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INTRODUCTION AND OBJECTIVES: Although the Psychometric Hepatic Encephalopathy Score (PHES) remains the gold standard in diagnosing minimal hepatic encephalopathy (MHE), its complexity limits its application in clinical practice. While more convenient tests, such as the Stroop test, Quickstroop, and the 1-min animal naming test (ANT-1), have emerged, they haven't been validated in our setting. Our objective was to validate these tests in our population. PATIENTS AND METHODS: This multicenter, observational, descriptive, and cross-sectional study was conducted in three hospitals in northeastern Mexico. MHE was defined as a PHES <-4. We included patients with cirrhosis aged >15 years without a history of overt hepatic encephalopathy. Data regarding sex, age, education, Child-Pugh/MELD-Na scores, etiology of cirrhosis, diabetes, hypertension, obesity, ascites, and clinically significant portal hypertension was collected. Fisher's exact test, Mann-Whitney U test, and receiver operating characteristic (ROC) curves were used for statistical analysis. RESULTS: Of the 121 patients included, 35.5 % were diagnosed with MHE. The presence of MHE was significantly associated with education level, years of study, and scores in the Stroop test, Quickstroop, and ANT-1. The AUROC curves were 77.9 %, 74.6 %, and 72.7 % for the Stroop test, Quickstroop, and ANT-1, respectively. The resulting cut-off points were 218.398 (sensitivity: 74 %; specificity: 74 %), 40.535 (sensitivity: 77 %; specificity: 68 %), and <16 animals (sensitivity: 58 %; specificity: 79 %), respectively. CONCLUSIONS: These tests are valid diagnostic tools for detecting MHE in our population. Their simpler use and applicability could increase the early diagnosis of MHE and prompt primary prophylaxis initiation for overt hepatic encephalopathy.

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Soccer is a team sport that requires players to process a significant amount of information quickly and respond with both speed and accuracy to the ever-changing demands of the game. As such, success in soccer depends not only on physical attributes but also on cognitive abilities such as perception and decision-making. The aim of the current study was to investigate the acute effects of caffeine ingestion on Stroop test performance before and after repeated small-sided games (SSG) in professional soccer players. Twelve professional male soccer players (29 ± 4.1 years; 78.1 ± 7.7 kg body mass) participated in this study. A randomized crossover double-blind placebo-controlled trial was used. Caffeine (5 mg.kg-1) or a placebo was ingested 45 min before a protocol consisting of five 5 min SSG with 1 min rest intervals. A computerized version of the colour Stroop test was completed immediately before and after the exercise protocol. During the Stroop test, words appeared on the computer screen in three different ways: (i) neutral words (neutral condition); (ii) correspondent colour (i.e., "red" painted in red; congruent condition), or; (iii) different colour (i.e., "red" painted in green; incongruent condition). The incongruent condition aimed to cause the interference effect, as the colour and the word did not match. Ratings of perceived exertion (RPE) were assessed after each SSG. RPE increased during the five sets of the SSG protocol (p < 0.001), without differences between the caffeine and placebo trials. The soccer-specific exercise protocol promoted a faster response during the Stroop test (two-way ANOVA main effect for SSG protocol: p < 0.05), with no differences in accuracy (p > 0.05). Caffeine ingestion resulted in slower reaction time during the Stroop test during the congruent and neutral trials but not during the incongruent trial (two-way ANOVA main effect for supplementation: p = 0.009, p = 0.045, and p = 0.071, respectively). Accuracy was lower in the caffeine trial in congruent and incongruent trials (p < 0.05 caffeine vs. placebo both on the pre- and post-SSG protocol). In conclusion, a soccer-specific exercise protocol improved the Stroop test performance in professional soccer players, but acute caffeine ingestion (5 mg.kg-1) was detrimental.

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The first clinical guidelines on hepatic encephalopathy were published in 2009. Almost 14 years since that first publication, numerous advances in the field of diagnosis, treatment, and special condition care have been made. Therefore, as an initiative of the Asociación Mexicana de Gastroenterología A.C., we present a current view of those aspects. The manuscript described herein was formulated by 24 experts that participated in six working groups, analyzing, discussing, and summarizing the following topics: Definition of hepatic encephalopathy; recommended classifications; epidemiologic panorama, worldwide and in Mexico; diagnostic tools; conditions that merit a differential diagnosis; treatment; and primary and secondary prophylaxis. Likewise, these guidelines emphasize the management of certain special conditions, such as hepatic encephalopathy in acute liver failure and acute-on-chronic liver failure, as well as specific care in patients with hepatic encephalopathy, such as the use of medications and types of sedation, describing those that are permitted or recommended, and those that are not.

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PURPOSE: Compare tracking groups with cognitive control functions and plasma brain-derived neurotrophic factors concentrations from childhood to adolescence. METHODS: This is a prospective study with 3 years of follow-up. At baseline, data from 394 individuals were collected (11.7 y), and data were obtained from 134 adolescents (14.9 y) at the 3-year follow-up. At both time points, anthropometric and maximal oxygen uptake data were collected. Cardiorespiratory fitness (CRF) groups were classified into high or low CRF. At follow-up, cognitive outcomes were collected via the Stroop and Corsi block test; plasma brain-derived neurotrophic factors concentrations were also analyzed. RESULTS: Comparisons demonstrated that maintaining high CRF over 3 years results in shorter reaction time, better inhibitory control, and higher working memory values. Likewise, the group that moved from low to high CRF over 3 years presented better reaction time. Plasma brain-derived neurotrophic factors concentrations were higher for the group that increased its CRF over the 3 years in relation to the low-low group (90.58 pg·mL-1; P = .004). However, after scaling by an allometric approach, differences were only found for reaction time and working memory between high-high and high-low groups. CONCLUSION: Maintaining high CRF over 3 years was positively related to reaction time and working memory in relation to adolescents that decreased their levels of CRF.

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Abstract The aim of this study was to verify whether obesity and acute physical exercise could influence the reactivity to mental stress. Twelve normal weight (NW) and ten obese (Ob) (31.82% women), normotensive individuals between 18 and 40 years old were evaluated. The Stroop color test was performed under two conditions: 1) Baseline and 2) 30 min after the end of aerobic physical exercise. Individuals performed 30 min of physical exercise (NW: 3.38 and Ob: 2.99 km·h-1; p< 0.05) between 50-60% of heart rate reserve (NW: 139±7 and Ob: 143±7 bpm). The reactivity to mental stress for systolic blood pressure - SBP (Δ2 min) and diastolic blood pressure - DBP (Δ2 and Δ4 min) was lower (p< 0.05) in Ob compared to NW group. The SBP reactivity to mental stress was less (p< 0.05) post-exercise in all moments (Δ2 and Δ4 min), regardless of obesity, while the DBP reactivity to mental stress was less post-exercise, only in NW. BP reactivity to stress correlated negatively with obesity indicators (r/Rho = - 0.42 to - 0.64), under the baseline condition, but not post-physical exercise. Obesity blunted BP reactivity to mental stress in normotensive young adults. Moderately-intensity acute aerobic exercise reduced SBP reactivity to mental stress, regardless of obesity, while it reduced DBP reactivity to mental stress, only in NW. In summary, acute physical exercise may be a one means to prevent cardiovascular changes.

Resumo O objetivo deste estudo foi verificar se a obesidade e o exercício físico agudo podem influenciar a reatividade ao estresse mental. Foram avaliados 12 indivíduos eutróficos (E) e dez obesos (Ob) (31,82% mulheres), normotensos entre 18 e 40 anos. O teste de cor Stroop foi realizado em duas condições: 1) Linha de base e 2) 30 min após o término do exercício físico aeróbio. Os indivíduos realizaram 30 min de exercício físico (E: 3,38 e Ob: 2,99 km•h-1; p<0,05) entre 50-60% da frequência cardíaca de reserva (E 139±7 e Ob: 143±7 bpm). A reatividade ao estresse mental para pressão arterial sistólica - PAS (Δ2 min) e pressão arterial diastólica - PAD (Δ2 e Δ4 min) foi menor (p< 0,05) no grupo Ob comparado ao grupo E. A reatividade da PAS ao estresse mental foi menor (p< 0,05) pós-exercício em todos os momentos (Δ2 e Δ4 min), independente da obesidade, enquanto a reatividade da PAD ao estresse mental foi menor pós-exercício, apenas no E. A reatividade da PA ao estresse correlacionou-se negativamente com os indicadores de obesidade (r/Rho = - 0,42 a - 0,64), na condição basal, mas não pós-exercício físico. A obesidade embotou a reatividade da PA ao estresse mental em adultos jovens normotensos. O exercício aeróbico agudo de ientesidade moderada reduziu a reatividade da PAS ao estresse mental, independentemente da obesidade, enquanto reduziu a reatividade da PAD ao estresse mental, apenas no E. Em resumo, o exercício físico agudo pode ser um meio de prevenir alterações cardiovasculares.

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Puerperium may lead to memory and executive/attentional complaints that interfere with women's daily life. This might be prevented by dietary compounds, such as neuroprotective polyphenols. Their bioactivity depends on their effects on lipid metabolism in different tissues, such as the brain, fat, and breast. Thus, a polyphenol-related cognitive improvement may be associated with changes of lipids in human milk, which are key for infant neurodevelopment. A cross-sectional study was conducted on 75 postpartum women from Córdoba (Argentina), involving several neuropsychological tests. Diet was registered to identify polyphenol intake and food pattern adherence, with sociodemographic and other psychological variables (insomnia, stress, subjective cognitive complaints) being also studied. Triacylglycerols, cholesterol, and their oxidative forms were analyzed as milk biomarkers. Multivariate statistical methods were applied. Results confirmed that women who consumed polyphenols presented better executive/attentional performance (i.e., higher correct responses, conceptual level responses, complete categories, verbal fluency; lower attentional interferences, and perseverative errors) and word retention with lower interference. Polyphenols were positively associated with milk lipids, which were higher in women with better cognition. Furthermore, they had lower oxidized triacylglycerols. In conclusion, polyphenolic intake during postpartum may improve executive/attentional functioning, memory, and milk lipid profile.

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Resumen La psicología y las neurociencias ofrecen nuevas perspectivas para comprender el comportamiento económico y del consumidor. La neuroeconomía provee un nuevo marco de referencia para comprender la forma en la que las estructuras neuroanatómicas del cerebro se encuentran implicadas en las decisiones financieras de los individuos. En este contexto, el objetivo de la investigación es identificar la asociación entre la inhibición cognitiva y la cantidad de dinero que gastan los universitarios. Participaron 40 jóvenes universitarios, 47.5 % hombres y 52.5 % mujeres, entre 18 y 25 años, de la Ciudad de Querétaro, México. La inhibición cognitiva se evaluó con el Test de Stroop. Además, se preguntó sobre datos sociodemográficos y los gastos mensuales. Los resultados muestran descriptivamente el nivel de gasto de los jóvenes y las puntuaciones del efecto Stroop. Los jóvenes tienen puntuaciones medias en Palabra, Color, Palabra - Color e Interferencia, acorde a los parámetros establecidos. Respecto al gasto mensual se observa que, en promedio, gastan $ 666 pesos mexicanos (34.04 USD / 31.13 EUR). Adicionalmente, se encontró un déficit en el control inhibitorio relacionado con un aumento en el nivel de gasto realizado por los estudiantes universitarios, es decir, aquellos que gastan y compran, en mayor medida presentan dificultades en su inhibición cognitiva (autocontrol). El control inhibitorio se asoció con la edad y esta, a su vez, con el nivel de dinero gastado. Por último, se profundiza en la utilidad de los resultados dentro de la neuroeconomía en México y demás países latinoamericanos, así como su aporte como línea de investigación.

Abstract Psychology and neuroscience offer new perspectives to understand consumer and economic behaviour. Neuroeconomics provides a new frame of reference to understand the way in which the neuroanatomical structures of the brain are involved in the financial decisions of people. Currently, measurement scales are an application alternative to assess people's executive functions and cognitive inhibition quickly. In the present study for the evaluation of cognitive inhibition we will use the Stroop Test (Golden, 1994), which examines the cognitive processes associated with cognitive flexibility; the interference resistance from external stimuli and its effect on behaviour. The plates that make up the Stroop test present different possibilities for analysis and interpretation. Within neuroeconomics, there is an area that investigates how cognitive and affective regulation is critical to achieve economic results, in addition to investigating the problems caused by consumption and spending that people have in their daily lives. There is research shown that individuals who make compulsive purchases show cognitive deficiencies and difficulties in inhibiting their responses. Furthermore, compulsive purchases correlate with financial executive functioning, particularly with impulse control, organization and planning, showing that compulsive purchases are not limited only to impulse control. In Latin America and particularly in Mexico, there are few studies on neuroeconomics or consumer neuroscience, so consider that this research is an innovative contribution to the subject in our region. In this context, the objective of the research is to identify the association between cognitive inhibition and the money university students spend. This research evaluated the association between cognitive inhibition and the money university students spend. A total of 40 university students participated, 47.5 % men and 52.5 % women, between 18 and 25 years, from the City of Querétaro, Mexico. Cognitive inhibition was evaluated with the Stroop Test. In addition, sociodemographic data and monthly expenses were asked. The results descriptively detailed the level of youth spending and the Stroop effect variables. Young people have mean scores in Word, Colour, Word - Colour and Interference, according to the established parameters. Regarding monthly expenses, it is observed that on average they spend $ 666 Mexican pesos (34.04 USD / 31.13 EUR). In addition, a deficit was found in the inhibitory control related to an increase in the level of expenditure made by university students, that is, those who spend and buy more have difficulties in their cognitive inhibition (self-control). Inhibitory control is associated with age and this time with the level of money spent. Additionally, the inhibition processes allows us to assume certain activity in the orbitofrontal cortex (OFC) and the dorsolateral prefrontal cortex (DLFC), while they are ready to spend and who has problems with the control of their money, they cannot realize the excessive expenses that it does not recognize the symptoms that drive it to compulsive buying. The findings provide evidence to the neuroeconomy, as well as to the posture of cognitive control. Furthermore, it is corroborated that performance tests are an alternative in the detection of executive functioning deficiencies in a short time of application and provide evidence in the approach to neuroeconomics through this form of measurement. This offers a novel vision to understand the personal finances of Mexicans and their economic behaviour. Financial and consumer behaviour has become our main line of research from a neuroeconomic perspective; in the future, we intend to continue this study by incorporating affective and neurobehavioral factors involved in financial decisions in young people of our country. Finally, the usefulness of the results within the neuroeconomics in Mexico and Latin America is deepened, as well as its contribution as a line of research.

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Background: Deep brain stimulation (DBS) is considered an alternative treatment for patients with rapidly developing Parkinson's disease (PD). DBS can cause cognitive changes, and it is necessary to perform an executive assessment before and after DBS to better define the prognosis. Objective: The aim of this study was to analyze the use of the Stroop test for assessment of cognitive functions in patients with PD undergoing DBS. Methods: The systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Pubmed, Scopus, PsycInfo, and Web of Science were used as electronic databases. All included studies assessed the cognitive ability of patients with PD undergoing DBS through the application of the Stroop test. Results: Thirty-five articles met the inclusion criteria. Among the studies, there were different formats of Stroop applications. Twenty-three articles presented negative results in relation to the individuals' performances in Stroop, compared to the control groups. The results suggested that there was no correlation between low performance in the test and global cognitive risk for the patients. Conclusion: Patients with DBS declined in Stroop performance and showed impairments in response inhibition and speed. These results are not related to the lack of cognitive security of DBS. The Stroop test can be combined with other cognitive instruments to ensure greater approximation of results with reality measures.

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INTRODUCTION AND OBJECTIVES: The EncephalApp Stroop Test was developed to more easily diagnose minimal hepatic encephalopathy (MHE). A cut-off of >274.9sec (ONtime+OFFtime) reached a 78% sensitivity and 90% specificity in the validation study, but it has been poorly studied in Brazil. We aim to analyze the usefulness of this diagnostic method and to describe a cut-off value to screen MHE in Brazil. METHODS: In this cross-sectional and single-center study, three positive psychometric tests defined the diagnosis of MHE as the gold standard. We evaluated gender, age, education, familiarity with smartphones, etiology of cirrhosis, Child-Pugh/MELD scores, and previous hepatic encephalopathy (HE). Healthy controls and patients without HE were compared for the task validation. The Chi-square and Mann-Whitney tests, logistic regression analysis, and ROC curves were used for statistical evaluation. RESULTS: We included 132 patients with cirrhosis (61% male) and 42 controls (62% male) around 51y. Sixty-three were diagnosed with MHE on psychometric tests and 23 had clinical HE. Viral hepatitis (38%) was the major etiology of cirrhosis. The median MELD was 10 and Child-Pugh A was more frequent (70%). There was no significant difference in test results between controls and patients without HE. There was also no influence of gender, age, education, and familiarity with smartphones in the test results. Child-Pugh A was associated with MHE (p=0.0106). A cut-off of >269.8sec (ONtime+OFFtime) had an 87% sensitivity and 77% specificity to detect MHE (p=0.002). CONCLUSION: This is a valid and reliable tool for screening MHE. However, optimal cut-off values need to be validated locally.

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Introduction: Regular aerobic exercise (AE) can reduce the cognitive losses typically experienced with aging can be blunted by regular aerobic exercise (AE). AE also induces acute improvement of cognitive function among older adults; and AE practice with blood flow restriction (BFR) addss other benefits to elderly health, such as improvements in aerobic fitness, and increase in muscle mass and strength, however, it is not clear which EA protocol is more efficient to cognitive function. Objectives: Thus, the aimof this study was to compare AE protocols with and without BFR on the inhibitory control of the elderly. Methodology: Twenty-one elderly performed the Stroop test before and after three AE sessions in a repeated measure, cross-over design: AE with high load (70% VO2max), AE with low load (40% VO2max), and AE with blood flow restriction (AE-BFR) BFR (40% VO2max and 50% of BFR). Results and discussion: There was no significant effect from experimental sessions on cognitive function, assessed by inhibitory control in Stroop test. Perhaps, the load applied was not proper to stimulate cognitive function improvements, as seen the moderate loads have been more efficient to increase cerebral blood flow, among other physiological mechanisms encompassed. Final Considerations: Moreover, we observed very heterogeneous responses among individuals and sessions, suggesting that future research also considers biological individuality.

Introdução: As perdas cognitivas tipicamente experimentadas com o envelhecimento podem ser atenuadas por exercícios aeróbicos (EA) regulares. EA também induz melhora aguda da função cognitiva em idosos; e a prática de EA com restrição de fluxo sanguíneo (RFS) agrega outros benefícios à saúde do idoso, como melhorias na aptidão aeróbia e aumento da massa e força muscular. No entanto, não está claro qual protocolo de EA é mais eficaz para a funcao cognitiva. Objetivos: Assim, o objetivo deste estudo foi comparar diferentes protocolos de EA com e sem RFS no controle inibitório de idosos. Metodologia: Vinte e um idosos realizaram o teste de Stroop antes e após três sessões de EA em medida repetida, desenho cruzado: EA com alta carga (70% VO2máx), EA com baixa carga (40% VO2máx) e EA com RFS (40% VO2máx e 50% do RFS). Resultados e discussão: Não houve efeito significativo das sessões experimentais na função cognitiva avaliada pelo controle inibitório no Stroop Test. Talvez, as cargas aplicadas não tenham sido adequadas para estimular melhorias no controle inibitório, visto que as cargas moderadas têm sido mais eficientes para aumentar o fluxo sanguíneo cerebral, entre outros mecanismos fisiológicos Considerações Finais: Além disso, observamos respostas bastante heterogêneas entre indivíduos e sessões, sugerindo que pesquisas futuras considere também a individualidade biológica.

Introducción: El ejercicio aeróbico regular (EA) puede reducir la perdida cognitiva tipicamente experimentada durante el envejecimiento. EA puede tambien inducir mejora en la funcion cognitiva entre adultos mayores, ademas, la practica de resticcion de flujo sanguíneo (RFS) agrega otros beneficios para la salud en los ancianos, así como mejoras en la aptitud aeróbica, aumento de la masa muscular y la fuerza, sin embargo, no está claro qué protocolo de EA es más eficiente para la función cognitiva. Objetivos: El objetivo de este estudio fue comparar los protocolos de EA con y sin RFS en el control inhibitorio de los ancianos. Metodología: Veintiún ancianos realizaron la prueba de Stroop antes y después de tres sesiones de EA en medida repetida, diseño cruzado: EA con carga alta (70% VO2max), EA con carga baja (40% VO2max) y EA con restricción del flujo sanguíneo (EA-RFS) RFS (40% VO2max y 50% de RFS). Resultados y discusión: No hubo efecto significativo de las sesiones experimentales sobre la función cognitiva, evaluada por el control inhibitorio en la prueba de Stroop. Quizás, la carga aplicada no fue la adecuada para estimular mejoras en la función cognitiva, ya que las cargas moderadas han sido más eficientes para aumentar el flujo sanguíneo cerebral, entre otros mecanismos fisiológicos englobados. Consideraciones finales: Además, nosotros observamos respuestas muy heterogéneas entre individuos y sesiones, lo que sugiere que para futuras investigaciones también se debe considerar la variabilidad biológica.

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Aging is related to a decrease in physiological abilities, especially cognitive functions. To unravel further evidence of age-related cognitive decline, we analyzed which physical and functional variables are predictors of cognitive performance in a sample of 498 Brazilian elderly (67.26% women). To do so, we used the Stroop test as a tool to evaluate executive functions and the General functional fitness index (GFFI) to evaluate the functional fitness of the participants. A linear regression analysis revealed that female sex (β=-0.097; t=-2.286; P=0.023), younger age (β=0.205; t=4.606; P<0.0001), more years of education (β=-0.280; t=-6.358; P<0.0001), and higher GFFI (β=-0.101; t=-2.347; P<0.02) were predictors of better cognitive performance. Body mass index (kg/m2) and nutritional status (underweight, eutrophic, overweight, or obese) were not predictors of cognitive performance. Interestingly, among the GFFI tasks, muscle strength influenced the test execution time, both in upper and lower limbs (elbow flexion: β=-0.201; t=-4.672; P<0.0001; sit-to-stand: β=-0.125; t=-2.580; P<0.01). Our findings showed that: 1) women performed the Stroop test faster than men; 2) the older the person, the lower was the cognitive performance; 3) the higher the education, the better the test execution time; and 4) higher scores in the GFFI were associated with a better performance in the Stroop test. Therefore, gender, age, education, and functional fitness and capacity were predictors of cognitive performance in the elderly.

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OBJECTIVE: This study developed and gained insight in an auditory Stroop test, implementable in cognitive hearing sciences. METHODS: An auditory Stroop test was developed and performed in 178 participants, aged between 18 and 69 years. This Auditory Stroop test consisted of two tests: Stroop-tones and Stroop-words whereby the pitch of pure-tones and spoken words (i.e., the words high and low) had to be identified by high or low, respectively. An interference score was calculated as a measure of verbal executive functioning. Regression models were conducted to examine the effect of age, sex, education, awakeness, hearing, as well as visual and verbal working memory, and processing speed on the auditory Stroop scores. Normative data were obtained per age decade. RESULTS: Compared to the visual counterparts, the auditory Stroop outcomes were better predicted by verbal working memory and processing speed. A trend was observed showing a decrease in performances with increasing age. No other participant-related variables had a significant relationship with the auditory Stroop test. CONCLUSION: This auditory Stroop test was considered a good test for measuring executive functioning using auditory stimuli. Implementing this auditory Stroop test within cognitive hearing sciences will contribute to unravel the auditory-cognitive perspective of speech understanding.

OBJETIVO: Este estudio desarrolló y alcanzó un claro entendimiento en una prueba auditiva de Stroop, implementable en las ciencias auditivas cognitivas. MÉTODOS: Se desarrolló un test auditivo de Stroop y se aplicó en 178 participantes entre los 18 y los 69 años de edad. Este test auditivo de Stroop constaba dos pruebas, a saber: Stroop-tonos y Stroop-palabras. El tono de los tonos puros y de las palabras habladas (es decir, las palabras alto y bajo) tenían que ser identificadas por alto o bajo, respectivamente. Se calculó una puntuación de interferencia como medida del funcionamiento ejecutivo verbal. Se realizaron modelos de regresión para examinar el efecto de la edad, el sexo, la educación, la vigilia, la audición, así como la memoria de trabajo visual y verbal y la velocidad de procesamiento en todas las puntuaciones auditivas de Stroop. Se obtuvieron datos normativos por década. RESULTADOS: Los resultados del Stroop auditivo podrían predecirse mejor por la memoria de trabajo verbal y la velocidad de procesamiento en comparación con las contrapartes visuales. Se observó una tendencia que mostraba una disminución de los resultados con el aumento de la edad. Ninguna otra variable relacionada con los participantes parecía tener una relación significativa con la prueba auditiva de Stroop. CONCLUSIÓN: Este test auditivo de Stroop se consideró una buena prueba para medir el funcionamiento ejecutivo utilizando estímulos auditivos. La aplicación de esta prueba auditiva de Stroop dentro de las ciencias auditivas cognitivas contribuirá a desentrañar la perspectiva auditivo-cognitiva de la comprensión del habla.

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Abstract Background: Fibromyalgia is a chronic pain disorder characterized by widespread musculoskeletal symptoms, primarily attributed to sensitization of somatosensory system carrying pain. Few reports have investigated the impact of fibromyalgia symptoms on cognition, corticomotor excitability, sleepiness, and the sleep quality — all of which can deteriorate the quality of life in fibromyalgia. However, the existing reports are underpowered and have conflicting directions of findings, limiting their generalizability. Therefore, the present study was designed to compare measures of cognition, corticomotor excitability, sleepiness, and sleep quality using standardized instruments in the recruited patients of fibromyalgia with pain-free controls. Methods: Diagnosed cases of fibromyalgia were recruited from the Rheumatology department for the cross-sectional, case-control study. Cognition (Mini-Mental State Examination, Stroop color-word task), corticomotor excitability (Resting motor threshold, Motor evoked potential amplitude), daytime sleepiness (Epworth sleepiness scale), and sleep quality (Pittsburgh sleep quality index) were studied according to the standard procedure. Results: Thirty-four patients of fibromyalgia and 30 pain-free controls were recruited for the study. Patients of fibromyalgia showed decreased cognitive scores (p = 0.05), lowered accuracy in Stroop color-word task (for color: 0.02, for word: 0.01), and prolonged reaction time (< 0.01, < 0.01). Excessive daytime sleepiness in patients were found (< 0.01) and worsened sleep quality (< 0.01) were found. Parameters of corticomotor excitability were comparable between patients of fibromyalgia and pain-free controls. Conclusions: Patients of fibromyalgia made more errors, had significantly increased reaction time for cognitive tasks, marked daytime sleepiness, and impaired quality of sleep. Future treatment strategies may include cognitive deficits and sleep disturbances as an integral part of fibromyalgia management.(AU)

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ABSTRACT BACKGROUND: Covert hepatic encephalopathy (CHE) is difficult to detect due to the lack of easily applicable screening tools. The Stroop EncephalApp is a smartphone application already validated for CHE screening. However, its applicability to the Brazilian population is not known. OBJECTIVE: To estimate the prevalence of CHE and evaluate the use of Stroop EncephalApp in a cirrhotic population in Brazil. METHODS: In this cross-sectional study, we evaluated 99 patients previously diagnosed with liver cirrhosis in a Private Hospital in Curitiba/PR. Patients were initially submitted to the mini mental state examination (MMSE) to exclude individuals with dementia. After, the Psychometric Hepatic Encephalopathy Score (PHES) test was performed and lastly, the Stroop EncephalApp test. Results were adjusted for age, sex and education levels to evaluate the accuracy of the app on detecting the disease, comparing its results with the gold standard method (PHES). Patients with one or more of the following were excluded: dementia, inadequate MMSE score, illiteracy, color blindness, history of drugs/alcohol abuse within the past 3 months and previous or actual episodes of encephalopathy. The statistical analysis was performed by SPSS 2.0 and the significance adopted by 5%. RESULTS: We included 82 individuals in the final analysis. Among these patients, 29 were diagnosed with CHE by the PHES test (35.36% prevalence) and 28 of those obtained equal diagnosis by the Stroop EncephalApp (96.6% sensitivity). A total of 53 patients obtained negative results for CHE by PHES, while the Stroop test classified 27 of them as having the disease. In the multivariate analysis, high levels of education were associated with better performance during the tests. No significant relationship was observed between age and sex with the probability of diagnosing CHE through the PHES test.

RESUMO CONTEXTO: A encefalopatia hepática mínima (EHM) é uma complicação neuro-psiquiátrica da cirrose cuja detecção é dificultada pela falta de ferramentas práticas. O Stroop EncephalApp é um aplicativo de smartphones capaz de detectar a doença, entretanto sua aplicabilidade na população brasileira ainda não é conhecida. OBJETIVO: Avaliar o uso do Stroop EncephalApp para diagnóstico e avaliação de EHM em uma população de pacientes cirróticos no Brasil. MÉTODOS: Através de um estudo observacional transversal, 99 indivíduos sabidamente cirróticos foram recrutados do ambulatório de hepatologia de um hospital privado em Curitiba/PR. Primeiramente, foram aplicados o mini exame do estado mental (MEEM) para excluir indivíduos com demência; após, foram aplicados o Escore Psicométrico da Encefalopatia Hepática (PHES), atual padrão-ouro para diagnóstico de EHM, e posteriormente o Stroop EncephalApp, ajustando para idade, sexo e anos de formação acadêmica, buscando avaliar a eficiência do aplicativo em detectar a doença e comparar seus resultados com o atual padrão-ouro. Foram excluídos do estudo indivíduos com demência, pontuação insuficiente no MEEM, analfabetos, daltônicos, e com histórico de abuso de álcool/drogas ilícitas nos últimos 3 meses e paciente com episódios prévios ou atuais de encefalopatia hepática. A análise estatística foi realizada pelo SPSS 2.0 e a significância adotada em 5%. RESULTADOS: Um total de 82 indivíduos foram incluídos na análise final. Destes, 29 foram diagnosticados com EHM (35,36% de prevalência) através do PHES e 28 obtiveram o mesmo resultado após a aplicação do Stroop (96,6% de sensibilidade). Cinquenta e três pacientes obtiveram um resultado negativo para EHM através do PHES, sendo que 27 desses obtiveram um resultado positivo para EHM através do Stroop. Na análise multivariada, níveis elevados de escolaridade estiveram associados com melhor desempenho durante a execução dos testes. Não houve associação significativa entre idade e sexo com a probabilidade de apresentar encefalopatia através do PHES. CONCLUSÃO: O Stroop EncephalApp é uma ferramenta viável e com boa sensibilidade para o screening de EHM, mas possui baixa especificidade na população estudada.

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Abstract Aim: The aim of the study was to analyze the impact of a based-team sports physical education class on inhibitory control of elementary school children. Methods: Were selected 29 elementary school students (13 boys and 16 girls; 10.7 ± 0.7 years old; 43.2 ± 8.2 kg weight; 147 ± 5 cm height). Participants were submitted to a 50-minute sports-based physical education class performed at moderate intensity. Inhibitory control was measured before and immediately after the end of the physical education class by the Stroop Test. Results: Results indicate that the variables derived from Stroop Test performance overall reaction time were significantly reduced after the physical education class (p < 0.05). Conclusion: These results suggest that a 50-minute sports-based physical education class performed at moderate intensity elicited a significant improvement on the inhibitory control elementary school students.

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Introdução: O teste de Stroop é comumente utilizado para avaliar a flexibilidade cognitiva e função executiva. O teste mostrou correlacionar-se com variáveis como idade, nível educacional e atividade física, porém, pouco se sabe sobre as variáveis relacionadas ao desempenho no teste em populações previamente ativas. Objetivo: Avaliar o desempenho no teste de Stroop em população fisicamente ativa. Métodos: 89 estudantes foram recrutados, os mesmos tiveram seus níveis de atividade física avaliado por questionário e composição corporal avaliada por bioimpedância. Resultado: Observamos que as variáveis relacionadas à prática de atividade física não apresentaram correlação com o teste de Stroop. Foi identificado correlação do teste com as variáveis peso corporal e índice de massa corporal (IMC), sendo que maiores valores de peso e IMC resultaram em melhor desempenho no teste. Conclusão: Para indivíduos fisicamente ativos, outros fatores parecem ser preponderantes à atividade física com relação ao desempenho no teste de Stroop.

Introduction: The Stroop test is commonly used to assess cognitive flexibility and executive function. The test was correlated with variables such as age, educational level and physical activity, but little is known about variables related to performance in this test in previously active populations. Objective: To evaluate Stroop performance in a physically active population. Methods: 89 recruited students had their physical activity levels assessed by questionnaire and body composition evaluated by bioimpedance. Result: We observed that variables related to the physical activity level did not present correlation with the Stroop test. Was identified correlation of the test with the variables body weight and body mass index (BMI), being that higher values of weight and BMI resulted in better Stroop performance. Conclusion: For physical active individuals, other factors may be preponderant to physical activity in relation to Stroop performance.

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RESUMO Objetivo O presente estudo analisou a confiabilidade do Teste dos Cinco Dígitos (FDT), um instrumento de avaliação dos processos atencionais baseado no paradigma Stroop. O teste usa números e quantidades para avaliação do efeito de interferência atencional. Métodos Avaliamos 49 adultos brasileiros por meio do FDT. Os participantes realizaram o teste em dois momentos, com aproximadamente duas semanas de intervalo. A confiabilidade do teste foi estimada pela consistência interna (método das metades) e pela avaliação da estabilidade teste-reteste (coeficiente de correlação intraclasse e teste de Wilcoxon para amostras repetidas). Resultados O tempo de resposta médio dos participantes apresentou discreta melhora nas etapas mais simples do teste e mais acentuada nas etapas mais complexas. A consistência interna do teste foi superior a 0,9. A estabilidade teste-reteste variou em função da etapa do teste, e todas as correlações foram significativas (p < 0,01) e explicaram entre 60% e 90% da variância encontrada. Conclusão O FDT apresenta evidências robustas de confiabilidade na amostra avaliada. Esse foi o primeiro estudo brasileiro a avaliar essa propriedade pelo método de teste-reteste. Os resultados propiciam melhor aplicabilidade do FDT nos contextos de clínica e pesquisa.

ABSTRACT Objective This study examined the reliability test of the Five Digits (FDT), an assessment tool of attentional processes based on Stroop paradigm. The test uses numbers and quantities for the assessment of attentional interference effect. Methods We assessed 49 Brazilian adults through FDT. Participants performed the test on two occasions, about two weeks apart. The test reliability was estimated by internal consistency (split-half method) and the evaluation of test-retest stability (intraclass correlation coefficient and Wilcoxon test for repeated measures). Results The mean response time of the participants showed a slight improvement in the simpler test measures and more pronounced in the more complex ones. The internal consistency of the test was 0.9. The test-retest stability varied depending on the test stage, where all correlations were significant (p < 0.01) and explained between 60% and 90% of the explained variance. Conclusion FDT provides robust evidence of reliability of the sample investigated. This was the first Brazilian study to evaluate this property by test-retest method. The results provide a better applicability of FDT in clinical and research settings.

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ABSTRACT Tests evaluating the attentional-executive system are widely used in clinical practice. However, proximity of an objective cognitive test with real-world situations (ecological validity) is not frequently investigated. The present study evaluate the association between measures of the Five Digit Test (FDT) and the Oral Trails Test (OTT) with self-reported cognitive failures in everyday life as measured by the Cognitive Failures Questionnaire (CFQ). Brazilian adults from 18-to-65 years old voluntarily performed the FDT and OTT tests and reported the frequency of cognitive failures in their everyday life through the CFQ. After controlling for the age effect, the measures of controlled attentional processes were associated with cognitive failures, yet the cognitive flexibility of both FDT and OTT accounted for by the majority of variance in most aspects of the CFQ factors. The FDT and the OTT measures were predictive of real-world problems such as cognitive failures in everyday activities/situations.

RESUMO Testes que avaliam o sistema atencional-executivo são amplamente adotados no contexto clínico. Contudo, a proximidade de uma medida cognitiva objetiva com situações reais (validade ecológica) são pouco investigadas. O presente estudo objetiva avaliar a associação entre o Teste dos Cinco Dígitos (FDT) e o Oral Trails Test (OTT) com falhas cognitivas do dia a dia relatadas no Questionário de Falhas Cognitivas (CFQ). Sessenta adultos brasileiros, de 18 a 65 e cinco anos, realizaram o FDT e o OTT e reportaram a frequência das falhas cognitivas por meio do CFQ. Controlando o efeito da idade, as medidas de processos atencionais controlados foram associadas com as falhas cognitivas, sendo que o componente de flexibilidade cognitiva do FDT e do OTT explicou a maior parte da variância das falhas. O FDT e o OTT foram preditores de problemas reais do dia a dia, como as falhas cognitivas.

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Este trabalho teve como objetivo realizar um estudo de validade de critério do teste Stroop de Cores e Palavras, para controle inibitório, na população de Curitiba e região metropolitana. Para isso foram realizados estudos, com três amostras, contendo, no total 234 participantes entre 18 a 63 anos de ambos os sexos. O primeiro estudo verificou a influência de duas versões traduzidas no desempenho dos participantes, uma contendo a cor vermelha (red) e a outra a cor rosa (pink), onde constatou-se que não existem diferenças significativas entre os resultados de cada versão. A segunda amostra consistiu em verificar a correlação entre a versão original, em inglês, e as duas versões em português (versão vermelha e versão rosa), sendo constatado, também, que não existem diferenças significativas entre as correlações das duas versões. Por fim, a terceira amostra consistiu na aplicação do Teste Stroop de Cores e Palavras, juntamente com o Teste de Trilhas e a Escala de Impulsividade de Barratt, para verificar se os dados estatísticos indicariam correlações estatisticamente significativas entre esses três testes que avaliam o constructo. O último estudo indicou que não existem correlações significativas entre os instrumentos, evidenciando a ausência de validade deste instrumento para a avaliação de controle inibitório.

This project had the objective to make a validity study of the Stroop Color and Word Test to inhibitory control for the population of Curitiba and metropolitan area. For this, studies were made with three samples, containing 234 participants, between 18 at 63 years old, both genders. The first study examined the influence of two translated versions, one containing the red color, and the other containing the pink color, and revealed that there aren’t significant differences between results of each version. The second sample consisted in verifying the correlations between original and the two translated versions, the result showed that are no significant differences between the original and the translate versions. At last, in the third sample were applied three test, Stroop Color and Word Test, Trail Making Test and Barratt Impulsiveness Scale, for identify if statistical analyses would show correlations between this tests. The last study did not showed significantly correlations between instruments, highlighting the lack of validity of this instrument for the assessment of inhibitory control.

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OBJECTIVE: The Trail Making Test (TMT) and Stroop Test (ST) are attention tests widely used in clinical practice and research. The aim of this study was to provide normative data for the adult Brazilian population and to study the influence of gender, age and education on the TMT parts A and B, and ST cards A, B and C. METHODS: We recruited 1447 healthy subjects aged ?18 years with an educational level of 0-25 years who were native speakers of Portuguese (Brazilian). The subjects were evaluated by the Matrix Reasoning and Vocabulary subtests of the Wechsler Adult Intelligence Scale-III, along with the TMTA, TMTB and ST A, B and C. RESULTS: Among the participants, mean intellectual efficiency was 103.20 (SD:12.0), age 41.0 (SD:16.4) years and education 11.9 (SD:5.6) years. There were significant differences between genders on the TMTA (p=0.002), TMTB (p=0.017) and STC (p=0.024). Age showed a positive correlation with all attention tests, whereas education showed a negative correlation. Gender was not found to be significant on the multiple linear regression model, but age and education maintained their interference. CONCLUSION: Gender did not have the major impact on attentional tasks observed for age and education, both of which should be considered in the stratification of normative samples.

OBJETIVO: Os testes de atenção Trail Making Test (TMT) e Stroop Test (ST) são largamente usados na prática clínica e em pesquisas. O objetivo deste estudo foi fornecer informação normativa para a população brasileira de adultos e estudar a interferência de gênero, idade e educação no TMT parte A e B e no ST cartão A, B e C. MÉTODOS: Recrutamos 1447 sujeitos saudáveis com idade ?18 anos, nível educacional de 0-25 anos, falantes nativos do Português (Brasil). Os sujeitos foram avaliados pelos subtestes do Wechsler Adult Intelligence Scale-III Raciocínio Matricial e Vocabulários, além do TMTA, TMTB e ST A, B e C. RESULTADOS: Entre os participantes a média de eficiência intelectual foi de 103,20 (SD:12,0), de idade 41,0 (SD:16,4) anos e de escolaridade 11,9 (SD: 5,6) anos. Houve diferenças significantes por gênero em TMTA (p=0,002), TMTB (p=0,017) e STC (p=0,024). Idade se correlacionou de modo positivo com todos os testes de atenção, enquanto a escolaridade correlacionou-se de modo negativo. Após o modelo de regressão linear múltipla o gênero não manteve correlação significativa, mas idade e escolaridade mantiveram sua interferência. CONCLUSÃO: O gênero não mostrou grande impacto nas tarefas atencionais como a idade e escolaridade que devem, portanto, ser consideradas na estratificação de amostras normativas.

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