Perfil neuropsicológico de personas adultas con VIH/SIDA

Los déficit neurológicos en el virus de inmunodeficiencia humana VIH, específicamente las alteraciones en el funcionamiento cognitivo, han estado presentes desde el inicio de su propagación y han sido una de las principales manifestaciones a lo largo de todas las etapas del virus. No obstante, gracias a los avances de la terapia antirretroviral se ha dado un aumento de la expectativa de vida de los pacientes, dándose de la misma manera un incremento en los déficits anteriormente mencionados. El objetivo del presente estudio es describir el perfil neuropsicológico de los pacientes con VIH y establecer si existen relaciones entre las funciones que se encuentren deterioradas, el tiempo de diagnóstico y la terapia antiretroviral. Para esto se llevo a cabo un estudio descriptivo de tipo exploratorio con el fin de medir las características de las funciones neuropsicológicas en un grupo de 24 pacientes pertenecientes al programa especial B24 del Hospital Universitario Mayor y Hospital de Barrios Unidos MÉDERI en Bogotá, Colombia. Para esto, se utilizó un protocolo de pruebas neuropsicológicas: Mini Mental StateExamination (MMSE), WAIS-III (sub-pruebas dígitos, letras y números, aritmética y semejanzas), Curva de aprendizaje auditivo verbal de Rey (RAVLT), WMS-III (sub-pruebas de recobro de historias y Localización), TMT A y B, Set Test de Isaacs, Figura Compleja de Rey y Test de Stroop. Dentro de los resultados se encontró que la medida de edad fue de 50 con un total de 19 hombres y 5 mujeres. Las funciones con mayor predominio de deterioro fueron la atención sostenida y alternante, la memoria declarativa, las funciones ejecutivas (específicamente en el control inhibitorio) y la velocidad de procesamiento, los pacientes presentan un rango de deterioro cognitivo leve (GDS 3). Se concluyó que el perfil de deterioro es mixto y que es necesario ampliar la muestra para obtener resultados más precisos en cuanto a las diferencias de acuerdo al tiempo de diagnóstico y la terapia antiretroviral.

A diabetes mellitus causa deterioro cognitivo em idosos? Um estudo de revisão

A Diabetes Mellitus (DM) refere-se a uma síndrome metabólica, com prejuízos físicos, sociais e psicológicos naqueles que a possuem. A doença tem um forte componente genético, e é subdividida em Diabetes Mellitus Tipo 1 (DM1), e Diabetes Mellitus Tipo 2 (DM2). A DM2 está associada a déficits funcionais e também cognitivos. Pesquisas revelam que as funções executivas dos idosos com DM encontram-se mais prejudicadas do que naqueles sem DM. Com o objetivo de aprofundar esta temática, esse estudo realiza uma revisão sistemática da literatura, através de publicações indexadas nos últimos oito anos, que abordam a relação entre DM2 e aspectos do deterioro cognitivo em idosos (flexibilidade cognitiva, flexibilidade mental e do pensamento e funções executivas). Nos estudos revisados, a maioria mostrou um grau de comprometimento relacionado com as funções cognitivas: flexibilidade do pensamento, atenção, memória de trabalho, sugerindo, inclusive, que a DM2 acelera o processo de deterioro, aumentando a possibilidade de desenvolvimento de demência. A prevalência de depressão é mais elevada em idosos com DM2, com comprometimento em muitas funções, além de outras complicações físicas identificadas. Os achados apontam para funcionamento cognitivo prejudicado em idosos com DM2, o que enfatiza a necessidade de desenvolvimento de programas de prevenção e intervenção.

Brief neuropsychological assessment of adults post-stroke in the left hemisphere

The neuropsychological assessment investigates cognitive deficits to improve the diagnosis, the prognosis and the rehabilitation of patients. In Brazil, stroke is a major cause of hospitalization and the leading cause of mortality and disability. The stroke in the left hemisphere (LH) is associated with different degrees of loss of language and other cognitive impairments, for example, in the memory. We compared the performance in brief neuropsychological tasks of the left hemisphere poststroke patients, without moderate or severe aphasia, with healthy controls. A list of 135 patients was selected based on inclusion criteria. The study included 15 patients with left stroke, paired by sex, age and education to 30 neurologically healthy adults. The data resulting from application of the Neupsilin Brief Neuropsychological Assessment Instrument were analyzed with the nonparametric Mann-Whitney U. Adults with LH stroke showed a significant reduction in performance when compared to healthy controls on language, working memory and ideomotor praxis, results also found in other studies of patients with left hemisphere stroke

Un estudio experimental de psico-pedagogía de las matemáticas.

Estudiar aquellos mecanismos y procesos implicados en la resolución de problemas aritméticos por parte de los niños, haciendo especial hincapié en los procesos mnémicos (working memory). Participan 40 sujetos, estudiantes de tercero de EGB, con edades comprendidas entre los 8 y 9 años, y siendo la mitad niñas y la otra mitad niños. Cada niño fue localizado por su maestra en el nivel de matemáticas en el que, a su juicio, el niño se encontraba (alto, medio, bajo). Como segundo factor se incluye en el diseño (mixto) la condición: introducción o no de una codificación visual del problema matemático (dibujar el problema). Todos los sujetos pasan por las dos condiciones (el orden se asigna al azar). Los problemas que se plantean a los niños se seleccionan de un texto de matemáticas similar al que éstos utilizan en clase. Finalmente, se consideró como variable dependiente la ejecución del sujeto en los problemas artiméticos que le fueron presentados. En el experimento se utilizan cuatro tipos de problemas clasificados de tal modo en función del tipo de proceso matemático que implica hallar la solución concreta: problemas simples (resultado directo de una operación única), problemas despejados, problemas intermedios y problemas compuestos. Se consideran correctas las soluciones a los problemas cuando el planteamiento ha sido correcto, a pesar de que en las operaciones hubiera podido haber algún error. Se consideran incorrectos lo que están mal planteados. Las pruebas estadísticas utilizadas son: análisis bivariante y análisis de regresión múltiple. En el grupo total el tratamiento experimental con tal no constituye una variable significativa, resultado, que la variable que explica la mayor proporción de varianza es el nivel previo de matemáticas. Tampoco tiene una incidencia significativa la variable tipo de problema. Sin embargo, se observa que la proporción de aciertos es significativamente diferente entre ambos tratamientos (permitir o no dibujar o visualizar el problema) en los niños de nivel medio en matemáticas. Este resultado no se produce entre los niños con niveles bajo o alto en matemáticas. Las conclusiones del trabajo apoyan parcialmente las hipótesis. Es precisamente en el nivel medio en matemáticas donde con más probabilidad los fallos en la ejecución se deben, no a no haber comprendido el problema, ni a no haber aprendido las estrategias artiméticas de solución, siendo otras las causas. Por lo que su ejecución puede ser mejorada con estrategias didácticas que añadan, a la codificación lingüística, una codificación visual del problema.

Visual efficiency detection index : a new composite measure of visual search

Visual search is an important component of our interaction with our surroundings, allowing us to successfully identify external cues that impact our spatial navigation. Previous research has established fixation duration, fixation count, saccade velocity, and saccade amplitude as important indices of visual search. We examined the Visual Efficiency Detection Index (VEDI) comprising multiple aspects of visual search performance into a single measure of global visual performance. Forty participants, 10 adults ages 22-48, and children ages 6, 8, and 10, completed tests of working memory and visual search in response to stimuli relevant to pedestrian decision making. Results indicated VEDI statistically relates to established indices of visual search in relation to their interpretability for human performance. The VEDI was also sensitive to developmental differences in visual search performance, suggesting insight to its utility in the developmental psychological literature.

Reflections on the concept of the central executive

Notes that the central executive lies at the heart of A. D. Baddeley's theory of working memory, but that what it does has been characterized in several different ways. This chapter reviews and brings together various interpretations of central executive functioning. The authors describe an experiment involving a novel cognitive task to point out the restrictive nature of the term 'executive capacity.' The chapter concludes by commenting briefly on the implications of a working memory model in which the executive does not play a major part.

Flavonoids and cognitive function: a review of human randomized controlled trial studies and recommendations for future studies

Evidence in support of the neuroprotective effects of flavonoids has increased significantly in recent years, although to date much of this evidence has emerged from animal rather than human studies. Nonetheless, with a view to making recommendations for future good practice, we review 15 existing human dietary intervention studies that have examined the effects of particular types of flavonoid on cognitive performance. The studies employed a total of 55 different cognitive tests covering a broad range of cognitive domains. Most studies incorporated at least one measure of executive function/working memory, with nine reporting significant improvements in performance as a function of flavonoid supplementation compared to a control group. However, some domains were overlooked completely (e.g. implicit memory, prospective memory), and for the most part there was little consistency in terms of the particular cognitive tests used making across study comparisons difficult. Furthermore, there was some confusion concerning what aspects of cognitive function particular tests were actually measuring. Overall, while initial results are encouraging, future studies need to pay careful attention when selecting cognitive measures, especially in terms of ensuring that tasks are actually sensitive enough to detect treatment effects.

Differential cognitive effects of Ginkgo biloba after acute and chronic treatment in healthy young volunteers

Acute doses of Ginkgo biloba have been shown to improve attention and memory in young, healthy participants, but there has been a lack of investigation into possible effects on executive function. In addition, only one study has investigated the effects of chronic treatment in young volunteers. This study was conducted to compare the effects of ginkgo after acute and chronic treatment on tests of attention, memory and executive function in healthy university students. Using a placebo-controlled double-blind design, in experiment 1, 52 students were randomly allocated to receive a single dose of ginkgo (120 mg, n=26) or placebo (n=26), and were tested 4h later. In experiment 2, 40 students were randomly allocated to receive ginkgo (120 mg/day; n=20) or placebo (n=20) for a 6-week period and were tested at baseline and after 6 weeks of treatment. In both experiments, participants underwent tests of sustained attention, episodic and working memory, mental flexibility and planning, and completed mood rating scales. The acute dose of ginkgo significantly improved performance on the sustained-attention task and pattern-recognition memory task; however, there were no effects on working memory, planning, mental flexibility or mood. After 6 weeks of treatment, there were no significant effects of ginkgo on mood or any of the cognitive tests. In line with the literature, after acute administration ginkgo improved performance in tests of attention and memory. However, there were no effects after 6 weeks, suggesting that tolerance develops to the effects in young, healthy participants.

Antecedent priming at trace positions in children's sentence processing

The present study examines whether children reactivate a moved constituent at its gap position and how children's more limited working memory span affects the way they process filler-gap dependencies. 46 5-7 year-old children and 54 adult controls participated in a cross-modal picture priming experiment and underwent a standardized working memory test. The results revealed a statistically significant interaction between the participants' working memory span and antecedent reactivation: High-span children (n = 19) and high-span adults (n = 22) showed evidence of antecedent priming at the gap site, while for low-span children and adults, there was no such effect. The antecedent priming effect in the high-span participants indicates that in both children and adults, dislocated arguments access their antecedents at gap positions. The absence of an antecedent reactivation effect in the low-span participants could mean that these participants required more time to integrate the dislocated constituent and reactivated the filler later during the sentence.

From dichotic listening to the irrelevant sound effect: a behavioural and neuroimaging analysis of the processing of unattended speech

The assumption that ignoring irrelevant sound in a serial recall situation is identical to ignoring a non-target channel in dichotic listening is challenged. Dichotic listening is open to moderating effects of working memory capacity (Conway et al., 2001) whereas irrelevant sound effects (ISE) are not (Beaman, 2004). A right ear processing bias is apparent in dichotic listening, whereas the bias is to the left ear in the ISE (Hadlington et al., 2004). Positron emission tomography (PET) imaging data (Scott et al., 2004, submitted) show bilateral activation of the superior temporal gyrus (STG) in the presence of intelligible, but ignored, background speech and right hemisphere activation of the STG in the presence of unintelligible background speech. It is suggested that the right STG may be involved in the ISE and a particularly strong left ear effect might occur because of the contralateral connections in audition. It is further suggested that left STG activity is associated with dichotic listening effects and may be influenced by working memory span capacity. The relationship of this functional and neuroanatomical model to known neural correlates of working memory is considered.

Component processes of early reading, spelling, and narrative writing skills in Turkish: a longitudinal study

The study examined: (a) the role of phonological, grammatical, and rapid automatized naming (RAN) skills in reading and spelling development; and (b) the component processes of early narrative writing skills. Fifty-seven Turkish-speaking children were followed from Grade 1 to Grade 2. RAN was the most powerful longitudinal predictor of reading speed and its effect was evident even when previous reading skills were taken into account. Broadly, the phonological and grammatical skills made reliable contributions to spelling performance but their effects were completely mediated by previous spelling skills. Different aspects of the narrative writing skills were related to different processing skills. While handwriting speed predicted writing fluency, spelling accuracy predicted spelling error rate. Vocabulary and working memory were the only reliable longitudinal predictors of the quality of composition content. The overall model, however, failed to explain any reliable variance in the structural quality of the compositions

On the nature and cause of Specific Language Impairment: a view from sentence processing and infant research

This paper addresses the nature and cause of Specific Language Impairment (SLI) by reviewing recent research in sentence processing of children with SLI compared to typically developing (TD) children and research in infant speech perception. These studies have revealed that children with SLI are sensitive to syntactic, semantic, and real-world information, but do not show sensitivity to grammatical morphemes with low phonetic saliency, and they show longer reaction times than age-matched controls. TD children from the age of 4 show trace reactivation, but some children with SLI fail to show this effect, which resembles the pattern of adults and TD children with low working memory. Finally, findings from the German Language Development (GLAD) Project have revealed that a group of children at risk for SLI had a history of an auditory delay and impaired processing of prosodic information in the first months of their life, which is not detectable later in life. Although this is a single project that needs to be replicated with a larger group of children, it provides preliminary support for accounts of SLI which make an explicit link between an early deficit in the processing of phonology and later language deficits, and the Computational Complexity Hypothesis that argues that the language deficit in children with SLI lies in difficulties integrating different types of information at the interfaces.

Cognitive tests used in chronic adult human randomised controlled trial micronutrient and phytochemical intervention studies

In recent years there has been a rapid growth of interest in exploring the relationship between nutritional therapies and the maintenance of cognitive function in adulthood. Emerging evidence reveals an increasingly complex picture with respect to the benefits of various food constituents on learning, memory and psychomotor function in adults. However, to date, there has been little consensus in human studies on the range of cognitive domains to be tested or the particular tests to be employed. To illustrate the potential difficulties that this poses, we conducted a systematic review of existing human adult randomised controlled trial (RCT) studies that have investigated the effects of 24 d to 36 months of supplementation with flavonoids and micronutrients on cognitive performance. There were thirty-nine studies employing a total of 121 different cognitive tasks that met the criteria for inclusion. Results showed that less than half of these studies reported positive effects of treatment, with some important cognitive domains either under-represented or not explored at all. Although there was some evidence of sensitivity to nutritional supplementation in a number of domains (for example, executive function, spatial working memory), interpretation is currently difficult given the prevailing 'scattergun approach' for selecting cognitive tests. Specifically, the practice means that it is often difficult to distinguish between a boundary condition for a particular nutrient and a lack of task sensitivity. We argue that for significant future progress to be made, researchers need to pay much closer attention to existing human RCT and animal data, as well as to more basic issues surrounding task sensitivity, statistical power and type I error.

Potential health effects of Champagne wine consumption

Epidemiological studies have suggested an inverse correlation between red wine consumption and the incidence of cardiovascular and neurodegenerative disorders. Although white wines are generally low in polyphenol content as compared to red wines, champagne has been shown to contain relatively high amounts of phenolic acids that may exert protective cellular actions in vivo. In this study, we have investigated the potential cardioprotective and neuroprotective effects of champagne. Our data suggest that a daily moderate consumption of champagne may improve vascular performance via the delivery of phenolic constituents capable of improving NO bioavailability and the modulation of metalloproteinase. Moreover, champagne intervention significantly increased spatial working memory in aged animals, whilst no improvement was observed in the presence of alcohol. Together, these data indicate that polyphenols present in champagne may induce cardioprotective and neuroprotective effects, delaying the onset of degenerative disorders.

Research review: reading comprehension in developmental disorders of language and communication

Background: Deficits in reading airment (SLI), Down syndrome (DS) and autism spectrum disorders (ASD). Methods: In this review (based on a search of the ISI Web of Knowledge database to 2011), the Simple View of Reading is used as a framework for considering reading comprehension in these groups. Conclusions: There is substantial evidence for reading comprehension impairments in SLI and growing evidence that weaknesses in this domain are common in DS and ASD. Further, in these groups reading comprehension is typically more impaired than word recognition. However, there is also evidence that some children and adolescents with DS, ASD and a history of SLI develop reading comprehension and word recognition skills at or above the age appropriate level. This review of the literature indicates that factors including word recognition, oral language, nonverbal ability and working memory may explain reading comprehension difficulties in SLI, DS and ASD. In addition, it highlights methodological issues, implications of poor reading comprehension and fruitful areas for future research.