RESUMO

OBJECTIVE: Neuropsychological assessment of preschool children is essential for early detection of delays and referral for intervention prior to school entry. This is especially pertinent in low- and middle-income countries (LMICs), which are disproportionately impacted by micronutrient deficiencies and teratogenic exposures. The Grenada Learning and Memory Scale (GLAMS) was created for use in limited resource settings and includes a shopping list and face-name association test. Here, we present psychometric and normative data for the GLAMS in a Grenadian preschool sample. METHODS: Typically developing children between 36 and 72 months of age, primarily English speaking, were recruited from public preschools in Grenada. Trained Early Childhood Assessors administered the GLAMS and NEPSY-II in schools, homes, and clinics. GLAMS score distributions, reliability, and convergent/divergent validity against NEPSY-II were evaluated. RESULTS: The sample consisted of 400 children (190 males, 210 females). GLAMS internal consistency, inter-rater agreement, and test-retest reliability were acceptable. Principal components analysis revealed two latent factors, aligned with expected verbal/visual memory constructs. A female advantage was observed in verbal memory. Moderate age effects were observed on list learning/recall and small age effects on face-name learning/recall. All GLAMS subtests were correlated with NEPSY-II Sentence Repetition, supporting convergent validity with a measure of verbal working memory. CONCLUSIONS: The GLAMS is a psychometrically sound measure of learning and memory in Grenadian preschool children. Further adaptation and scale-up to global LMICs are recommended.

RESUMO

BACKGROUND: Aneurysmal subarachnoid hemorrhage (aSAH) is associated with a high incidence of long-term cognitive impairment, decreased quality of life (QoL), and psychiatric disorders. The effects of glibenclamide on such outcomes in the setting of aSAH are unknown. OBJECTIVE: To assess the impact of glibenclamide in patients with aSAH on cognitive performance, QoL, and emotional aspects. METHODS: Patients identified with aSAH were randomly allocated to receive 5 mg of glibenclamide for 21 days or placebo, starting within 96 hours of the ictus. After 6 months, patients were evaluated with Montreal Cognitive Assessment test (cognitive performance), Medical Outcomes Short-form Health Survey (QoL), and Hospital Anxiety and Depression Scale and Screen for Post-traumatic Stress Symptoms (emotional aspects). RESULTS: The mean Montreal Cognitive Assessment score was 22.5 ± 6.2. No statistically significant difference was found between groups, with a mean score of 21.7 ± 6.4 in the Glibenclamide group and 23.4 ± 6.2 in the placebo group (P = 0.392). A score <23 was observed in 16 patients (35.6%) and its frequency was similar between groups (P = 0.900). The most frequently impaired domains were Attention (N = 21/45; 46.7%) and Visuospatial (18/45; 40.0%). Impairment of each domain was similar between groups (P > 0.05). In each domain, the mean score was similar between groups (P > 0.05). The Hospital Anxiety and Depression Scale scores did not differ between groups (P > 0.05). The mean Screen for Post-traumatic Stress Symptoms score as well as the mean scores of its domains were similar between groups (P > 0.05). CONCLUSIONS: Glibenclamide did not improve cognitive performance, QoL, and emotional aspects after 6 months of follow-up of aSAH survivors.

RESUMO

Dementia is a global public health issue, with 57.5 million people living with at least one type of dementia in 2019 worldwide, and projected to rise to 152 million by 2050. Objective: We assessed the cognitive function in diabetic patients aged 60 or older in Bukavu city, in the eastern Republic of the Congo (DRC). Methods: This case-control study involved 123 patients with established diabetes mellitus (DM) and 123 controls over 60-year-olds also with high rates of illiteracy. Cognitive function was assessed using the Swahili version of the Community Screening Instrument for Dementia (CSI-D). Results: Foremost, our study revealed language-related differences between Swahili spoken in other eastern African countries such as Tanzania and Kenya, where the Swahili CSI-D is readily applied, compared to the Swahili spoken in Bukavu (DRC). Our results also showed that cognitive impairment was present in 18.7% of the total 246 participants. Remarkably, the prevalence rate of cognitive impairment was higher in the non-diabetic group (12.2 versus 25.2%; p=0.009). Participants aged 80 or older were more likely to present with cognitive impairment compared to those aged less than 80 (adjusted odds ratio - aOR=70.27; 95% confidence interval - 95%CI 3.94-125.15; p=0.004). We also found that patients living with DM for more than 20 years were three times more likely to be impaired compared to those who were recently diagnosed with DM (aOR=3.63; 95%CI 1.70-18.81; p=0.026). Conclusion: This study revealed that cognitive impairment was relatively high in Bukavu city. It emphasizes the lack of effective tools to assess cognitive function. This requires, therefore, that research be adapted to the intellect and cultural experiences of the patients.

A demência é uma questão de saúde pública global, afetando 57,5 milhões de pessoas com pelo menos um tipo de demência em 2019 em todo o mundo, com uma previsão de aumento para 152 milhões até 2050. Objetivo: Avaliou-se a função cognitiva em pacientes diabéticos com 60 anos ou mais na cidade de Bukavu, no leste da República Democrática do Congo (RDC). Métodos: Este estudo de caso-controle incluiu 123 pacientes com diabetes mellitus (DM) estabelecido e 123 controles com mais de 60 anos, com altas taxas de analfabetismo. A função cognitiva foi avaliada utilizando a versão swahili do Instrumento de Triagem Comunitária para Demência (Community Screening Instrument for Dementia ­ CSI-D). Resultados: O presente estudo revelou diferenças relacionadas à linguagem entre o swahili falado em outros países do leste da África, como Tanzânia e Quênia, onde o CSI-D swahili é prontamente aplicado, em comparação com o swahili falado em Bukavu (RDC). Observou-se também deficiência cognitiva em 18,7% dos 246 participantes. Notadamente, a taxa de prevalência de deficiência cognitiva foi maior no grupo não diabético (12,2 versus 25,2%; p=0,009). Participantes com 80 anos ou mais tiveram maior probabilidade de apresentar deficiência cognitiva em comparação com aqueles com menos de 80 anos (odds ratios ajustados ­ aOR=70,27; intervalo de confiança de 95% ­ IC95% 3,94­125,15; p=0,004). Também observou-se que pacientes vivendo com DM por mais de 20 anos tinham três vezes mais chances de serem afetados em comparação com aqueles que foram recentemente diagnosticados com DM (aOR=3,63; IC95% 1,70­18,81; p=0,026). Conclusão: Este estudo revelou que a deficiência cognitiva era relativamente alta na cidade de Bukavu. Enfatizou-se a falta de ferramentas eficazes para avaliar a função cognitiva, o que requer, portanto, que a pesquisa seja adaptada ao intelecto e às experiências culturais dos pacientes.

RESUMO

Introduction: In transitioning from Industry 4.0 to the forthcoming Industry 5.0, this research explores the fusion of the humanistic view and technological developments to redefine Continuing Engineering Education (CEE). Industry 5.0 introduces concepts like biomanufacturing and human-centricity, embodying the integration of sustainability and resiliency principles in CEE, thereby shaping the upskilling and reskilling initiatives for the future workforce. The interaction of sophisticated concepts such as Human-Machine Interface and Brain-Computer Interface (BCI) forms a conceptual bridge toward the approaching Fifth Industrial Revolution, allowing one to understand human beings and the impact of their biological development across diverse and changing workplace settings. Methods: Our research is based on recent studies into Knowledge, Skills, and Abilities taxonomies, linking these elements with dynamic labor market profiles. This work intends to integrate a biometric perspective to conceptualize and describe how cognitive abilities could be represented by linking a Neuropsychological test and a biometric assessment. We administered the brief Neuropsychological Battery in Spanish (Neuropsi Breve). At the same time, 15 engineering students used the Emotiv insight device that allowed the EEG recollection to measure performance metrics such as attention, stress, engagement, and excitement. Results: The findings of this research illustrate a methodology that allowed the first approach to the cognitive abilities of engineering students to be from neurobiological and behavioral perspectives. Additionally, two profiles were extracted from the results. The first illustrates the Neuropsi test areas, its most common mistakes, and its performance ratings regarding the students' sample. The second profile shows the interaction between the EEG and Neuropsi test, showing engineering students' cognitive and emotional states based on biometric levels. Discussions: The study demonstrates the potential of integrating neurobiological assessment into engineering education, highlighting a significant advancement in addressing the skills requirements of Industry 5.0. The results suggest that obtaining a comprehensive understanding of students' cognitive abilities is possible, and educational interventions can be adapted by combining neuropsychological approaches with EEG data collection. In the future, it is essential to refine these evaluation methods further and explore their applicability in different engineering disciplines. Additionally, it is necessary to investigate the long-term impact of these methods on workforce preparation and performance.

RESUMO

Five Digit Test (FDT) is an executive function assessment tool designed to be used across the lifespan, from children to the aged. Objective: To provide validity evidence for FDT in the neuropsychological assessment of working memory in the aged. Methods: A total of 100 subjects, aged between 56 and 86 years, representing both genders with varying levels of education, underwent a comprehensive clinical history and neuropsychological evaluation using FDT. The mean age of participants was 71.04 years, with 67.3% having intermediate education. Participants were categorized into two groups: Control Group and Cognitive Decline Group. To establish validity evidence, FDT scores (both time and errors) were correlated with the WAIS-III Digits scale. Spearman's correlation coefficient and ROC curve methodology were employed to determine psychometric properties. Results: A significant and moderate negative correlation was evident between FDT Shifting (number of errors) and Digits score (rho=-0.51; p<0.0001), Direct Order (rho=-0.39; p<0.0001), and Indirect Order (rho=-0.46; p<0.0001). The area under the curve was higher for FDT Shifting (errors) (AUC=0.935) for a cutoff point greater than or equal to 5 points, compared to Digits (AUC=0.748). Conclusion: The assessment of the number of errors in FDT Shifting appears to be a statistically significant tool for evaluating working memory impairment in the aged.

O Teste dos Cinco Dígitos (Five Digit Test ­ FDT) é um instrumento de função executiva para avaliação ao longo da vida, desde crianças até idosos. Objetivo: Apresentar evidências de validade para o FDT na avaliação neuropsicológica da memória operacional em idosos. Métodos: O total de 100 participantes, com idades entre 56 a 86 anos, de ambos os sexos, diferentes níveis de escolaridade, foi submetido a anamnese clínica detalhada e avaliação neuropsicológica por meio do FDT. A média de idade foi igual a 71,04 anos, 67,3% com escolaridade média. Os participantes foram divididos em dois grupos: Grupo Controle e com Declínio Cognitivo. Para verificar evidências de validade, os escores do FDT (tempo e erros) foram correlacionados ao subteste Dígitos da WAIS-III. O coeficiente de correlação de Spearman e a metodologia da Curva Receiver Operating Characteristic (ROC) foram utilizados para determinar as propriedades psicométricas. Resultados: Verificaram-se coeficientes de correlação negativa significativos e moderados entre o FDT Alternância (número de erros) e o escore do Dígitos (rho=-0,51; p<0,0001), Ordem Direta (rho=-0,39; p<0,0001) e Ordem Indireta (rho=-0,46; p<0,0001). A área sob a curva (AUC) apresentou-se no item FDT Alternância (número de erros) com maior valor (AUC=0,935) para um ponto de corte maior e igual a 5 pontos em comparação ao Dígitos (AUC=0,748). Conclusão: A avaliação do número de erros no item Alternância do FDT parece ser uma ferramenta estatisticamente significativa para avaliar o comprometimento da memória operacional em idosos.

RESUMO

Urofacial syndrome or Ochoa syndrome (UFS or UFOS) is a rare disease characterized by inverted facial expression and bladder dysfunction that was described for the first time in Colombia. It is an autosomal recessive pathology with mutations in the HPSE2 and LRIG2 genes. However, 16% of patients do not have any mutations associated with the syndrome. Despite the importance of neurobiology in its pathophysiology, there are no neurological, neuropsychological, or psychological studies in these patients. A 30-year-old male from Medellín, Colombia, with a significant perinatal history, was diagnosed with grade 4 hydronephrosis on his first ultrasound test. At 4 months of age, symptoms such as hypomimia, lagophthalmos, and recurrent urinary tract infections started to manifest. Imaging studies revealed urinary tract dilatation, vesicoureteral reflux, and a double collector system on his left side, which led to the diagnosis of UFS. Multiple procedures, including vesicostomy, ureterostomy, and enterocystoplasty, were performed. At 20 years of age, he achieved urinary sphincter control. Genetic analysis revealed a founder pathogenic variant, c.1516C > T (p.Arg506Ter), in the HPSE2 gene, which produces a truncated protein that lacks 86 amino acids. This variant is classified as pathogenic according to the ClinVar database for UFS. The mutation age is approximately 260-360 years, and the two alleles share a 7.2-7.4 Mb IBD segment. Moreover, we detected European local ancestry in the IBD segment, which is consistent with a Spanish introduction. Neurological examination, neuropsychological assessment, and psychological testing revealed no abnormalities, except for high stress levels. Clinical analysis of this patient revealed distorted facial expression and detrusor-sphincter dyssynergia, which are typical of patients with UFS. Genetic analysis revealed a pathogenic variant in the HPSE2 gene of European origin and a mutation age of 260-360 years. From a neurological, neuropsychological, and psychological (emotional and personality) perspective, the patient showed no signs or symptoms of clinical interest.

RESUMO

INTRODUCTION: We aimed to determine the effect of years of schooling (YoS) and age on the Mexican adaptation of the Consortium to Establish a Registry for Alzheimer's Disease (CERAD-MX) scores in preclinical carriers group (PCG) and non-carriers group (NCG) of the APP V717I mutation. METHODS: We included 39 first-degree Mexican relatives of APP V717I carriers (PCG = 15; NCG = 24). We report eight CERAD-MX tasks: Mini-Mental State Examination (MMSE), Word List Learning (WLL), Delayed Recall (WLD) and Recognition (WLR), Constructional Praxis Copy (CPC) and Recall (CPR), Semantic Verbal Fluency (SVF), and Verbal Boston Naming (VBN), comparing both groups' performance and simulating new samples' random vectors by inverse transform sampling. RESULTS: PCG and NCG performed similarly on CERAD-MX. In both groups, YoS and age influence all z scores. A positive age effect resulted for PCG on CPC and SVF; for the NCG on MMSE, SVF, and VBN. DISCUSSION: All tasks are influenced by YoS. Higher YoS/younger age or YoS/older age interactions affected different tasks, suggesting that YoS confounds outcomes. Highlights: Years of schooling (YoS) and age affect the Mexican adaptation of the Consortium to Establish a Registry for Alzheimer's Disease scores of APP V717I preclinical carriers.Preclinical carriers underperformed non-carriers on Constructional Praxis Recall.Fewer YoS emerges as a confounding variable when detecting cognitive failures.Younger participants in both groups overperformed the older ones in the Memory tasks.Randomized data simulation increases statistical power when analyzing rare diseases.

RESUMO

Today, talking about autism spectrum disorder (ASD) is the same as talking about cases that occur in one in 160 births worldwide. Some of them will be able to live independently when they grow up while others will have less autonomy and will be more dependent, requiring the support of caregivers throughout their lives. Objective: Understanding the emotional burden that this could generate on parents, we sought to analyze the level of stress and coping techniques in caregivers of children with ASD in Chile, 2021. Methods: Interview with a sample composed of 61 parents or guardians of people with ASD. Results: After data analysis, it was possible to perform a statistically significant correlation (p=0.002) between the level of stress and the coping strategies (problem-solving, self-criticism, emotional expression, wishful thinking, social support, cognitive restructuring, problem avoidance, and social withdrawal). In addition, positive strategies that reduce stress levels in parents or caregivers of children with ASD were identified (problem resolution, cognitive restructuring, social support, and emotional expression). Conclusion: Through this research, it was possible to respond to each of the stated objectives, managing to determine what were the characteristics of caregivers and their main difficulties. It was also observed that the majority lost the possibility of working to dedicate themselves to the care of the diagnosed person.

Hoje, falar sobre transtorno do espectro autista (TEA) é falar sobre casos que ocorrem em um a cada 160 nascimentos em todo o mundo. Alguns deles conseguirão viver de forma independente quando crescerem, e outros terão menos autonomia e serão mais dependentes, necessitando do apoio de cuidadores ao longo da vida. Objetivo: Entendendo o gasto emocional que isso pode gerar nos pais, buscamos analisar o nível de estresse e as técnicas de enfrentamento em cuidadores de crianças com TEA no Chile, 2021. Métodos: Entrevistar uma amostra composta de 61 pais ou responsáveis de pessoas com TEA. Resultados: Isto nos permitiu obter, após a análise dos dados, uma correlação estatisticamente significativa (p=0,002) entre o nível de estresse e as estratégias de coping (resolução de problemas, autocrítica, expressão emocional, wishful thinking, apoio social, reestruturação cognitiva, evitação de problemas e retraimento social). Além disso, foram identificadas estratégias positivas que reduzem os níveis de estresse em pais ou cuidadores de crianças com TEA (resolução de problemas, reestruturação cognitiva, apoio social e expressão emocional). Conclusão: Além disso, esta investigação conseguiu responder a cada um dos objetivos enunciados, conseguindo determinar quais eram as características dos cuidadores e quais as suas principais dificuldades. Observar-se-á também que a maioria perdeu a possibilidade de trabalhar para se dedicar ao cuidado da pessoa diagnosticada.

RESUMO

BACKGROUND: In 2020, the prevalence of cancer rose to 844,778 cases among the population aged 0-19 years. Approximately 90% of individuals under 18 years of age reside in low- and middle-income countries, where cancer survivors report adverse outcomes that negatively impact their general health, emotional state, and external factors such as academic performance due to the effect of these outcomes on executive functions. The Wisconsin Cart Sorting Test (WCST) is the gold standard for evaluating executive functioning. Therefore, this article (1) reports the performance of the Wisconsin Card Sorting Test (WCST) in oncopediatric patients from Cali, Colombia; (2) indicates the reliability of the WCST; (3) describes the association between cancer type and executive functioning in patients; (4) describes the differences between patients with various executive deficits and their executive total scores; and (5) describes the association between cancer type and the presence of brain deficits based on the WCST. METHODS: In this cross-sectional observational study, 24 oncopediatric patients were interviewed and evaluated via the WCST. RESULTS: The mean age was 12.08 years (SD 3.98); 20.8% of the patients were women, 70.8% had a primary diagnosis of leukemia, 8% exhibited acquired brain deficits, and more than 75% displayed adequate functional indicators of executive functions. Robust statistics were employed to explore the differences between the types of diagnosis and performance in executive functions, and no statistically significant differences were found (p = 0.156). We found that the WCST has a reliable Cronbach's α of 0.804. Oncopediatric patients without brain deficits presented strong results in terms of executive functions (p = 0.002), with a moderate effect size (0.727). CONCLUSIONS: The WCST is reliable for discriminating executive functioning among pediatric cancer patients. The evidence suggests that there were no differences in the executive functioning of the participants based on the types of cancer being evaluated.

RESUMO

Despite the increasing knowledge in the past years, only minimal attention has been directed to the neuropsychological aspects and the prevalence of cognitive impairment associated with reversible cerebral vasoconstriction syndrome (RCVS). Objective: To describe the frequency and expand the understanding of cognitive dysfunction in RCVS. Methods: The neuropsychological evaluation was performed using a battery consisting of specific neuropsychological instruments that were administered to patients diagnosed with RCVS. A triage was conducted to exclude other potential causes of cognitive impairment. Performance on the tests was treated as a categorical variable, and a cutoff of -1.5 Z-score was adopted to indicate impaired performance. Results: Seven patients diagnosed with RCVS were evaluated, all of whom had a bachelor's degree and normal score in the Mini-Mental State Examination. The average time between diagnosis and neuropsychological evaluation was 1.8 years. Among the patients, 85.6% (n=6) exhibited performance below that of the normal population in at least two of the administered tests. Specifically, 71.4% (n=5) showed alterations in tests from the Psychological Battery for Attention Assessment, with impairment observed in concentrated (n=1), divided (n=3), or alternating (n=4) attention. Furthermore, 28.6% (n=2) demonstrated impairments in the Phonological Verbal Fluency Task, another 28.6% (n=2) exhibited difficulties copying elements of the Rey Complex Figure, and 14.3% (n=1) displayed lower performance in the Five-Digit test, all indicating executive dysfunction. Conclusion: This study provides evidence that cognitive impairment associated with RCVS is more prevalent than previously believed and has not received sufficient attention. Specifically, attention and executive functions are the cognitive domains most significantly impacted by RCVS.

Apesar do crescente conhecimento nos últimos anos, pouca atenção tem sido direcionada aos aspectos neuropsicológicos e à prevalência de declínio cognitivo associado à Síndrome de Vasoconstrição Cerebral Reversível (SVCR). Objetivo: Descrever a frequência e expandir o entendimento da disfunção cognitiva associada à SVCR. Métodos: A avaliação neuropsicológica foi realizada por meio de uma bateria composta de instrumentos neuropsicológicos específicos, que foram aplicados aos pacientes com SVCR. Uma triagem foi realizada para excluir outras potenciais causas de declínio cognitivo. O desempenho nos testes foi considerado como variável categórica, e o corte de −1,5 escore z foi adotado para indicar desempenho comprometido. Resultados: Sete pacientes com diagnóstico de SVCR foram avaliados, os quais tinham todos nível de ensino superior e pontuação normal no Miniexame do Estado Mental. A média de tempo entre o diagnóstico e a avaliação neuropsicológica foi de 1,8 ano. Dentre os pacientes, 85,6%(n=6) apresentaram desempenho comprometido em pelo menos dois dos testes aplicados. Especificamente, 71,4% (n=5) apresentaram alterações nos testes da Bateria Psicológica para Avaliação da Atenção, com comprometimento observado nas atenções concentrada (n=1), dividida (n=3), ou alternada (n=4). Além disso, 28,6% (n=2) demonstraram comprometimento na Fluência Verbal Fonológica, 28,6% (n=2) exibiram dificuldades na cópia da Figura Complexa de Rey e um paciente obteve desempenho alterado no Teste dos Cinco Dígitos, todos indicando disfunção executiva. Conclusão: Este estudo fornece evidência de que o declínio cognitivo associado à SVCR é mais prevalente do que se acreditava anteriormente. Especialmente, os domínios mais significativamente comprometidos foram a atenção e as funções executivas.

RESUMO

BACKGROUND: Tobacco smoking is an important, modifiable, environmental risk factor for multiple sclerosis (MS) with a relevant impact on health-related quality of life (HRQOL). We aimed to assess the use of tobacco in individuals with MS from Latin America (LATAM), and its impact on HRQOL. METHODS: We conducted a cross-sectional study based on a LATAM web-based survey. Demographics, social and clinical data, information on physical disability, and HRQOL scores were collected using the MS Impact Scale-29 (MSIS-29), the Fatigue Severity Scale (FSS), and the Hospital Anxiety and Depression Scale-Anxiety (HADS-A). Individuals with MS were classified at the time of the survey as follows: never-smokers (ie, patients who reported they had never smoked), past smokers (those who had smoked tobacco but not during the past year), or current smokers. For the analysis, groups were compared. RESULTS: 425 patients (74.6% female) from 17 LATAM countries were included, mean age 43.6 ± 11 years and median Expanded Disability Status Scale score 2. There were 122 (28.7%) current smokers, 178 (41.9%) past smokers, and 125 (30.4%) never-smokers. Current smokers had significantly higher MSIS-29 physical (physical worsening), FSS (fatigue), and HADS-A (anxiety) scores compared with past and never-smokers after being adjusted for covariables. No significant differences were observed in any of the other analyzed demographic, clinical, and therapeutic variables. Thirty percent of the current and past smokers groups had never had their neurologists discuss smoking cessation with them. CONCLUSIONS: Individuals with MS who were current smokers had higher fatigue and anxiety scores and worse HRQOL compared with past and never-smokers.

RESUMO

OBJECTIVE: To estimate rates and time to reach emergence of consciousness from vegetative state/unresponsive wakefulness syndrome (VS/UWS), and explore factors associated with improved recovery in children and adolescents with disorders of consciousness (DoC) following severe traumatic and non-traumatic brain injury. METHODS: Analytical, retrospective, cohort study. Clinical records of consecutively referred patients admitted in VS/UWS to a neurological rehabilitation institute in Argentina, between 2005 and 2021 were reviewed. Seventy children and adolescents were included in the analysis. A specialized 12-week rehabilitation program was administered, and emergence was defined by scores ≥44 points on the Western Neuro Sensory Stimulation Profile (WNSSP), sustained for at least 3 weeks on consecutive weekly evaluations. RESULTS: Emergence from VS/UWS to consciousness occurred within 5.4 (SD 2.6) weeks in almost one-third of patients. Multivariate Cox regression analysis showed emergence was significantly lower in patients with hypoxic ischemic encephalopathy compared to patients with other non-traumatic etiologies [HRadj 0.23 (95% CI 0.06-0.89); p = 0.03)]. CONCLUSIONS: Our findings reinforce growing evidence on the impact of etiology on DoC recovery in pediatric populations, ultimately influencing treatment and family-related decisions in child neurorehabilitation.

Assuntos

RESUMO

Transcranial magnetic stimulation (TMS) has been found to be promising in the neurorehabilitation of post-stroke patients. Aphasia and cognitive impairment (CI) are prevalent post-stroke; however, there is still a lack of consensus about the characteristics of interventions based on TMS and its neuropsychological and anatomical-functional benefits. Therefore, studies that contribute to creating TMS protocols for these neurological conditions are necessary. To analyze the evidence of the neuropsychological and anatomical-functional TMS effects in post-stroke patients with CI and aphasia and determine the characteristics of the most used TMS in research practice. The present study followed the PRISMA guidelines and included articles from PubMed, Scopus, Web of Science, ScienceDirect, and EMBASE databases, published between January 2010 and March 2023. In the 15 articles reviewed, it was found that attention, memory, executive function, language comprehension, naming, and verbal fluency (semantic and phonological) are the neuropsychological domains that improved post-TMS. Moreover, TMS in aphasia and post-stroke CI contribute to greater frontal activation (in the inferior frontal gyrus, pars triangularis, and opercularis). Temporoparietal effects were also found. The observed effects occur when TMS is implemented in repetitive modality, at a frequency of 1 Hz, in sessions of 30 min, and that last more than 2 weeks in duration. The use of TMS contributes to the neurorehabilitation process in post-stroke patients with CI and aphasia. However, it is still necessary to standardize future intervention protocols based on accurate TMS characteristics.

RESUMO

Resumen Introducción: El trastorno obsesivo-compulsivo (TOC) se caracteriza por obsesiones y compulsiones. Las obsesiones corresponden a ideas o imágenes intrusivas y la compulsión es el acto motor o cognitivo para aplacar la obsesión. Su prevalência mundial es del 3 % y existen diferentes factores que influyen en su aparición, que pueden ser biológicos, psicológicos o ambientales. Por otra parte, las funciones ejecutivas son un conjunto de habilidades que regulan la cognición y el comportamiento, donde este estudio busca describir la relación y afectación de las funciones ejecutivas en personas que padecen TOC. Materiales y métodos: Artículo de revisión narrativa a partir del estado del arte sobre el TOC y las funciones ejecutivas. Resultados: Diversos estudios han reportado la relación clínico-anatómica entre signos y síntomas característicos del TOC y la alteración evidenciada en funciones ejecutivas. Las funciones ejecutivas impactan el funcionamiento en la vida diaria y se encuentran fuertemente relacionadas al TOC, generando limitaciones funcionales en estos pacientes. Para esta afección hay tratamientos como las terapias farmacológica, psicológica y quirúrgica. Discusión: Se encuentra la necesidad de implementar, dentro de su tratamiento, la rehabilitación neuropsicológica para rehabilitar y fortalecer las funciones ejecutivas, buscando que se desarrolle de manera integral y que le permita a la persona desenvolverse de manera óptima en su día a día. Conclusión: Las funciones ejecutivas son un componente fundamental para nuestro funcionamiento y autonomía, es por esto que al estar el TOC directamente relacionado con fallas en estas funciones, se considera un punto importante para tener en cuenta al acompañar y tratar a personas que presentan este trastorno.

Abstract Introduction: Obsessive-compulsive disorder (OCD) is characterized by obsessions and compulsions. Obsessions correspond to intrusive ideas or images and compulsion is the motor or cognitive act to appease the obsession. Its worldwide prevalence is 3%. There are different factors that influence its appearance, which can be biological, psychological and environmental. Executive functions are a set of skills that regulate cognition and behavior. The objective is to describe the relationship and impact of executive functions in people who suffer from OCD. Materials and methods: Narrative review article based on the state of the art on obsessive-compulsive disorder and executive functions. Results: Various studies report a clinical-anatomical relationship between characteristic signs and symptoms of OCD and alterations evident in executive functions. Executive functions impact functioning in daily life. These functions are strongly related to OCD, generating functional limitations in these patients. For this condition there are treatments such as pharmacological, psychological and surgical therapy. Discussion: There is a need to implement neuropsychological rehabilitation within its treatment to rehabilitate and strengthen such processes, seeking to develop it comprehensively and allow the person to function optimally in their daily lives. Conclusion: Executive functions are a fundamental component for our functioning and autonomy, which is why, since OCD is directly related to failures in these functions, they are considered an important point to take into account when accompanying and treating people who present this condition. disorder.

RESUMO

The Aggie Figures Learning Test (AFLT) is a visual memory assessment tool, which was constructed as an analog to the Rey Auditory Verbal Learning Test (RAVLT). Since the test holds close resemblance to the RAVLT, it is possible to make meaningful comparisons between these two tests. These comparisons are notably relevant in the assessment of material-specific memory impairments in epilepsy. However, the AFLT convergent validity has not yet been established. OBJECTIVE: The purpose of the present study was to demonstrate the convergent validity of the AFLT and to provide norms for an adult population ranging from 18 to 58. METHOD: 140 healthy volunteers participated in the study. They ranged in age from 18 to 58 years, with 12 to 25 years of education. Subjects were assessed with a comprehensive neuropsychological battery which included the ALFT (A version) and the Rey-Osterrieth Complex Figure (ROCF). RESULTS: Positive correlations were found between the scores of both tests for recent memory (r = 0.606, p < 0.01), delayed free recall (r = 0.534, p < 0.01) and recognition memory (r = 0.202, p < 0.05). These results demonstrate the convergent validity of the AFLT. CONCLUSIONS: The AFLT is a visual memory assessment tool with adequate psychometric properties, which allows a comprehensive evaluation of visual memory processes.

RESUMO

We conducted two studies to evaluate the construct validity, short term test-retest reliability, and sensitivity to mental fatigue of the Stroop task when used with older adults. In Study 1, 40 participants visited our lab on two separate days. On the first visit, they took five screening scales, and we measured their height and body mass. On the second visit, they completed the Stroop task twice with a 30-minute interval between assessments. In Study 2, 15 different participants took a 30-minute Flanker/Reverse Flanker task during the interval between the two administrations of the Stroop tasks and they gave subjective ratings of their mental fatigue on the Visual Analogue Scale (VAS) prior to taking either of the Stroop tasks. In Study 1, participants showed a ceiling effect on the Stroop accuracy measure, there was strong concurrent validity for the Stroop with significant score differences between the Stroop's congruent and incongruent conditions (p < .001), and there was excellent response time reliability (ICC = 0.926) on day two when participants took the Stroop twice within a 30-minute inter-test interval. However, there were significant test-retest performance differences with respect to cognitive inhibition (p < .001). In Study 2, mental fatigue from the Flanker/Reverse Flanker test resulted in a significantly worse second Stroop performance (p = .045). We concluded that the Stroop task demonstrated strong concurrent validity and response time reliability among older adults, but it showed sensitivity to mental fatigue, and repeated administrations within the short 30-minute test-retest interval revealed that the most important Stroop measure (cognitive inhibition) was unreliable. We discuss the implications of these findings.

Assuntos

RESUMO

OBJECTIVE: The study aimed to carry out a cross-cultural analysis by comparing Five-Point test scores for two different countries. The Five-Point test measures design fluency, an executive function, and is an inexpensive test that makes it more accessible to assessment settings, including under-resourced settings. METHODS: Adults in Argentina (n = 90) and South Africa (n = 90) with tertiary levels of education were tested on the Five-Point Test. ANOVA was applied to compare the scores of the two groups on the total number of unique designs produced (Total Unique Designs). RESULTS: The study found no significant differences in the Total Unique Designs scores between the two groups (p = .13; η = 0.01). Correlations between demographic variables and the Total Unique Designs scores varied slightly across both samples. CONCLUSIONS: Despite large cultural differences between both samples (language, race, religion, income) scores on this test did not differ significantly. These findings provide initial evidence of scalar equivalence on the test across these samples. Norms for the Five-Point Test Total Unique Designs scores might be used interchangeably between these two highly educated groups from different countries.

RESUMO

OBJECTIVE: To assess cognitive, behavioral, and adaptive functions in children and young adults with hemophilia treated according to contemporary standards of care. STUDY DESIGN: Evolving Treatment of Hemophilia's Impact on Neurodevelopment, Intelligence, and Other Cognitive Functions (eTHINK) is a US-based, prospective, cross-sectional, observational study (September 2018 through October 2019). Males (aged 1-21 years) with hemophilia A or B of any severity, with or without inhibitors, were eligible. Participants underwent neurologic examinations and age-appropriate neuropsychological assessments, including standardized tests/ratings scales of early development, cognition, emotional/behavioral adjustment, and adaptive skills. RESULTS: Five hundred and fifty-one males with hemophilia A (n = 433) or B (n = 101) were enrolled. Performance on cognitive tests was largely comparable with that of age-matched US population norms, although participants in certain age groups (4-5 and 10-21 years) performed worse on measures of attention and processing speed. Furthermore, adolescents and young adults and those with comorbid attention-deficit/hyperactivity disorder (ADHD; n = 64) reported more adaptive and executive function problems in daily life. Incidence of ADHD in adolescents (21%) was higher than expected in the general population. CONCLUSIONS: In general, males with hemophilia demonstrated age-appropriate intellectual, behavioral, and adaptive development. However, specific patient/age groups showed poorer attention performance and concerns for executive and adaptive development. This study established a normative data set for monitoring neurodevelopment in individuals with hemophilia and highlight the importance of screening and intervention for challenges with cognitive and adaptive skills in this population. CLINICAL TRIAL REGISTRATION: Evolving Treatment of Hemophilia's Impact on Neurodevelopment, Intelligence, and Other Cognitive Functions (eTHINK); NCT03660774; https://clinicaltrials.gov/ct2/show/NCT03660774.

Assuntos

RESUMO

Central nervous system tumors produce adverse outcomes in daily life, although low-grade gliomas are rare in adults. In neurological clinics, the state of impairment of executive functions goes unnoticed in the examinations and interviews carried out. For this reason, the objective of this study was to describe the executive function of a 59-year-old adult neurocancer patient. This study is novel in integrating and demonstrating biological effects and outcomes in performance evaluated by a neuropsychological instrument and psychological interviews. For this purpose, pre- and post-evaluations were carried out of neurological and neuropsychological functioning through neuroimaging techniques (iRM, spectroscopy, electroencephalography), hospital medical history, psychological interviews, and the Wisconsin Card Classification Test (WCST). There was evidence of deterioration in executive performance, as evidenced by the increase in perseverative scores, failure to maintain one's attitude, and an inability to learn in relation to clinical samples. This information coincides with the evolution of neuroimaging over time. Our case shows that the presence of the tumor is associated with alterations in executive functions that are not very evident in clinical interviews or are explicit in neuropsychological evaluations. In this study, we quantified the degree of impairment of executive functions in a patient with low-grade glioma in a middle-income country where research is scarce.

Assuntos

RESUMO

OBJETIVO: A avaliação neuropsicológica tem alta relevância na adolescência e em situação de conflito com a lei, com privação de liberdade em instituições socioeducativas, pode auxiliar, compondo abordagens psicossociais que identifiquem as funções neuropsicológicas, situando-as a partir da historicidade do indivíduo. Deste modo, para compreender esse problema, foi objetivo desse estudo avaliar e descrever as funções neuropsicológicas de adolescentes meninas privadas de liberdade em instituição socioeducativa. MÉTODOS: As participantes foram 19 meninas avaliadas com os instrumentos: Barratt Scale, Inventário de Expressão de Raiva, teste Wisconsin de classificação de cartas, protocolo neuropsicológico, questionário para uso de drogas e Hare Psychopathy Checklist Revised. RESULTADOS: O uso de drogas na vida ocorreu em 80,0% dos casos. Verificaram-se altos escores de impulsividade total (M=75,8, DP=5,4), traço de raiva (M=24,5, DP=7,3) e respostas perseverativas (M =38,5, DP =19,9). Em conjunto com PCL-R total (M=17,5, DP=3,6) e com QI total (M=79,1, DP=16,2), esses níveis auxiliaram na caracterização das funções de autocontrole. CONCLUSÕES: Os dados foram interpretados como indicativos de baixo funcionamento executivo, altos níveis de raiva, de impulsividade, de uso de drogas e de traços de psicopatia. Foram relatadas adversidades durante a infância, o que pode ter contribuído para um desempenho prejudicado nas funções cognitivas e emocionais dessas meninas.

OBJECTIVE: Neuropsychological assessment is highly relevant in adolescence and in situations of conflict with the law, with deprivation of liberty in socio-educational institutions, it can help, composing psychosocial approaches that identify neuropsychological functions, situating them based on the individual's historicity. Therefore, to understand this problem, the objective of this study was to evaluate and describe the neuropsychological functions of adolescent girls deprived of liberty in a socio-educational institution. METHODS: The participants were 19 girls evaluated with the following instruments: Barratt Scale, Anger Expression Inventory, Wisconsin Card Sorting Test, Neuropsychological protocol, drug use questionnaire and Hare Psychopathy Checklist Revised. RESULTS: Lifetime drug use occurred in 80.0% of cases. There were high scores for total impulsivity (M=75.8, SD=5,4), trait anger (M=24.5, SD=7.3) and perseverative responses (M=38.5, SD=19.9). Together with total PCL-R (M=17.5, SD=3.6) and total IQ (M=79.1, SD=16), these levels helped to characterize self-control functions. CONCLUSIONS: The data were interpreted as indicating low executive functioning, high levels of anger, impulsivity, drug use and psychopathic traits. Adversities were reported during childhood, which may have contributed to impaired performance in the cognitive and emotional functions of these girls.

OBJETIVO: La evaluación neuropsicológica es de gran relevancia en la adolescencia y en las situaciones de conflicto con la ley, con privación de libertad en instituciones socioeducativas, puede ayudar, componiendo enfoques psicosociales que identifiquen funciones neuropsicológicas, las situando en función de la historicidad del individuo. Por tanto, para comprender esta problemática, el objetivo de este estudio fue evaluar y describir las funciones neuropsicológicas de niñas adolescentes privadas de libertad en una institución socioeducativa. MÉTODOS: Las participantes fueron 19 niñas evaluadas con los siguientes instrumentos: Escala de Barratt, Inventario de Expresión de Ira, Test de clasificación de cartas de Wisconsin, protocolo neuropsicológico, cuestionario de consumo de drogas y Lista de Verificación de Psicopatía de Hare Revisada. RESULTADOS: El consumo de drogas durante la vida ocurrió en el 80,0% de los casos. Hubo puntuaciones altas en impulsividad total (M = 75,8, DE = 5,4), rasgo de ira (M = 24,5, DE = 7,3) y respuestas perseverativas (M = 38,5, DE = 19,9). Junto con el PCL-R total (M=17,5, DE=3,6) y el CI total (M=79,1, DE=16,2), estos niveles ayudaron a caracterizar las funciones de autocontrol. CONCLUSIONES: Se interpretó que los datos indicaban un bajo funcionamiento ejecutivo, altos niveles de ira, impulsividad, consumo de drogas y rasgos psicopáticos. Se informaron adversidades durante la infancia, que pueden haber contribuido al deterioro del desempeño en las funciones cognitivas y emocionales de estas niñas.

Assuntos