Elaboração e validade do teste de rastreio de doença da Alzheimer com provérbios (TRDAP) para indivíduos a partir de sessenta anos

A escassez de instrumentos para a avaliação e a triagem da doença de Alzheimer, (DA), notadamente denominados de rastreio, com características de padronização e validados para o Nordeste, motivou este Estudo. Visando à triagem de uma etapa mais leve da doença e encaminhamento precoce ao tratamento multidisciplinar foi elaborado o Teste de Rastreio da Doença de Alzheimer com Provérbios (TRDAP), a partir de um Jogo de Memória de Provérbios, construído como recurso terapêutico ocupacional. Está composto de três etapas conforme a função neuropsicológica avaliada, a A (memória de curto prazo), B (funções executivas e linguagem) e C (memória episódica), além do reconhecimento de provérbios. O Estudo foi realizado em uma amostra de conveniência, com 91 idosos (28 DA e 63 controles), a partir de 60 anos, com um ou mais anos de escolaridade. Foram controladas as variáveis, como doenças intercorrentes ou déficits sensoriais que pudessem comprometer o desempenho dos pacientes, nos testes. O protocolo constou de oito testes selecionados por especialistas: Miniexame do Estado Mental (para validade convergente), Escala de Depressão Geriátrica EDG (validade discriminante), Lista de Palavras, Fluência Verbal, Span de Dígitos, Figura Neuropsi, Teste do Relógio, Atividade de Vida Diária e Instrumental. Os resultados confirmaram a validade de construto convergente e discriminante, assim como a relação significativa (p<0,005) com todos os testes, exceto com o EDG. Quanto à validade concorrente, não houve discordância com o critério da avaliação médica observou-se consistência interna aceitável, conferindo confiabilidade no instrumento, o que não ocorreu com MEEM. Tais resultados permitem afirmar que o TRDAP possui características psicométricas, adequadas ao rastreio da fase leve da DA para população estudada

Efeitos do treino em esteira na marcha com dupla tarefa de indivíduos com doença de Parkinson: ensaio clínico controlado randomizado

Background: The gait automaticity loss difficults realization of concurrent activities - Dual Task (DT). In these situations, individuals with Parkinson`s disease (PD) show a significant reduction in gait velocity and stride length, as strides variability and asymmetry increased, factors predisposing to falls. However, recent studies have shown that training involving DT may cause subsequent improvements in gait variables with DT in individuals with PD. The treadmill use was adopted by this study, by promoting greater regularity in step and enhance training. Objective:To investigate immediate effects of gait training associated with cognitive tasks on gait in individuals with PD. Methods: Twenty-two volunteers were randomly divided into two groups: control group (n = 11), who performed gait training on a treadmill for 20 minutes, and the experimental group (n = 11), who performed treadmill gait training for 20 minutes associated with cognitive tasks of verbal fluency, memory, and spatial planning. Participants were evaluated in phase on of antiparkinsonian medication as the demographic, clinical and anthropometric (identification form), cognitive status (Montreal Cognitive Assessment - MoCA), executive function (Frontal Assessment Battery), level of physical disability (Hoehn and Yahr Modified), motor and functional status (Unified Rating Scale for Parkinson`s Disease - UPDRS), and kinematics (Qualisys Motion Capture System). Results: There were not differences between groups, but both showed improvement after the intervention. The control group had an increase in velocity (p = 0.008), stride length (p = 0.04), step length (p = 0.02) and decreased double support time(p = 0.03). The experimental group showed an increase in speed (p = 0.002), stride length (p = 0.008), step length (p = 0.02) and cadence (p = 0.01), as well as a decrease in the width stride (p = 0.001) and total support time (p = 0.02). As the angular variables, the experimental group had a significant increase in the initial contact angle of ankle (p = 0.01). Conclusion: The gait training combined with cognitive activities didn`t provide significant improvements in gait variables with DT, but this study was the first to demonstrate that gait training on treadmill as simple task minimized the negative interference of DT in PD

Alterações da default mode network provocadas pela ingestão de Ayahuasca investigadas por Ressonância Magnética Funcional

Ayahuasca is psychotropic beverage that has been used for ages by indigenous populations in South America, notably in the Amazon region, for religious and medicinal purposes. The tea is obtained by the decoction of leaves from the Psychotria viridis with the bark and stalk of a shrub, the Banisteriopsis caapi. The first is rich in N-N-dimethyltryptamine (DMT), which has an important and well-known hallucinogenic effect due to its agonistic action in serotonin receptors, specifically 5-HT2A. On the other hand, β-carbolines present in B. caapi, particularly harmine and harmaline, are potent monoamine oxidase inhibitors (MAOi). In addition, the tetrahydroharmine (THH), also present in B. caapi, acts as mild selective serotonin reuptake inhibitor and a weak MAOi. This unique composition induces a number of affective, sensitive, perceptual and cognitive changes in individuals under the effect of Ayahuasca. On the other hand, there is growing interest in the Default Mode Network (DMN), which has been consistently observed in functional neuroimaging studies. The key components of this network include structures in the brain midline, as the anterior medial frontal cortex, ventral medial frontal cortex, posterior cingulate cortex, precuneus, and some regions within the inferior parietal lobe and middle temporal gyrus. It has been argued that DMN participate in tasks involving self-judgments, autobiographical memory retrieval, mental simulations, thinking in perspective, meditative states, and others. In general, these tasks require an internal focus of attention, hence the conclusion that the DMN is associated with introspective mental activity. Therefore, this study aimed to evaluate by functional magnetic resonance imaging (fMRI) changes in DMN caused via the ingestion of Ayahuasca by 10 healthy subjects while submitted to two fMRI protocols: a verbal fluency task and a resting state acquisition. In general, it was observed that Ayahuasca causes a reduction in the fMRI signal in central nodes of DMN, such as the anterior cingulate cortex, the medial prefrontal cortex, the posterior cingulate cortex, precuneus and inferior parietal lobe. Furthermore, changes in connectivity patterns of the DMN were observed, especially a decrease in the functional connectivity of the precuneus. Together, these findings indicate an association between the altered state of consciousness experienced by individuals under the effect of Ayahuasca, and changes in the stream of spontaneous thoughts leading to an increased introspective mental activity

Efeitos de um programa de treino cognitivo e das técnicas de higiene do sono para as funções executivas e para a qualidade de sono em idosos saudáveis

The aging process causes changes in the elderly’s sleep/awake standard impairing their cognitive abilities, particularly executive functioning, which already suffers loss by aging. The literature suggests that executive function and preserved sleep quality are key to maintaining good quality of life and independence of older people, requiring interventions to minimize the impact of losses incurred by the aging process. This study evaluated the effect of a cognitive training program and sleep hygiene techniques for executive functions and sleep quality in healthy older people. The participants were 41 healthy older adults, of both sexes, who were randomly divided into four groups: control group [GC], cognitive training group [GTC], sleep hygiene group [GHS] and training group + hygiene [GTH]. The research was developed in three stages: 1st - initial assessment of cognition and sleep; 2nd - specific intervention to each group; 3rd - post-intervention revaluation. The results showed that GTC had significant improvements in cognitive tasks flexibility, planning, verbal fluency and some aspects of episodic memory, besides gains in sleep quality and decrease on daytime hypersomnolence. The GHS improved sleep quality and daytime sleepiness as well and had significant improvements in insights capacity, planning, attention and in all evaluated aspects of episodic memory. The GTH had significant gains in cognitive flexibility, problem solving, verbal fluency, attention and episodic memory. The CG showed significant worsening in excessive daytime sleepiness in capacity planning. Thus, we conclude that cognitive training interventions and sleep hygiene strategies are useful in improving cognitive performance and quality of healthy elderly sleep.

Graph analysis of verbal fluency test discriminate between patients with Alzheimer’s disease, Mild Cognitive Impairment and normal elderly controls

Verbal fluency is the ability to produce a satisfying sequence of spoken words during a given time interval. The core of verbal fluency lies in the capacity to manage the executive aspects of language. The standard scores of the semantic verbal fluency test are broadly used in the neuropsychological assessment of the elderly, and different analytical methods are likely to extract even more information from the data generated in this test. Graph theory, a mathematical approach to analyze relations between items, represents a promising tool to understand a variety of neuropsychological states. This study reports a graph analysis of data generated by the semantic verbal fluency test by cognitively healthy elderly (NC), patients with Mild Cognitive Impairment – subtypes amnestic(aMCI) and amnestic multiple domain (a+mdMCI) - and patients with Alzheimer’s disease (AD). Sequences of words were represented as a speech graph in which every word corresponded to a node and temporal links between words were represented by directed edges. To characterize the structure of the data we calculated 13 speech graph attributes (SGAs). The individuals were compared when divided in three (NC – MCI – AD) and four (NC – aMCI – a+mdMCI – AD) groups. When the three groups were compared, significant differences were found in the standard measure of correct words produced, and three SGA: diameter, average shortest path, and network density. SGA sorted the elderly groups with good specificity and sensitivity. When the four groups were compared, the groups differed significantly in network density, except between the two MCI subtypes and NC and aMCI. The diameter of the network and the average shortest path were significantly different between the NC and AD, and between aMCI and AD. SGA sorted the elderly in their groups with good specificity and sensitivity, performing better than the standard score of the task. These findings provide support for a new methodological frame to assess the strength of semantic memory through the verbal fluency task, with potential to amplify the predictive power of this test. Graph analysis is likely to become clinically relevant in neurology and psychiatry, and may be particularly useful for the differential diagnosis of the elderly.

Indícios sincrônicos de gramaticalização: o uso do verbo chegar em orações coordenadas e na perífrase verbal [chegar (e) + v2]: contribuições para o ensino de gramática.

Based on North American Functional Linguistic Theory, our proposal is to describe and analyze the use of verb CHEGAR in verbal periphrasis such as [CHEGAR (E) + V2], where CHEGAR does not demonstrate a significance linked to physical movement. In linguistic literature, such periphrasis has been attributed several functions, related to aspectualization, emphasis of negative segments, and construction of mental spaces, among others. This study considers that the function of verb CHEGAR in the periphrasis in question is to indicate a global aspect, emphasizing a range of semantic-pragmatic nuances such as the sudden, instantaneous, or even abrupt character of the events refered to by the principal verb of the construction (V2), and/or the taking of initiative (sudden) by the agent (in the syntactic role of periphrastic subject), and/or subjective evaluations which go from surprise to frustration. Our objectives are the following: i) to describe and analyze the semanticpragmatic, morphosyntactic and social relationships which characterize the use of CHEGAR in verbal periphrases like [CHEGAR (E) + V2] and in coordinated/juxtaposed speech in which CHEGAR is the principal verb of the first utterance and is an elocution verb and the principal verb of the second; ii) identify, based on this description and analysis, synchrony proof in the grammaticalization of CHEGAR as an auxiliary verb in the periphrasis refered to. There was observed to be a strong similarity between coordinate/juxtaposed and periphrastic constructions. Such similarities strengthen the hypothesis that the use of CHEGAR as a lexical verb in coordinate/juxtaposed structures is the origin of the use of CHEGAR in the periphrastic structure, since the many properties encountered with higher frequency in lexical use are also just as frequently used as auxiliaries. Nevertheless, between the two constructions being studied, sufficient difference can be observed to see that CHEGAR, in the periphrasis [CHEGAR (E) V2], is behaving like an auxiliary verb, and shows typical properties of these types of verbs: i) in 100% of occurrences, it does not have a complement;ii) it has a co-referential subject in 100% of cases; iii) it does not appear with intervening material between it and V2. Besides this, CHEGAR, in periphrases, is predominant in nonneutral evaluation contexts, denoted by V2. Inspired by the results obtained, we propose strategies for the discussion of the [CHEGAR (E) V2] periphrases in both elementary and high schools.

A influência do feedback verbal na cooperação em crianças

Human cooperation is a hallmark of this species due to its wide extension to genetically unrelated individuals and complex division of labor. It is considered an evolutionary puzzle, because the theory of evolution by natural selection predicts that self-interested individuals tend to be selected. Different theories have been proposed to explain the evolution of cooperation, which the most important are kin selection and reciprocal altruism. Considering the evolutionary continuity between species, humans and other primates have several common traits that help to promote cooperation between individuals of these species. Two features, however, seem to be particularly humans: inequality aversion and preferences in relation to others. Although human cooperation is not necessarily related to morality, cooperative traits are the basis for moral tendencies. The development of human morality is a combination of early prosocial tendencies, cooperative skills displayed at different ages, social learning and cultural transmission of norms. The social stimulus seems to be particularly important in promoting cooperative behavior in children and adults. In order to study the influence of social stimuli, as verbal feedback, on children cooperation, a study was conducted with children in a public goods game. 407 children from public schools in Natal / RN, divided into 21 groups, between six and nine years, participated in eight rounds of this game. After each round, seven groups received praise for larger donations, seven groups have been criticized by smaller donations, and the other seven received no comment. Children cooperated more when criticized, without significant differences between sexes, although young children have cooperated more negative than older children. The results are likely related to the anticipation and avoidance of punishment associated with the feedback (although this did not occur), and greater sensitivity to the authority in younger children. Nevertheless, the cooperation decreased in all groups until the last day of play. The results suggest an early sensitivity to moral punishment, whose role in the maintenance of social relations must have been important in the evolution of cooperation in humans

A poética do corpo não-verbal: um olhar para a comicidade em cena

Throughout our history as an actor, director and teacher, we appreciate comedic performances they proposed a dialogue with the public through the body language of the performers whose performances abdicate the use of speech of the actors. This way of representing, in the silence of the stage, caught our attention and sparked our curiosity about the subject, which is directly related to the poetic constructions of the body on the scene. Before initial readings on the subject, we begin to understand that for a long time in human history, especially in the West, understanding body was constructed from various epistemological looks disregarded the body as a unit, an incarnation of the subject in all . This kind of thinking, reflecting the philosophy of modernity, reverberated strongly about the aesthetic issues of art making, here specifically in Theatre. For several centuries the theatrical make up molded from various aesthetic elements, but ignoring the potential of embodiment of the artist, ie the theatrical text, for example, was considered for a long time, as the main element of the scene and gave little emphasis on dramaturgy elaborate body. With the emergence of reflections on the subject, brought especially from the early twentieth century, the perception of the body as a creative element and creator, also began to gain ground. Over time artistic practices began to glimpse the creative possibilities of the body, including rethinking its relationship with the text written with the spoken word. And as part of these new reflections on the body in the creation process, we proposed this research, we have entitled "A poetics of non-verbal body: a look at the comic on the scene." In our research on this subject, also seek to understand how the corporeality of the actor may give us clues to realize / build nonverbal body and comical scene. From this perspective we can analyze how could the construction of a comical and non-verbal dramaturgy from the phenomenology of laughter. And with that look, we want to point out some aspects and procedures, arising from reflections on corporeality and comedy, that constitute, among other possible, non-verbal construction methodology scenic.

Graph analysis of verbal fluency test discriminate between patients with Alzheimer’s disease, Mild Cognitive Impairment and normal elderly controls

Verbal fluency is the ability to produce a satisfying sequence of spoken words during a given time interval. The core of verbal fluency lies in the capacity to manage the executive aspects of language. The standard scores of the semantic verbal fluency test are broadly used in the neuropsychological assessment of the elderly, and different analytical methods are likely to extract even more information from the data generated in this test. Graph theory, a mathematical approach to analyze relations between items, represents a promising tool to understand a variety of neuropsychological states. This study reports a graph analysis of data generated by the semantic verbal fluency test by cognitively healthy elderly (NC), patients with Mild Cognitive Impairment – subtypes amnestic(aMCI) and amnestic multiple domain (a+mdMCI) - and patients with Alzheimer’s disease (AD). Sequences of words were represented as a speech graph in which every word corresponded to a node and temporal links between words were represented by directed edges. To characterize the structure of the data we calculated 13 speech graph attributes (SGAs). The individuals were compared when divided in three (NC – MCI – AD) and four (NC – aMCI – a+mdMCI – AD) groups. When the three groups were compared, significant differences were found in the standard measure of correct words produced, and three SGA: diameter, average shortest path, and network density. SGA sorted the elderly groups with good specificity and sensitivity. When the four groups were compared, the groups differed significantly in network density, except between the two MCI subtypes and NC and aMCI. The diameter of the network and the average shortest path were significantly different between the NC and AD, and between aMCI and AD. SGA sorted the elderly in their groups with good specificity and sensitivity, performing better than the standard score of the task. These findings provide support for a new methodological frame to assess the strength of semantic memory through the verbal fluency task, with potential to amplify the predictive power of this test. Graph analysis is likely to become clinically relevant in neurology and psychiatry, and may be particularly useful for the differential diagnosis of the elderly.