizar el funcionamiento cognitivo de un paciente donde concomitan alteraciones conductuales y del lenguaje, típicas de la demencia frontotemporal. Caso clínico: Mujer diestra, de 50 años de edad, con cambios conductuales marcados, a los cuales, de forma progresiva, se sumaron alteraciones del lenguaje, en un periodo de evolución de aproximadamente un año y seis meses. Por imágenes de tomografía axial computarizada, se confirma atrofia cortical a predominio frontal. Se emplearon para la evaluación la batería neuropsicológica breve NEUROPSI, la escala Hasegawa y la batería de evaluación frontal de Litvan; se constata predominio de alteraciones en el lenguaje impresivo y expresivo, las funciones ejecutivas y en la memoria verbal. Conclusiones: Las alteraciones detectadas, confirman la coexistencia de manifestaciones de la variante conductual (con tendencia a la desinhibición) y la variante semántica de la demencia frontotemporal(AU)


Introduction: The richness of the neuropsychological manifestations of frontotemporal dementia has allowed the identification of different variants of the disease. However, there are patients in whom the clinical characteristics of more than one variant are intertwined, which has led to question the current classifications. Objective: To characterize the cognitive functioning of a patient with concomitant behavioral and language disorders, typical of frontotemporal dementia. Case presentation: Right-handed female, 50 years old, affected by marked behavioral changes, to which language alterations were progressively added in a period of evolution of approximately one year and six months. Images of Computerized Axial Tomography that confirm cortical atrophy mainly frontal. The Neuropsychological Battery abbreviated NEUROPSI, the Hasegawa Scale and the Litvan Frontal Evaluation Battery were used for the evaluation, with a predominance of alterations in printed and expressive language, executive functions and verbal memory. Conclusions: The alterations detected confirm the coexistence of manifestations of the behavioral variant (with a tendency to disinhibition) and the semantic variant of frontotemporal dementia(AU)


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Demência Frontotemporal , Demência Frontotemporal/diagnóstico , Transtornos da Linguagem , Testes Neuropsicológicos/normas
8.
Front Endocrinol (Lausanne) ; 12: 671659, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34220711

RESUMO

Introduction: It is rare for a euthyroid mother to carry a child with a fetal goiter. However, cases of congenital hypothyroidism (CH) caused by thyroid dyshormonogenesis have been reported. Even though gene mutations associated with fetal goiter have been reported in a few studies, the effects on intellectual development have not been investigated. This study aimed to characterize and investigate the underlying genetic mechanism of CH and neuropsychological development and growth of two siblings with CH-induced fetal goiters. Case report: Two male siblings from a non-consanguineous marriage with CH and fetal goiter were diagnosed by ultrasonography at 32- and 26-weeks of gestation. This condition was confirmed by cordocentesis in the first pregnancy (TSH: 135 µIU/ml). The mother was euthyroid, and no intra-amniotic levothyroxine treatment was performed. Peripheral blood DNA was screened for TPO mutations. The new deletion p.Cys296Alafs*21 and the p.Arg665Trp mutation, inherited from heterozygous parents, were identified in both patients. Functional analysis showed both mutations reduced the TPO enzyme activity and impaired the membrane localization. The p.Cys296Alafs*21 mutation produces a protein product with a drastically reduced molecular weight. Additionally, a complete clinical and neuropsychological evaluation was also performed. The WISC IV test was employed to provide an overall measure of the siblings' cognitive and intellectual abilities. No growth retardation was detected in either child. In general, both children showed normal neuropsychological development; however, they exhibited slight reduction of Processing Speed Index scores, which are sensitive to neurological and attentional factors and motor maturation activity. Notably, the younger sibling obtained significantly low scores in the Operational Memory Index, a measure of attention capacity and psychoneurological immaturity. Conclusion: We described a new TPO compound heterozygosity that severely impaired the TPO activity and membrane localization leading to severe CH and fetal goiter. This is the first report showing the neuropsychological evaluation in patients with dyshormonogenetic fetal goiter. More studies are needed to understand the neurodevelopmental outcomes of neonates with CH-induced fetal goiters.


Assuntos
Autoantígenos/genética , Hipotireoidismo Congênito/diagnóstico por imagem , Bócio/diagnóstico por imagem , Iodeto Peroxidase/genética , Proteínas de Ligação ao Ferro/genética , Mutação , Hipotireoidismo Congênito/genética , Análise Mutacional de DNA , Feminino , Bócio/genética , Humanos , Recém-Nascido , Masculino , Gravidez , Ultrassonografia Pré-Natal
9.
Int J Psychol Res (Medellin) ; 13(2): 49-58, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33329877

RESUMO

Semantic memory (SM) is a type of long-term memory associated with the storage of general information about the world. Here we assessed the characteristics of the SM battery, developed by Catricalà et al. (2013), in a sample of Colombian children. This battery was originally conceived to evaluate adults, and features six subtests that assess SM in different modalities, using a common set of 48 stimuli in both living and nonliving categories. The design of the current study is of a cross-sectional and exploratory type. The sample was composed of 111 children, 57 boys (51%) and 54 girls (49%), who were 6 (n = 68) and 7 (n = 43) years old and had no intellectual disability. Robust linear regression models and correlation networks were used. We found an effect of age on general intelligence after correcting for gender, and no differences on the six subtest scores after corrections for gender and age were performed. Furthermore, age was found to be positively associated with the naming of colored photographs (ß = .75, p = .039), naming in response to an oral description (ß = 1.81, p = .039), picture sorting at four levels (ß = 7.22, p = .029), and sentence verification (ß = 26.66, p = .01). In addition, there were differences between the results obtained in adults in the original study and in the children of our study. This exploratory study supports the feasibility of the Spanish translation of the Catricalà et al. (2013) battery to assess SM in children with a nonclinical condition. Future studies are needed to evaluate the psychometric properties of this SM battery, and to corroborate and expand our findings in a larger sample of control children, and in children with some degree of intellectual disability or suffering of some neurodegenerative or psychiatric conditions.


La memoria semántica (SM) es un tipo de memoria a largo plazo asociada con el almacenamiento de información general sobre el mundo. Aquí evaluamos las características de la batería SM, desarrollada por Catricalà et al. (2013), en una muestra de niños colombianos. Esta batería fue concebida originalmente para evaluar adultos, y presenta seis subpruebas que evalúan SM en diferentes modalidades, utilizando un conjunto común de 48 estímulos en las categorías de vida y no vida. El diseño del presente estudio es de tipo transversal y exploratorio. La muestra estaba compuesta por 111 niños, 57 niños (51%) y 54 niñas (49%), que tenían 6 (n = 68) y 7 (n = 43 ) años y no tenían discapacidad intelectual. Se utilizaron modelos de regresión lineal robustos y redes de correlación. Encontramos un efecto de la edad en la inteligencia general después de corregir por género, y no hubo diferencias en las seis puntuaciones de la subprueba después de realizar correcciones por género y edad. Además, se encontró que la edad se asociaba positivamente con el nombramiento de fotografías en color (ß = .75, p = .039), nombrando en respuesta a una descripción oral (ß = 1.81, p = .039), clasificación de imágenes en cuatro niveles (ß = 7.22, p = .029) y verificación de oraciones (ß = 26.66, p = .01). Además, hubo diferencias entre los resultados obtenidos en adultos en el estudio original y en los niños de nuestro estudio. Este estudio exploratorio respalda la viabilidad de la traducción al español de Catricalà et al. (2013) batería para evaluar SM en niños con una condición no clínica. Se necesitan estudios futuros para evaluar las propiedades psicométricas de esta batería SM, y para corroborar y expandir nuestros hallazgos en una muestra más grande de niños control, y en niños con algún grado de discapacidad intelectual o que padecen algunas condiciones neurodegenerativas o psiquiátricas.

10.
rev. psicogente ; 23(44): 93-112, jul.-dic. 2020. tab
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1361211

RESUMO

Resumen Objetivo: El Trastorno por Déficit de Atención con Hiperactividad/impulsividad (TDAH) es una de las dificultades de aprendizaje más comunes en las escuelas chilenas. Se caracteriza por un patrón de funcionamiento atípico en atención e inhibición, con fuerte compromiso de otras funciones ejecutivas. Uno de los desafíos que plantea este trastorno está referido al proceso de diagnosis, el cual no suele ser suficientemente preciso. Se pretende explorar las diferencias en la distribución de dos muestras de estudiantes con y sin TDAH diagnosticadas con una escala de observación conductual a través de la evaluación de las funciones ejecutivas de atención, inhibición y flexibilidad cognitiva. Método: En este estudio se evaluó a 132 escolares, 66 con TDAH y 66 sin TDAH, en las variables de atención, inhibición y flexibilidad cognitiva de un colegio de la ciudad de Concepción en Chile. Se contrastó el rendimiento cognitivo con los diagnósticos y se reagrupó a los estudiantes en los subtipos conocidos del trastorno. Resultados: La evaluación neuropsicológica mostró que en el grupo con TDAH había alumnos que no cumplían los criterios diagnósticos para estar incluidos en él. En el grupo sin TDAH se observó un fenómeno semejante. En ambos grupos la evaluación neuropsicológica de la atención y la inhibición resultaron útiles para diagnosticar con mayor certeza y para determinar el subtipo al que pertenecía cada estudiante con TDAH detectado. La flexibilidad cognitiva solo permitió diferenciar a los sujetos con y sin TDAH. Conclusiones: En ambos grupos estudiados fue posible encontrar sujetos mal diagnosticados; el sobrediagnóstico fue de 43,93 % en el grupo con TDAH, mientras que el infradiagnóstico fue de 42,42 % en el grupo sin TDAH.


Abstract Objective: Attention Deficit Hyperactivity/Impulsivity Disorder (ADHD) is one of the most common learning difficulties in Chilean schools. It is characterized by an atypical functioning pattern in attention and inhibition, strongly compromising other executive functions. One of the challenges posed by this disorder is the diagnosis process, which is often not sufficiently accurate. The intention is to study the distribution of two students samples, with and without ADHD, diagnosed by a behavioral observation scale through the evaluation of attention, inhibition, and cognitive flexibility executive functions. Method: This study evaluated 132 students, 66 with ADHD and 66 without ADHD, considering the attention, inhibition, and cognitive flexibility variables of a school in the city of Concepción in Chile. Cognitive performance was contrasted with the diagnoses, and students were regrouped in the disorder known subtypes. Results: The neuropsychological evaluation showed that in the ADHD group, there were students who did not meet the diagnostic criteria to be included in the group. A similar phenomenon was observed in the group without ADHD. In both the groups, the neuropsychological evaluation of attention and inhibition was useful in providing a more certain dignosis and in determining the subtype to which each student detected with ADHD belonged. Cognitive flexibility was only useful in differentiating betwen the subjects with and without ADHD. Conclusions: In both the groups studied, it was possible to find misdiagnosed subjects; the overdiagnosis was 43,93 % in the ADHD group, while the under-diagnosis was 42,42 % in the group without ADHD.

11.
Neurologia (Engl Ed) ; 2020 Nov 05.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-33160725

RESUMO

INTRODUCTION: Population ageing poses a challenge for countries in preventing and detecting neurodegenerative disorders. The Montreal Cognitive Assessment (MoCA), a short, simple, valid, and reliable screening test, assesses general cognitive status, and is useful in public health contexts. This study aims to normalise and standardise the MoCA test for the Chilean population. METHOD: We performed a descriptive, correlational validation study of the MoCA test, using a sample including 526 healthy individuals of both sexes, aged between 18 and 90 years, from the north, centre, and south of Chile. We analysed the effects of age, education level, and sex on MoCA performance. RESULTS: Age and education level had a significant impact on general cognitive performance, as determined by MoCA score. Age, education, and sex account for 1-7% of variance. The mean (standard deviation) score for the total sample was 24.04 (3.22), whereas the normal range originally defined for the instrument is 26-30 points. Older adults with less formal education presented poorer results and lower cognitive performance. We propose a protocol for evaluating results by percentiles and scores for different age ranges, and an individual normalised scalar score. DISCUSSION: We present normative data for the MoCA test in the Chilean population, and propose cut-off points for different age ranges to discriminate normal cognitive performance from neurocognitive disorders; results are adjusted for education level. This proposal would assist in the use of the test and reduce the rate of false positives.

12.
Seizure ; 82: 125-132, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33068959

RESUMO

PURPOSE: To evaluate impulsiveness in adult patients with JME and its relationship with personality traits and executive functioning. METHODS: Patients completed psychiatric evaluation (DSM IV), Barratt Impulsiveness Scale (BIS-11), Neo Revised Personality Inventory (NEO PI-R) and executive functioning evaluation comprising Controlled Oral Word Association (COWA), Digit Span, Trail Making Tests (TMT), Stroop Test (ST) and Wisconsin Card Sorting Test (WSCT). Healthy controls (63 % female, mean age 35.7 yrs. (±8.37)) were examined to allow calculation of z-scores. RESULTS: 50 patients (70 % female; mean age 32.5 yrs. (±9.2)) presented higher scores of Total (z=-0.37; p = 0.005) and Motor Impulsiveness (z=-0.79; p < 0.001) on BIS-11. Motor Impulsiveness was associated with higher rates of mild psychiatric disorders (depression and anxiety) (p = 0.035) and worse myoclonic seizure control (p = 0.007). NEO PI-R showed differences on Neuroticism (z=-0.60; p < 0.001), Openness (z = 0.38; p = 0.043), Agreeableness (z=-0.38; p = 0.033) and Conscientiousness (z=-0.53; p = 0.003). There were positive correlations between BIS-11 and Neuroticism with Total, Motor and Non-Planning Impulsiveness, on the other hand, Conscientiousness was negatively correlated with these as well as with Attentive Impulsiveness. Patients performance was worse than that of controls on COWA (z=-0.43; p = 0.009) and WCST's Total Number of Completed Categories (z=-2.08; p = 0.005), Trials Taken to Complete First Category (z=-1.56; p = 0.013), Percentage of Total Errors (z=-1.56; p < 0.001), Perseverative Errors (z=-0.73; p = 0.002), Non-Perseverative Errors (z=-1.05; p = 0.003) and Conceptual Level Responses (z=-1.52; p < 0.001). Non-Planning Impulsiveness correlated with Performance (ST and TMT). CONCLUSION: Patients with JME present with impulsive behavior, personality features and executive dysfunction which are linked and may lead to lack of commitment in treatment and affect other aspects of life.


Assuntos
Função Executiva , Epilepsia Mioclônica Juvenil , Personalidade , Adulto , Feminino , Humanos , Masculino , Epilepsia Mioclônica Juvenil/psicologia , Testes Neuropsicológicos , Inventário de Personalidade
13.
Rev. Investig. Innov. Cienc. Salud ; 2(1): 98-115, 2020. tab, ilus
Artigo em Espanhol | LILACS, COLNAL | ID: biblio-1391189

RESUMO

El Complejo de Esclerosis Tuberosa (CET) es un trastorno genético de heren-cia autosómica dominante causado por la mutación en uno de los genes TSC1 o TSC2. Los pacientes con una afectación CET grave de tipo neurológica posible-mente presentarán epilepsia, discapacidad intelectual, problemas específicos del aprendizaje y trastornos de la conducta, por lo que la evaluación neuropsicológica en individuos con esta patología cobra un carácter importante al proporcionar información sobre los déficits cognitivos que subyacen en la afectación cerebral, que alteran el funcionamiento intelectual y los aspectos adaptativos. El actual tra-bajo presenta el perfil de una paciente adulta femenina con antecedente de CET, epilepsia y discapacidad intelectual, así como la descripción de una propuesta de intervención neuropsicológica basada en el funcionamiento ejecutivo dorsolateral.


Tuberous Sclerosis Complex (TSC) is an autosomal dominant inherited genetic disorder caused by mutation in one of the TSC1 or TSC2 genes. Patients with severe neurological-type CET involvement may have epilepsy, intellectual disability, specific learning problems, and behavioral disorders. For this reason, the neuropsychological evaluation in individuals with this pathology becomes an important character by providing information on the cognitive deficits that underlie brain involvement that alter intellectual functioning and adaptive aspects. The current work presents the cognitive profile of a female adult patient with a history of TSC, epilepsy and intellectual disability and the description of a proposed neuropsychological intervention based on dorsolateral executive functioning.


Assuntos
Humanos , Esclerose , Esclerose Tuberosa , Mutação/genética , Neuropsicologia/métodos , Epilepsia , Disfunção Cognitiva , Doenças da Imunodeficiência Primária/genética , Transtornos da Memória , Deficiência Intelectual/fisiopatologia
14.
Revista Areté ; 20(1): 1-8, 2020. graf, ilus
Artigo em Espanhol | LILACS, COLNAL | ID: biblio-1354768

RESUMO

El test del reloj es una evaluación utilizada para valorar diversas funciones cognitivas, entre ellas el lenguaje (la comprensión verbal), la atención, la memoria, la planificación, el razonamiento, la capacidad de inhibición y el análisis visoespacial en el espacio gráfico. En el presente estudio de tipo descriptivo y transversal, se utilizó esta prueba como una herramienta sencilla de screening en base a una selección de 100 pacientes adultos y se propone, a partir de los hallazgos obtenidos, una tabla de valoración con nuevos criterios de puntuación evaluando posteriormente, si existen variaciones en la interpretación subjetiva de la misma mediante la participación de otros inter-evaluadores (E1, E2, E3). Los resultados indican que los nuevos criterios de puntuación resultaron fáciles de aplicar e interpretar, no encontrándose diferentes estadísticamente relevantes entre todos los inter-evaluadores.


The quick test is an evaluation used to assess various cognitive functions, including language (verbal comprehension), attention, memory, planning, reasoning, the ability to inhibit, and visuospatial analysis in graphic space. In the present study, this test will be found as a simple detection tool based on a selection of 100 adult patients and, based on the obteined findings, a valuation table with new scoring criteria is proposed, subsequently evaluating whether there are variations in the subjective interpretation of it through the participation of other inter-evaluators (E1, E2, E3). The results indicated by the new scoring criteria were easy to apply and interpret, and no statistically relevant differences were found among all the inter-evaluators.


Assuntos
Programas de Rastreamento , Testes Neuropsicológicos , Pacientes , Atenção , Cognição , Compreensão , Memória
15.
Arq. neuropsiquiatr ; Arq. neuropsiquiatr;77(6): 429-435, June 2019. tab, graf
Artigo em Inglês | Sec. Est. Saúde SP, LILACS, SESSP-IIERPROD, Sec. Est. Saúde SP | ID: biblio-1011356

RESUMO

Background Although classical human T-cell lymphocyte virus type 1 (HTLV-1)-associated myelopathy/tropical spastic paraparesis syndrome is the most frequent HTLV-1-associated neurological disorder, some "minor" neurological disorders can be seen in "asymptomatic" carriers. These disorders, including cognitive alterations already described in clinical cases and studies, may constitute an intermediate syndrome (IMS) between the asymptomatic state and myelopathy. The aim of this study was to investigate the presence of cognitive deficits in patients with HTLV-1 virus, who usually are diagnosed as asymptomatic. Methods A total of 54 HTLV-1-infected patients were evaluated, 35 asymptomatic and 19 with minor neurological alterations (evaluated by a neurologist); 25 HTLV-1-seronegative individuals served as controls. The instruments used were: Beck's Depression Inventory, Lawton's Daily Life Activity Scale, and a complete neuropsychological battery. The application of these evaluation instruments was performed blindly, with the evaluator neuropsychologist not knowing the clinical condition of the patient. Results Most of the participants in this cohort, including seronegative controls, were female (n = 57, 72.21%), their mean age was 52.34 years (SD = 14.29) and their average schooling was 9.70 years (SD = 4.11). Discussion Participants classified with IMS had lower gross scores when compared with both the patients classified as asymptomatic and with the control group, and when tested for auditory episodic memory of immediate (p < 0.01), and late (p = 0.01), recall. Conclusion Patients with IMS presented with memory impairment when compared with asymptomatic patients and seronegative individuals; this is one of the symptoms that aids in the classification of the syndrome.


RESUMO Apesar da síndrome de HAM / TSP clássica ser a perturbação neurológica mais atribuída, alguns distúrbios neurológicos denominados "menores" são vistos em portadores "assintomáticos" de HTLV-1. Esses distúrbios, incluindo alterações cognitivas já observadas em descrições de casos clínicos e estudos, podendo constituir uma verdadeira síndrome clínica intermediária (SI) entre o estado assintomático e mielopatia. O objetivo deste estudo foi investigar a presença de déficits cognitivos em pacientes portadores do vírus HTLV-1 diagnosticados classicamente como assintomáticos. Métodos Foram avaliadas 54 pessoas, sendo 35 assintomáticos, 19 com alterações neurológicas menores (avaliados por um neurologista) e 25 HTLV-1 negativo. Os instrumentos utilizados foram: Inventário Beck de Depressão, Escala de Atividades de Vida Diária de Lawton e uma completa bateria neuropsicológica. A aplicação destes instrumentos de avaliação foi realizada de forma cega, ou seja, a avaliadora não sabia a condição clinica do paciente. Resultados A maioria dos participantes era do sexo feminino (n = 57, 72,21%), com idade média de 52.34 anos (DP = 14,29) e escolaridade média de 9.70 anos (DP = 4,11). Discussão Avaliando o desempenho cognitivo nos três grupos, foi possível observar que os participantes classificados com SI, apresentaram menores escores brutos, quando comparados, com os pacientes com classificação assintomática e grupo controle e, em relação à memória episódica auditiva de evocação imediata (p < 0,01) (p = 0,01) e tardia. Conclusão Diante dos resultados foi possível concluir que os pacientes com SI apresentam comprometimento de memória quando comparado com os outros grupos, sendo possível, ser este um dos sintomas para auxiliar na classificação da síndrome.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Infecções por HTLV-I/psicologia , Disfunção Cognitiva/virologia , Transtornos da Memória/virologia , Valores de Referência , Infecções por HTLV-I/fisiopatologia , Estudos de Casos e Controles , Estudos Transversais , Inquéritos e Questionários , Análise de Variância , Estatísticas não Paramétricas , Escolaridade , Disfunção Cognitiva/fisiopatologia , Transtornos da Memória/fisiopatologia , Testes Neuropsicológicos
16.
Psicopedagogia ; 36(109): 3-9, jan.-abr. 2019. graf
Artigo em Português | LILACS-Express | LILACS | ID: biblio-1002936

RESUMO

INTRODUÇÃO: A memória operacional é composta por um conjunto de processos cognitivos elaborados que combinam tanto o armazenamento temporário como o processamento das informações recebidas. Este sistema está envolvido em atividades cognitivas superiores como compreensão da linguagem, leitura, aritmética e resolução de problemas. A literatura indica que estudantes com dificuldades de aprendizagem podem apresentar prejuízos no processamento, armazenamento ou manipulação de informações. Assim, estudos que investigam o desenvolvimento da memória operacional são essenciais para a compreensão do processo de aprendizagem. OBJETIVO: Avaliar a memória operacional de escolares e correlacionar os resultados com o desempenho acadêmico. MÉTODO: A amostra foi composta por 30 escolares do Ensino Fundamental e Médio, com idade média de 10,4 (DP=3,45) anos, 50% do sexo feminino e 73,3% de escola particular. Os participantes foram avaliados a partir dos subtestes que compõem o Índice de Memória Operacional do WISC-IV (Dígitos, Aritmética e Sequência de Números e Letras) e pelo instrumento complementar Cubos de Corsi. A duração de cada avaliação foi de aproximadamente 1 hora. O desempenho acadêmico dos estudantes foi analisado a partir do boletim escolar. RESULTADOS/CONCLUSÃO: Os resultados demonstram que a memória operacional exerce uma influência direta no desempenho acadêmico, sendo necessária a sua investigação e a identificação precoce de déficits, para que medidas de prevenção e de intervenção possam ser adotadas, evitando, assim, prejuízo acadêmico e futuras dificuldades de aprendizagem.


INTRODUCTION: Working memory consists of a set of elaborate cognitive processes developed that combine the temporary storage and the processing of the information received. This system is involved in higher cognitive activities such as language comprehension, reading, arithmetic and problem solving. The literature indicates that students with learning disabilities may have losses in processing, storage or manipulation of information. Thus, studies that investigate the development of working memory are essential for understanding the learning process. OBJECTIVE: To evaluate the working memory of schoolchildren and to correlate the results with the academic performance. METHODS: The sample was composed of 30 elementary and middle school students, with an average age of 10.4 (SD=3.45) years, 50% female and 73.3% of private school. Participants were evaluated from the subtests that comprise the Working Memory Index of the WISC-IV (Digits, Arithmetic and Sequence of Numbers and Letters) and the complementary instrument Corsi Block. The time of each evaluation was approximately 1 hour. The academic performance of the students was analyzed from the school report card. RESULTS/CONCLUSION: The results show that working memory exerts a direct influence on academic performance, requiring its investigation and early identification of deficits, so that prevention and intervention measures can be adopted, avoiding academic impairment and future learning difficulties.

17.
Rev. ecuat. neurol ; Rev. ecuat. neurol;27(3): 36-43, sep.-dic. 2018. tab, graf
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1004043

RESUMO

Resumen La corteza pre-frontal es la base de las habilidades mentales de mayor complejidad del desarrollo humano. En su proceso de evaluación, la escala EFECO brinda un importante aporte para valorar su estado. En investigaciones previas se ha estudiado esta escala con su configuración de 67 ítems, narrativa centrada en el déficit y evaluación de 8 funciones ejecutiva. En esta investigación se presentan los siguientes aportes: una nueva versión de la escala, centrada en su narrativa en la habilidad ejecutiva, propuesta de ítems para valorar la función ejecutiva de verificación y una versión resumida de la escala en 42 ítems. En el estudio participaron 118 adultos saludables entre 18 y 25 años de edad (M edad = 20.72, DE = 1.65). En los resultados se encontró que la escala EFECO II-VC (versión modificada y completa) obtuvo como consistencia interna α = .96 y sus sub-escalas consistencia interna entre α = .64 y .81. La escala EFECO II-VR (versión modificada y resumida) obtuvo α = .94 y sus sub-escalas entre α = .68 y .79. La consistencia interna de los factores en los que se engloban las funciones ejecutivas se presentaron adecuados: el sistema supervisor de la cognición II-VC α = .93 y II-VR α = .70, mientras que el sistema supervisor de la conducta II-VC α = .93 y II-VR α = .81. Las correlaciones entre las funciones ejecutivas valoradas con ambas escalas fueron entre medianas y grandes r = .36 y .94. Se cierra el trabajo discutiendo el aporte clínico y científico de la modificación de la escala EFECO.


Abstract The pre-frontal cortex is the basis of the most complex mental abilities of human development. In its evaluation process, the EFECO scale provides an important contribution to assess its status. In previous investigations this scale has been studied with its configuration of 67 items, narrative focused on the deficit and evaluation of 8 executive functions. This research presents a new version of the scale, centered on its narrative in executive ability, proposed items to assess executive verification function and a summarized version of 42 items. The study included 118 healthy adults between 18 and 25 years of age (M age = 20.72, SD = 1.65). In the results it was found that the EFECO II-VC scale (modified and complete version) obtained as internal consistency α = .96 and its sub-scales internal consistency between α = .64 and .81. The EFECO II-VR scale (modified and summarized version) obtained α = .94 and its sub-scales between α = .68 and .79. The internal consistency of the factors in which the executive functions are included were adequate: the supervisory system of cognition II-VC α = .93 and II-VR α = .70, while the supervisor system of behavior II- VC α = .93 and II-VR α = .81. The correlations between the executive functions assessed with both scales were between medium and large r = .36 and .94. The work is closed discussing the clinical and scientific contribution of the modification of the EFECO scale.

18.
JMIR Res Protoc ; 7(8): e172, 2018 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-30131319

RESUMO

BACKGROUND: Cognitive impairment is considered one of the most feared chronic conditions among the older adult population since its incidence is approximately twice more frequent than that of dementia. In Mexico, no studies or reports of older adults using technology for cognitive interventions have been published, given that institutions usually frame cognitive stimulation tasks in paper and pencil (ie, in the traditional manner). OBJECTIVE: The objective of this study was to create and analyze the effect, viability, and impact of a mobile app for cognitive stimulation implemented among a group of elderly adults (over 60 years of age) from the state of Hidalgo in Mexico. METHODS: This study was a nonprobabilistic pilot trial using convenience sampling. An intervention was implemented among a group of 22 older adults between 60 and 80 years of age over 12 weeks. Half of the older adults were stimulated with the mobile app (experimental group) and the other half followed the traditional paper and pencil training (control group). Assessments with the Mini-Mental State Examination (MMSE) and the Neuropsi, a neuropsychological test validated in Mexico, were done before and after both cognitive stimulations. RESULTS: According to the analyzed data, 6/11 (55%) participants from the experimental group obtained better results in their cognitive skills, and 5 (45%) of the adults maintained their score, given that the participants were able to execute the exercises repetitively. Meanwhile, for the control group, only 3/11 (27%) participants obtained better results in the postevaluation. Significant values for results of the MMSE were obtained in the postevaluation for the experimental group compared to the control group, while results did not show significant differences in the Neuropsi. Regarding the validation of the app, all the participants evaluated its pertinence positively. CONCLUSIONS: The intervention data show that the experimental group obtained better results in the postevaluation given that the participants were able to execute the exercises repetitively. The control group could not accomplish this since they had to respond on the manual and no further attempts were provided. However, both groups increased their score in the neuropsychological evaluations. This suggests that a longer and more frequent intervention is required. REGISTERED REPORT IDENTIFIER: RR1-10.2196/9603.

19.
Med. U.P.B ; 37(1): 25-35, ene. 2018.
Artigo em Inglês | LILACS, COLNAL | ID: biblio-878937

RESUMO

Objetivo: la terapia electroconvulsiva (TEC) se ha considerado un tratamiento seguro y eficaz para episodios de depresión mayor, para episodios maníacos y otros trastornos psiquiátricos serios. El estudio describe los efectos cognitivos de la TEC en pacientes referidos para tratamiento a una clínica privada. Metodología: estudio descriptivo del tipo de serie de casos. En cada participante se realizó una evaluación basal antes del inicio de la TEC y otras dos (una a la semana y otra a los seis meses) después de terminado el ciclo de tratamientos, para describir el efecto de la TEC frontotemporal bilateral en la función neurocognitiva mediante el cambio, desde el estado basal hasta la evaluación final en los dominios de memoria, velocidad psicomotora, tiempo de reacción, atención compleja y flexibilidad cognoscitiva, así como en la función cognoscitiva global; y determinar su seguridad por el reporte de eventos adversos. La evaluación cognitiva se realizó con una batería de pruebas neuropsicológicas y la severidad de la enfermedad psiquiátrica se evaluó con la escala Clinical Global Impression Severity (CGI-S). Se incluyeron seis pacientes remitidos para tratamiento durante el periodo de seis meses. Resultados: no se observaron diferencias estadísticamente significativas entre las medianas de las evaluaciones de CGI-S, ni de la función cognitiva global, así como de ninguno de los dominios evaluados. Conclusiones: la TEC no produjo cambios en las funciones cognitivas analizadas en los seis pacientes estudiados.


Objective: Electroconvulsive therapy (ECT) has been considered a safe and effective treatment for depression, manic episodes, and other serious psychiatric conditions. Its main reported side effect has been cognitive impairment. This study describes the cognitive effects of ECT in psychiatric patients referred for treatment at a private clinic. Methodology: Descriptive case series study. A baseline assessment conducted before starting ECT, and another two (at one week and at six months) after completing the treatment cycle were used to describe the effects of frontotemporal bilateral ECT on neurocognitive function in terms of the change from the baseline to the final assessment in the domains of memory, psychomotor speed, reaction time, complex attention, and cognitive flexibility, as well as global cognitive function, as well as to determine ECT's safety by reporting adverse events. Cognitive assessment was conducted with a neuropsychological test battery and severity of psychiatric illness with the Clinical Global Impression-Severity scale (CGI-S). Six patients referred for treatment during six months were included. Results: No statistically significant differences were observed between the medians of the evaluations of CGI-S scale, global cognitive function or any of the domains evaluated. Conclusions: ECT did not produce changes in the cognitive functions assessed in the six studied patients.


Objetivo: a terapia eletroconvulsiva (TEC) se há considerado um tratamento seguro e eficaz para episódios de depressão maior, para episódios maníacos e outros transtornos psiquiátricos sérios. O estudo descreve os efeitos cognitivos da TEC em pacientes referidos para tratamento a uma clínica privada. Metodologia: estudo descritivo do tipo de série de casos. Em cada participante se realizou uma avaliação basal antes do início da TEC e outras dois (uma em uma semana e outra aos seis meses) depois de terminado o ciclo de tratamentos, para descrever o efeito da TEC frontotemporal bilateral na função neurocognitiva mediante a mudança, desde o estado basal até a avaliação final nos domínios de memória, velocidade psicomotora, tempo de reação, atenção complexa e flexibilidade cognoscitiva, assim como na função cognoscitiva global; e determinar sua segurança pelo reporte de eventos adversos. A avaliação cognitiva se realizou com uma bateria de provas neuropsicológicas e a severidade da doença psiquiátrica se avaliou com a escala Clinical Global Impression Severity (CGI-S). Se incluíram seis pacientes remitidos para tratamento durante o período de seis meses. Resultados: não se observaram diferencias estatisticamente significativas entre as média das avaliações de CGI-S, nem da função cognitiva global, assim como de nenhum dos domínios avaliados. Conclusões: a TEC não produziu mudanças nas funções cognitivas analisadas nos seis pacientes estudados.


Assuntos
Eletroconvulsoterapia , Cognição , Depressão , Disfunção Cognitiva , Testes Neuropsicológicos
20.
Int J Psychol Res (Medellin) ; 11(2): 35-45, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-32612777

RESUMO

OBJECTIVE: To analyze the relationship of depressive symptoms with differentiated components of cognitive function in older adults using the Neuronorma.Co protocol. METHODOLOGY: We analyzed the cognitive performance of 144 adults, 58.3% women, with an average age of 68.1 ± 11.2 years. A factor analysis of main components was performed to identify independent factors of cognitive function. Multiple linear regression analysis was used to estimate the type and strength of association between depressive symptoms and neurocognitive performance components. RESULTS: Seven differentiated components of cognitive performance were identified. In the multivariate analysis, interference control and language were affected by the total score on the Yesavage Geriatric Depression Scale. CONCLUSIONS: The presence and intensity of depressive symptoms is associated with a lower performance in tasks dependent on executive control.


OBJETIVO: Analizar la relación de los síntomas depresivos con componentes diferenciados de la función cognitiva de adultos mayores usando el protocolo Neuronorma.Co. METODOLOGÍA: Se analizó el rendimiento cognitivo de 144 adultos, 58, 3% mujeres, con una edad media de 68, 1 ± 11, 2 años. Se realizó un análisis factorial de componentes principales, para identificar factores independientes de la función cognitiva. Se usó el análisis de regresión lineal múltiple para estimar el tipo y la fuerza de asociación entre síntomas depresivos y los componentes del desempeño neurocognitivo. RESULTADOS: Se identificaron siete componentes diferenciados del rendimiento cognitivo. En el análisis multivariado el control de la interferencia y el lenguaje resultaron afectados por la puntuación total en la Escala de Depresión Geriátrica de Yesavage.

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