RESUMO
Este estudo buscou grupos de processamento executivo em crianças com diagnóstico de Transtorno de Déficit de Atenção/Hiperatividade (TDAH). Para tal, foram utilizadas medidas de flexibilidade cognitiva (FC), inibição (IN) e memória de trabalho (MT) e conduzidas análises de clusters hierárquicos e MANCOVA (p=0.05). Foram identificados três subgrupos com os seguintes perfis de processamento executivo: 1) déficits em FC e IN; 2) déficits em IN; 3) déficits em FC e MT. Esses resultados indicaram a presença de diferentes perfis de déficits em componentes executivos entre crianças com diagnóstico de TDAH. Esses achados podem contribuir para a elaboração de estratégias de intervenção e de programas de psicoeducação para estudantes com diagnóstico de TDAH em contextos clínicos e educacionais.(AU)
OBJECTIVE: This study aimed to characterize executive processing subgroups among children with Attention Deficit Hyperactivity Disorder (ADHD). METHOD: Sixty-one children with ADHD, with ages from six to twelve years old, were examined using instruments that evaluate the executive components of cognitive flexibility (CF), inhibition (IN) and working memory (WM). Analysis of hierarchical clusters and MANCOVA (p≤0.05) were conducted. RESULTS: Participants were divided in three clusters: 1) deficits in CF and in IN; 2) deficits in IN; 3) deficits in CF and in WM. CONCLUSIONS: the results indicated different neuropsychological profiles among children with ADHD, with different cognitive strengths and weaknesses. Clusters did not differ with respect to biological, clinical, and sociocultural factors. The findings may be useful for educational and health institutions, supporting psychoeducation programs and intervention strategies for students with ADHD.(AU)
Este estudio investigó grupos de procesamiento ejecutivo en niños diagnosticados con trastorno por déficit de atención e hiperactividad (TDAH). Para ello, se utilizaron medidas de flexibilidad cognitiva (FC), inhibición (IN) y memoria de trabajo (MT) y se realizaron análisis de conglomerados jerárquicos y MANCOVA (p=0.05). Se identificaron tres subgrupos con los siguientes perfiles de procesamiento ejecutivo: 1) déficits en FC e IN; 2) déficits en IN; 3) déficits en FC y MT. Estos resultados indicaron la presencia de diferentes perfiles de déficit en los componentes ejecutivos entre los niños diagnosticados con TDAH. Estos datos pueden contribuir al desarrollo de estrategias de intervención y programas de psicoeducación para estudiantes diagnosticados con TDAH en contextos clínicos y educativos.(AU)
Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Função Executiva , NeuropsicologiaRESUMO
Data regarding clinical and neuropsychological features of attention deficit in children with lower cognitive ability is still scarce. The objective was to analyze the response patterns on the Continuous Performance Test II in children with Intellectual Disability and Attention Defficit Hyperactivity Disorder (ADHD). This is a cross-sectional study, in which patients were divided into 2 groups: one group with ADHD and Full IQ > 80 and another group with ADHD + Full IQ score < 80. They were afterwards administered the CPT II (Continuous Performance Test). A total of 215 children were included in the study, 57% of them with ADHD IQ > 80 and 43% with ADHD + Lower Intellectual Performance (LIP). Patients with ADHD and Lower Intellectual Performance presented more omissions error, slower reaction time and greater variability in the performance as the tests progresses, as well as worse stimulus detection and discrimination capacity. The results observed supply new information for the proper understanding of the functioning of attention processes in a poorly studied population.
Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Atenção/fisiologia , Deficiência Intelectual/diagnóstico , Testes Neuropsicológicos , Adolescente , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Criança , Estudos Transversais , Feminino , Humanos , Deficiência Intelectual/psicologia , Masculino , Tempo de Reação/fisiologiaRESUMO
BACKGROUND: Previous studies have demonstrated that acute poisoning from exposure to organophosphate (OP) pesticides in agricultural workers causes adverse health effects. However, neuropsychological and cognitive effects of chronic occupational exposure to OP pesticides remain controversial. OBJECTIVE: To identify, evaluate, and systematize existing evidence regarding chronic exposure to OP pesticides and neuropsychological effects in farmworkers. METHODS: Using the PubMed search engine, a systematic review process was implemented and replicated according to the PRISMA statement. Eligibility criteria included workers over 18 years of age exposed to OP pesticides as well as assessment of neuropsychological and cognitive functioning. Search terms were in English and Spanish languages and included organophosphate and workers. RESULTS: Of the search results, 33 of 1,256 articles meet eligibility criteria. Twenty-four studies found an association between chronic occupational exposure to OP pesticides and low neuropsychological performance in workers. We classified nine of the studies to have study design limitations. Studies indicated occupational exposure to OP pesticides is linked to difficulties in executive functions, psychomotor speed, verbal, memory, attention, processing speed, visual-spatial functioning, and coordination. Nine studies find no relationship between OP pesticides exposure and neuropsychological performance. CONCLUSIONS: Overall, evidence suggests an association between chronic occupational exposure to OP pesticides and neuropsychological effects. However, there is no consensus about the specific cognitive skills affected.
Assuntos
Doenças dos Trabalhadores Agrícolas/induzido quimicamente , Síndromes Neurotóxicas/etiologia , Organofosfatos/efeitos adversos , Praguicidas/efeitos adversos , Doenças dos Trabalhadores Agrícolas/psicologia , Cognição/efeitos dos fármacos , Fazendeiros/psicologia , Humanos , Memória/efeitos dos fármacos , Destreza Motora/efeitos dos fármacos , Síndromes Neurotóxicas/psicologia , Exposição Ocupacional/efeitos adversosRESUMO
Infrastructure for conducting neurological research in resource-limited settings (RLS) is limited. The lack of neurological and neuropsychological (NP) assessment and normative data needed for clinical interpretation impedes research and clinical care. Here, we report on ACTG 5271, which provided neurological training of clinical site personnel and collected neurocognitive normative comparison data in diverse settings. At ten sites in seven RLS countries, we provided training for NP assessments. We collected normative comparison data on HIV- participants from Brazil (n = 240), India (n = 480), Malawi (n = 481), Peru (n = 239), South Africa (480), Thailand (n = 240), and Zimbabwe (n = 240). Participants had a negative HIV test within 30 days before standardized NP exams were administered at baseline and 770 at 6 months. Participants were enrolled in eight strata, gender (female and male), education (<10 and ≥10 years), and age (<35 and ≥35 years). Of 2400 enrolled, 770 completed the 6-month follow-up. As expected, significant between-country differences were evident in all the neurocognitive test scores (p < 0.0001). There was variation between the age, gender, and education strata on the neurocognitive tests. Age and education were important variables for all tests; older participants had poorer performance, and those with higher education had better performance. Women had better performance on verbal learning/memory and speed of processing tests, while men performed better on motor tests. This study provides the necessary neurocognitive normative data needed to build infrastructure for future neurological and neurocognitive studies in diverse RLS. These normative data are a much-needed resource for both clinicians and researchers.
Assuntos
Ensaios Clínicos como Assunto , Cognição/fisiologia , Pessoal de Saúde/educação , Testes de Estado Mental e Demência , Adulto , África , Fatores Etários , Ásia , Disfunção Cognitiva/complicações , Disfunção Cognitiva/psicologia , Países em Desenvolvimento/economia , Escolaridade , Feminino , Infecções por HIV/complicações , Infecções por HIV/psicologia , Voluntários Saudáveis , Humanos , Masculino , Pessoa de Meia-Idade , Valores de Referência , Fatores Sexuais , América do Sul , Aprendizagem Verbal/fisiologiaRESUMO
Abstract Background In recent years, growing interest in the neuropsychology of bipolar disorder has emerged, giving rise to the accumulation of a robust body of evidence on this topic and to several related questions. Objective To provide a state-of-the-art overview of the neuropsychological profile of bipolar disorder. Method A thorough literature search was performed. Published research evidence was summarized and organized along three key pathways: findings from cross-sectional studies of cognition in bipolar patients, cognitive heterogeneity among affected subjects, and trajectory of neuropsychological deficits. Results At least two thirds of bipolar patients display neuropsychological deficits, even in euthymia. Although bipolar disorder was found to be associated with an increased risk of dementia, data from elderly subjects and longitudinal research do not support a worsening of cognitive performance over time. Discussion Cognitive dysfunctions are part of the clinical conceptualization of bipolar illness. However, they may not be present in all affected subjects and their course appears to be stable in most cases. Available evidence may be highlighting the fact that bipolar disorder is characterized by remarkable heterogeneity regarding cognitive outcomes. Different variables may be related to such heterogeneity and should be the focus of therapeutic approaches and further research.