Theory of Mind in Huntington's Disease: A Systematic Review of 20 Years of Research.

Background: People with Huntington's disease (HD) exhibit neurocognitive alterations throughout the disease, including deficits in social cognitive processes such as Theory of Mind (ToM). Objective: The aim is to identify methodologies and ToM instruments employed in HD, alongside relevant findings, within the scientific literature of the past two decades. Methods: We conducted a comprehensive search for relevant papers in the SCOPUS, PubMed, APA-PsyArticles, Web of Science, Redalyc, and SciELO databases. In the selection process, we specifically focused on studies that included individuals with a confirmed genetic status of HD and investigated ToM functioning in patients with and without motor symptoms. The systematic review followed the PRISMA protocol. Results: A total of 27 papers were selected for this systematic review, covering the period from 2003 to 2023. The findings consistently indicate that ToM is globally affected in patients with manifest motor symptoms. In individuals without motor symptoms, impairments are focused on the affective dimensions of ToM. Conclusions: Based on our analysis, affective ToM could be considered a potential biomarker for HD. Therefore, it is recommended that ToM assessment be included as part of neuropsychological evaluation protocols in clinical settings. Suchinclusion could aid in the identification of early stages of the disease and provide new opportunities for treatment, particularly with emerging drugs like antisense oligomers. The Prospero registration number for this review is CRD42020209769.

Uncovering the Genetic and Molecular Features of Huntington's Disease in Northern Colombia.

Huntington's disease (HD) is a genetic disorder caused by a CAG trinucleotide expansion in the huntingtin (HTT) gene. Juan de Acosta, Atlántico, a city located on the Caribbean coast of Colombia, is home to the world's second-largest HD pedigree. Here, we include 291 descendants of this pedigree with at least one family member with HD. Blood samples were collected, and genomic DNA was extracted. We quantified the HTT CAG expansion using an amplicon sequencing protocol. The genetic heterogeneity was measured as the ratio of the mosaicism allele's read peak and the slippage ratio of the allele's read peak from our sequence data. The statistical and bioinformatic analyses were performed with a significance threshold of p < 0.05. We found that the average HTT CAG repeat length in all participants was 21.91 (SD = 8.92). Of the 291 participants, 33 (11.3%, 18 females) had a positive molecular diagnosis for HD. Most affected individuals were adults, and the most common primary and secondary alleles were 17/7 (CAG/CCG) and 17/10 (CAG/CCG), respectively. The mosaicism increased with age in the participants with HD, while the slippage analyses revealed differences by the HD allele type only for the secondary allele. The slippage tended to increase with the HTT CAG repeat length in the participants with HD, but the increase was not statistically significant. This study analyzed the genetic and molecular features of 291 participants, including 33 with HD. We found that the mosaicism increased with age in the participants with HD, particularly for the secondary allele. The most common haplotype was 17/7_17/10. The slippage for the secondary allele varied by the HD allele type, but there was no significant difference in the slippage by sex. Our findings offer valuable insights into HD and could have implications for future research and clinical management.

Impulsive and Omission Errors: Potential Temporal Processing Endophenotypes in ADHD.

Temporal processing (TP) is associated with functions such as perception, verbal skills, temporal perspective, and future planning, and is intercorrelated with working memory, attention, and inhibitory control, which are highly impaired in individuals with attention deficit hyperactivity disorder (ADHD). Here we evaluate TP measures as potential endophenotypes in Caribbean families ascertained from probands affected by ADHD. A total of 232 individuals were recruited and clinically evaluated using an extensive battery of neuropsychological tasks and reaction time (RT)-based task paradigms. Further, the heritability (genetic variance underpinning phenotype) was estimated as a measure of the genetics apportionment. A predictive framework for ADHD diagnosis was derived using these tasks. We found that individuals with ADHD differed from controls in neuropsychological tasks assessing mental control, visual-verbal memory, verbal fluency, verbal, and semantic fluency. In addition, TP measures such as RT, errors, and variability were also affected in individuals with ADHD. Moreover, we determined that only omission and commission errors had significant heritability. In conclusion, we have disentangled omission and commission errors as possible TP endophenotypes in ADHD, which can be suitable to assess the neurobiological and genetic basis of ADHD. A predictive model using these endophenotypes led to remarkable sensitivity, specificity, precision and classification rate for ADHD diagnosis, and may be a useful tool for patients' diagnosis, follow-up, and longitudinal assessment in the clinical setting.

ADGRL3, FGF1 and DRD4: Linkage and Association with Working Memory and Perceptual Organization Candidate Endophenotypes in ADHD.

Attention deficit hyperactivity disorder (ADHD) is a highly heritable neurobehavioral disorder that affects children worldwide, with detrimental long-term consequences in affected individuals. ADHD-affected patients display visual-motor and visuospatial abilities and skills that depart from those exhibited by non-affected individuals and struggle with perceptual organization, which might partially explain impulsive responses. Endophenotypes (quantifiable or dimensional constructs that are closely related to the root cause of the disease) might provide a more powerful and objective framework for dissecting the underlying neurobiology of ADHD than that of categories offered by the syndromic classification. In here, we explore the potential presence of the linkage and association of single-nucleotide polymorphisms (SNPs), harbored in genes implicated in the etiology of ADHD (ADGRL3, DRD4, and FGF1), with cognitive endophenotypes related to working memory and perceptual organization in 113 nuclear families. These families were ascertained from a geographical area of the Caribbean coast, in the north of Colombia, where the community is characterized by its ethnic diversity and differential gene pool. We found a significant association and linkage of markers ADGRL3-rs1565902, DRD4-rs916457 and FGF1-rs2282794 to neuropsychological tasks outlining working memory and perceptual organization such as performance in the digits forward and backward, arithmetic, similarities, the completion of figures and the assembly of objects. Our results provide strong support to understand ADHD as a combination of working memory and perceptual organization deficits and highlight the importance of the genetic background shaping the neurobiology, clinical complexity, and physiopathology of ADHD. Further, this study supplements new information regarding an ethnically diverse community with a vast African American contribution, where ADHD studies are scarce.

Genetic Variation Underpinning ADHD Risk in a Caribbean Community.

Attention Deficit Hyperactivity Disorder (ADHD) is a highly heritable and prevalent neurodevelopmental disorder that frequently persists into adulthood. Strong evidence from genetic studies indicates that single nucleotide polymorphisms (SNPs) harboured in the ADGRL3 (LPHN3), SNAP25, FGF1, DRD4, and SLC6A2 genes are associated with ADHD. We genotyped 26 SNPs harboured in genes previously reported to be associated with ADHD and evaluated their potential association in 386 individuals belonging to 113 nuclear families from a Caribbean community in Barranquilla, Colombia, using family-based association tests. SNPs rs362990-SNAP25 (T allele; p = 2.46 × 10-4), rs2282794-FGF1 (A allele; p = 1.33 × 10-2), rs2122642-ADGRL3 (C allele, p = 3.5 × 10-2), and ADGRL3 haplotype CCC (markers rs1565902-rs10001410-rs2122642, OR = 1.74, Ppermuted = 0.021) were significantly associated with ADHD. Our results confirm the susceptibility to ADHD conferred by SNAP25, FGF1, and ADGRL3 variants in a community with a significant African American component, and provide evidence supporting the existence of specific patterns of genetic stratification underpinning the susceptibility to ADHD. Knowledge of population genetics is crucial to define risk and predict susceptibility to disease.

ADGRL3 (LPHN3) variants predict substance use disorder.

Genetic factors are strongly implicated in the susceptibility to develop externalizing syndromes such as attention-deficit/hyperactivity disorder (ADHD), oppositional defiant disorder, conduct disorder, and substance use disorder (SUD). Variants in the ADGRL3 (LPHN3) gene predispose to ADHD and predict ADHD severity, disruptive behaviors comorbidity, long-term outcome, and response to treatment. In this study, we investigated whether variants within ADGRL3 are associated with SUD, a disorder that is frequently co-morbid with ADHD. Using family-based, case-control, and longitudinal samples from disparate regions of the world (n = 2698), recruited either for clinical, genetic epidemiological or pharmacogenomic studies of ADHD, we assembled recursive-partitioning frameworks (classification tree analyses) with clinical, demographic, and ADGRL3 genetic information to predict SUD susceptibility. Our results indicate that SUD can be efficiently and robustly predicted in ADHD participants. The genetic models used remained highly efficient in predicting SUD in a large sample of individuals with severe SUD from a psychiatric institution that were not ascertained on the basis of ADHD diagnosis, thus identifying ADGRL3 as a risk gene for SUD. Recursive-partitioning analyses revealed that rs4860437 was the predominant predictive variant. This new methodological approach offers novel insights into higher order predictive interactions and offers a unique opportunity for translational application in the clinical assessment of patients at high risk for SUD.

Atypical Modulations of N170 Component during Emotional Processing and Their Links to Social Behaviors in Ex-combatants.

Emotional processing (EP) is crucial for the elaboration and implementation of adaptive social strategies. EP is also necessary for the expression of social cognition and behavior (SCB) patterns. It is well-known that war contexts induce socio-emotional atypical functioning, in particular for those who participate in combats. Thus, ex-combatants represent an ideal non-clinical population to explore EP modulation and to evaluate its relation with SCB. The aim of this study was to explore EP and its relation with SCB dimensions such as empathy, theory of mind and social skills in a sample of 50 subjects, of which 30 were ex-combatants from illegally armed groups in Colombia, and 20 controls without combat experience. We adapted an Emotional Recognition Task for faces and words and synchronized it with electroencephalographic recording. Ex-combatants presented with higher assertion skills and showed more pronounced brain responses to faces than Controls. They did not show the bias toward anger observed in control participants whereby the latter group was more likely to misclassify neutral faces as angry. However, ex-combatants showed an atypical word valence processing. That is, words with different emotions yielded no differences in N170 modulations. SCB variables were successfully predicted by neurocognitive variables. Our results suggest that in ex-combatants the links between EP and SCB functions are reorganized. This may reflect neurocognitive modulations associated to chronic exposure to war experiences.

Social Cognitive Training Improves Emotional Processing and Reduces Aggressive Attitudes in Ex-combatants.

Emotional processing (EP) is a complex cognitive function necessary to successfully adjust to social environments where we need to interpret and respond to cues that convey threat or reward signals. Ex-combatants have consistently shown atypical EP as well as poor social interactions. Available reintegration programs aim to facilitate the re-adaptation of ex-combatants to their communities. However, they do not incorporate actions to improve EP and to enhance cognitive-emotional regulation. The present study was aimed at evaluating the usefulness of an intervention focused on Social Cognitive Training (SCT), which was designed to equip ex-combatants enrolled in the Social Reintegration Route with EP and social cognition skills. A group of 31 ex-combatants (mean age of 37.2, 29 men) from Colombian illegal armed groups were recruited into this study. Of these, 16 were invited to take part in a SCT and the other continued with the conventional reintegration intervention. Both groups underwent 12 training sessions in a period 12-14 weeks. They were assessed with a comprehensive protocol which included Psychosocial, Behavioral, and Emotion Processing instruments. The scores on these instruments prior to and after the intervention were compared within and between groups. Both groups were matched at baseline. Ex-combatants receiving the SCT experienced significant improvements in EP and a reduction in aggressive attitudes, effects not observed in those continuing the conventional reintegration intervention. This is the first study that achieves such outcomes in such a population using SCT intervention. We discuss the implications of such results toward better social reintegration strategies.

Trombólisis con activador recombinante del plasminógeno tisular (rt-PA) para el ataque cerebro vascular agudo: la experiencia colombiana / Thrombolysis with rt-PA for acute stroke: Colombian experience

RESUMEN El tratamiento con activador recombinante del plasminógeno tisular (sigla en inglés rt-PA), aplicado por vía intravenosa (VIV) es el procedimiento de primera línea en casos de ataque cerebrovascular agudo (ACVA) en una ventana de 4,5 horas. En Colombia hay una experiencia publicada del uso exitoso de este medicamento. En el número actual se publica una nueva experiencia del uso de rt-PA en el caribe colombiano, de gran utilidad para reseñar los artículos publicados en Colombia acerca del tema.

ABSTRACT Treatment with intravenous recombinant tissue plasminogen activator (rt-PA) for acute stroke (AS) is the first line procedure for patients in 4,5 hours window. In Colombia there is a published experience about the successful use of this medication. In the currently issue a new experience from Colombian Caribbean is presented, which it is taken in advantage for briefly reviewing the published papers about the theme in our country.

Prepotent response inhibition and reaction times in children with attention deficit/hyperactivity disorder from a Caribbean community.

Impairment in inhibitory control has been postulated as an underlying hallmark of attention deficit/hyperactivity disorder (ADHD), which can be utilized as a quantitative trait for genetic studies. Here, we evaluate whether inhibitory control, measured by simple automatized prepotent response (PR) inhibition variables, is a robust discriminant function for the diagnosis of ADHD in children and can be used as an endophenotype for future genetic studies. One hundred fifty-two school children (30.9% female, 67.8% with ADHD) were recruited. The ADHD checklist was used as the screening tool, whilst the DSM-IV Mini International Neuropsychiatry Interview, neurologic interview and neurologic examination, and the WISC III FSIQ test were administered as the gold standard procedure to assert ADHD diagnosis. A Go/No-Go task using a naturalistic and automatized visual signal was administered. A linear multifactor model (MANOVA) was fitted to compare groups including ADHD status, age, and gender as multiple independent factors. Linear discriminant analysis and the receiver operating characteristic curve were used to assess the predictive performance of PR inhibition variables for ADHD diagnosis. We found that four variables of prepotent response reaction time- and prepotent response inhibition established statistically significant differences between children with and without ADHD. Furthermore, these variables generated a strong discriminant function with a total classification capability of 73, 84% specificity, 68% sensitivity, and 90% positive predictive value for ADHD diagnosis, which support reaction times as a candidate endophenotype that could potentially be used in future ADHD genetic research.

Evaluating empathy in Colombian ex-combatants: Examination of the internal structure of the Interpersonal Reactivity Index (IRI) in Spanish.

The Republic of Colombia has a long-standing history of internal armed conflict, further complicated by the ideological assumptions underlying their war. In recent years, its government designed the Program for Reincorporation to Civilian Life (Programa para la Reincorporación a la Vida Civil, PRVC), aiming demobilization of thousands of insurgents who were involved in guerilla and paramilitary forces. One PRVC goal involves the psychological characterization of its reincorporated members, aiming the informed design of effective and efficacious interventions to improve their adjustment. We are interested in the examination of empathy in this population. Empathy refers to the ability to predict, understand, and experience other's feelings. Empathy appears to have an effect on level of aggressive behavior. The Interpersonal Reactivity Index (IRI; Davis, 1980, 1983) is a well-established 28-item self-report tool for the assessment of empathy, including 4 scales: Perspective Taking, Fantasy, Empathic Concern, and Personal Distress. Versions in Spanish were validated in Spain and Chile, but no norms for Colombians exist. We examined the factorial structure of the IRI in a sample of 548 (83.4% males) members of the PRVC. Ten items with low factor loadings were eliminated following a series of confirmatory factor analyses (CFA). The final 4-factor model (Model 2) reached an acceptable fit (e.g., CFI = .898). A second-order CFA demonstrated that empathic concern correlated too high with a common "empathy" latent factor. With these results at hand, our 18-item IRI version in Spanish achieved a factorial structure comparable to that previously validated for Spanish speakers from other countries. (PsycINFO Database Record

Conglomerados de clases latentes en 408 miembros de 120 familias nucleares de Barranquilla con un caso índice afectado de trastorno de atención hiperactividad (TDAH) / Latent class clusters in 408 members of 120 nuclear families from Barranquilla with a proband attention deficit hyperactivity disorder (adhd) affected case

Resumen Introducción: el análisis de conglomerados de clases latentes (ACCL) es un procedimiento estadístico para agrupamientos, dependiendo de la respuesta a cada ítem. Se ha usado con el trastorno de atención hiperactividad (TDAH), para derivar tipos sutiles de casos en estudios genéticos. Objetivo: analizar los CCL de 408 miembros de 120 familias con un caso índice de TDAH, en relación con los síntomas registrados en la entrevista psiquiátrica. Pacientes y métodos: a partir de un caso índice (niño escolarizado de Barranquilla con diagnóstico estándar de oro de TDAH) se construyeron familias nucleares, las cuales de evaluaron para el diagnóstico de TDAH y comorbilidades. La muestra fue de 408 miembros de 120 familias, edad 26,6 ± 15,4 años. Con el programa para computador Latent-Gold 4,0 se hizo el ACCL con la respuesta nominal para cada síntoma de TDAH, y la presencia o no de comorbilidades con TOD y TDC. Se usó el sexo y la edad como covariables categóricas. Se hizo un análisis cruzado de cada conglomerado con el diagnóstico estándar de oro. Resultados: el mejor modelo (índices de verosimilitud) fue de 6 CCL (p Bootstrap = 0,08). El conglomerado 1 (32,5 %) son adultos, predominio de sexo femenino, probabilidad < 20 % de síntomas y comorbilidades. El segundo (17,4 %) son adultos y niños de sexo masculino con 40 a 80 % de síntomas de TDAH combinado. El grupo tres (15,7 %) son niños con ~100 % síntomas de TDAH combinado, TOD y TDC. El cuarto conglomerado (14,3 %) son adultos de ambos sexos con 20 a 50 % probabilidades de hiperactividad-impulsividad, TOD (70 %) y TDC (40 %). El grupo 5 (10,6 %) en un 80 % adultos con 30 a 90 % probabilidades de inatención sin comorbilidades. El conglomerado 6 (9,5 %) con altas probabilidades de síntomas de inatención. Conclusiones: se derivaron 6 CCL. Cuatro conglomerados son de afectados, 1 de no afectados y 1 con similar proporción de afectados y no afectados, los cuales podrían ser usados en análisis con marcadores genéticos de susceptibilidad para TDAH.

Summary Introduction: Latent class cluster analysis (LCCA) is a statistical procedure to sort a sample, according to item response of each member of a sample. It has been used with ADHD in order to derive mild cases for genetic studies. Objective: To analyze LCC from 408 members of 120 nuclear families with a ADHD proband, related to registered symptoms obtained with a structured psychiatric interview. Patient and methods: From a proband (school -gold standard- ADHD affected child from Barranquilla) nuclear families were recruited, which were assess for ADHD and comorbidities diagnoses. Sample was 408 members of 120 nuclear families, mean age 26,6 ± 15,4 years old. Using Latent Gold 4,0 software, an ACCL with each ADHD categorical symptoms, and comorbidities with ODD and CD was run. Gender and age were used as categorical active covariables. A cross tabulation analysis between LCC and ADHD gold standard diagnosis was done. Results: The best model (maximum likelihood index) was a 6 LCC (p Bootstrap = 0,08). Cluster 1 (32,5%) were predominantly female adults with low (< 20%) probability of ADHD symptoms. Cluster 2 (17,4%) were adults and children with 40 to 80% probabilities of combined ADHD symptoms. Cluster 3 (15,7%) were children with ~100% of ADHD combined symptoms with ODD and CD comorbidities. Cluster 4 (14,3%) were adults of both genders with 20 to 50% probabilities of hyperactivity - impulsivity and ODD (70%) and CD (40%). Cluster 5 (10,6%) were 80% adults with 30 to 90% probabilities of inattentive symptoms without comorbidities. Cluster 6 (9,5%) had high probabilities of inattentive symptoms. Conclusions: A 6 LCC model was obtained. Four LCC were ADHD affected, one was unaffected and one with similar proportion of affected and unaffected members, which would are able to be used for genetic analyses with ADHD susceptibility gene markers.

Cross-cultural validation of a behavioral screener for executive functions: Guidelines for clinical use among Colombian children with and without ADHD.

Garcia-Barrera, Kamphaus, and Bandalos (2011) derived a 25-item executive functioning screener from the Behavior Assessment System for Children (BASC), measuring 4 latent executive constructs: problem solving, attentional control, behavioral control, and emotional control. The current study included a cross-cultural examination of this screener in Colombian children with and without attention-deficit/hyperactivity disorder (ADHD). BASC teacher ratings were collected for Colombian children ages 6-11 years (848 healthy children [53% boys] and 155 children with ADHD [76% boys]). To examine the psychometric properties of the screener, a multistep procedure was implemented, including (a) confirmatory factor analysis (CFA) and factorial invariance testing across gender, age group (6-8 years, 9-11 years), and ADHD status to replicate and extend the original derivation; (b) item response theory (IRT) analysis to evaluate the information provided by individual items; and (c) given IRT results, a repeated CFA and invariance testing after the exclusion of 1 item from the problem-solving factor. The 24-item 4-factor model fit was adequate for controls and for ADHD participants. Results support the use of the 24-item executive functioning screener in a cross-cultural context. In turn, in supplemental material, normative data for the Colombian sample are reported along with bilingual guidelines (i.e., Spanish/English) for implementing the screener in clinical practice. Even though the screener is useful when examining executive functions, it was not designed as a diagnostic measure for developmental disorders such as ADHD; as such, it should only inform about status of executive functioning.

Dimensiones de la empatía en excombatientes del conflicto armado Colombiano utilizando una escala estandarizada / Dimensions of empathy in ex-combatants of the Colombian armed conflict using a standardized scale

Introducción: La empatía es uno de los constructos de la llamadas neurociencias sociales. Se define como una disposición de dimensiones múltiples que permite colocarse en el estado emocional del otro. Colombia presenta un conflicto interno irregular prolongado, que ha venido deteriorándose en crueldad. Objetivos: Evaluar las dimensiones de la empatía de 285 excombatientes del conflicto armado colombiano, usando el Índice de Reactividad Interpersonal (IRI) en español. Métodos y sujetos: Se seleccionó una muestra de 285 excombatientes, 241 (84,6 %) hombres: 85,3 % paramilitares y 14,7 % guerrilleros. Se les aplicó el IRI de 28 ítems. Se realizaron 3 análisis de factores exploratorios (AFE) y análisis factoriales confirmatorios (AFC), utilizando ecuaciones estructurales. Resultados: Un primer AFE obtuvo 9 factores (KMO = 0,74 y 54,7 % de varianza, consistencia interna [CI]: 0,22-0,63). Un segundo AFE con 20 ítems con cargas superiores a 0,4 mostró una estructura de 6 factores (KMO = 0,70, 50,3 % de varianza; CI: 0,37-0,63). Un tercer AFE forzó las 4 dimensiones originales (KMO = 0,74, varianza 33,77 % y CI: 0,44-0,77). El AFC mostró índices de bondad de ajuste adecuados para los 3 modelos. El de 4 factores obtuvo los más bajos, y el de 6 factores, los más altos. El modelo de 4 factores obtuvo la mejor CI. Conclusión: El IRI en español en excombatientes del conflicto Colombiano tiene estructuras posibles de 4, 6 y 9 factores. El mejor ajuste es la de 6 factores. La de 4 factores tuvo mejor CI.

Introduction: Empathy is one of the main concepts of in social neurosciences. It is defined as a trait with multiple dimensions allowing individuals to place themselves in the emotional states of others. Colombia has an irregular, internal and long-lasting armed conflict which has been increasing its cruelty levels. Objectives: to assess the empathy dimensions of 285 ex-combatants from the internal Colombian conflict, using the Interpersonal Reactivity Index(IRI) in Spanish. Methodology and Subjects: a sample of 285 male ex-combatants, 241 (84, 6%) males: 85,3% paramilitaries, and 14,7% guerillas. The 28 Item IRI questionnaires were administered. 3 exploratory factor analyses (EFA) were performed. Confirmatory factor analyses (CFA) were developed using structural equation procedures. Results: The first EFA obtained 9 factors (KMO=0,74, variance 54,7% and internal consistency (IC): 0,22 - 0,63). The second EFA produced 20 items with burdens above 0,4 and showed a 6-factor structure (KMO=0,70, variance 50,3%, IC: 0,37 - 0,63). The third EFA forced the 4 original IRI dimensions (KMO=0,74, variance 33,77, IC: 0,44 - 0,77. CFAs showed goodness of adjustment indexes adequate for the three models. The 4-factor model obtained the lowest value, while the 6-factor model obtained the highest. The 4- factor model showed the best IC. Conclusion: The Spanish IRI administered to ex-combatants of the Colombian conflict has possible structures of 4, 6 and 9 factors. The best adjustment was for the 6-fctor. The 4-factor model exhibited the best IC.

[Dimensions of Empathy in Ex-Combatants of the Colombian Armed Conflict Using a Standardized Scale]. / Dimensiones de la empatía en excombatientes del conflicto armado colombiano utilizando una escala estandarizada.

INTRODUCTION: Empathy is one of the main concepts of in social neurosciences. It is defined as a trait with multiple dimensions allowing individuals to place themselves in the emotional states of others. Colombia has an irregular, internal and long-lasting armed conflict which has been increasing its cruelty levels. OBJECTIVES: to assess the empathy dimensions of 285 ex-combatants from the internal Colombian conflict, using the Interpersonal Reactivity Index(IRI) in Spanish. METHODOLOGY AND SUBJECTS: a sample of 285 male ex-combatants, 241 (84, 6%) males: 85,3% paramilitaries, and 14,7% guerillas. The 28 Item IRI questionnaires were administered. 3 exploratory factor analyses (EFA) were performed. Confirmatory factor analyses (CFA) were developed using structural equation procedures. RESULTS: The first EFA obtained 9 factors (KMO=0,74, variance 54,7% and internal consistency (IC): 0,22 - 0,63). The second EFA produced 20 items with burdens above 0,4 and showed a 6-factor structure (KMO=0,70, variance 50,3%, IC: 0,37 - 0,63). The third EFA forced the 4 original IRI dimensions (KMO=0,74, variance 33,77, IC: 0,44 - 0,77. CFAs showed goodness of adjustment indexes adequate for the three models. The 4-factor model obtained the lowest value, while the 6-factor model obtained the highest. The 4- factor model showed the best IC. CONCLUSION: The Spanish IRI administered to ex-combatants of the Colombian conflict has possible structures of 4, 6 and 9 factors. The best adjustment was for the 6-fctor. The 4-factor model exhibited the best IC.

Analysis of brain metabolism by proton magnetic resonance spectroscopy (1H-MRS) in attention-deficit/hyperactivity disorder suggests a generalized differential ontogenic pattern from controls.

Attention-deficit/hyperactivity disorder (ADHD) is the most common behavioral disorder of childhood. Preliminary studies with proton magnetic resonance spectroscopy ((1)H-MRS) of the brain have reported differences in brain metabolite concentration-to-Cr ratios between individuals with ADHD and unaffected controls in several frontal brain regions including anterior cingulate cortex. Using multivoxel (1)H-MRS, we compared 14 individuals affected with ADHD to 20 individuals without ADHD from the same genetic isolate. After controlling by sex, age, and multiple testing, we found significant differences at the right posterior cingulate of the Glx/Cr ratio density distribution function between ADHD cases and controls (P < 0.05). Furthermore, we found several interactions of metabolite concentration-to-Cr ratio, age, and ADHD status: Ins/Cr and Glx/Cr ratios at the left posterior cingulate, and NAA/Cr at the splenius, right posterior cingulate, and at the left posterior cingulate. We also found a differential metabolite ratio interaction between ADHD cases and controls for Ins/Cr and NAA/Cr at the right striatum. These results show that: (1) NAA/Cr, Glx/Cr, and Ins/Cr ratios, as reported in other studies, exhibit significant differences between ADHD cases and controls; (2) differences of these metabolite ratios between ADHD cases and controls evolve in specific and recognizable patterns throughout age, a finding that replicates previous results obtained by structural MRI, where is demonstrated that brain ontogeny follows a different program in ADHD cases and controls; (3) Ins/Cr and NAA/Cr ratios, at the right striatum, interact in a differential way between ADHD cases and controls. As a whole, these results replicate previous 1H-MRS findings and add new intriguing differential metabolic and ontogeny patterns between ADHD cases and controls that warrant further pursue.

[Diagnostic validity of attention deficit/hyperactivity disorder: from phenomenology to neurobiology (II)]. / Validez del diagnostico de trastorno por deficit de atencion/hiperactividad: de lo fenomenologico a lo neurobiologico (II).

The diagnostic criteria for the attention deficit/hyperactivity disorder (ADHD) were defined by the American Psychiatric Association in the Diagnostic and Statistical Manual of Mental Disorders, fourth version. ADHD is a neuro-psychiatric disorder associated with impairments in everyday life and behavioral dysregulation (i.e. inattention, hyper-activity and impulsivity), and it has showed empirical evidence from clinical, pharmacological, and psychometric studies. Nevertheless, the role of neurobiological impairments in the presentation of the symptoms remains unclear. For this paper, the authors reviewed Spanish and English literature that support the neurobiological validity of the disorder, aimed to present evidence associated with its cognitive and behavioral phenotype (e.g. in: neuropsychology, electrophysiology, structural and functional magnetic resonance imaging, neurochemistry and genetics). Additionally, an integrative theoretical clinical and scientific proposal is presented. Finally, the introduction of neurobiological marker as part of the definitive diagnosis is suggested, as a started point for the identification of therapeutic targets.

Potential cognitive endophenotypes in multigenerational families: segregating ADHD from a genetic isolate.

Endophenotypes are neurobiological markers cosegregating and associated with illness. These biomarkers represent a promising strategy to dissect ADHD biological causes. This study was aimed at contrasting the genetics of neuropsychological tasks for intelligence, attention, memory, visual-motor skills, and executive function in children from multigenerational and extended pedigrees that cluster ADHD in a genetic isolate. In a sample of 288 children and adolescents, 194 (67.4%) ADHD affected and 94 (32.6%) unaffected, a battery of neuropsychological tests was utilized to assess the association between genetic transmission and the ADHD phenotype. We found significant differences between affected and unaffected children in the WISC block design, PIQ and FSIQ, continuous vigilance, and visual-motor skills, and these variables exhibited a significant heritability. Given the association between these neuropsychological variables and ADHD, and also the high genetic component underlying their transmission in the studied pedigrees, we suggest that these variables be considered as potential cognitive endophenotypes suitable as quantitative trait loci (QTLs) in future studies of linkage and association.

Alteraciones de la atención y de la función ejecutiva en niños y adolescentes con trastorno afectivo bipolar / Impaired attention and executive function in children and adolescents with bipolar disorder

IntroduccIón. La definición precisa de las características neuropsicológicas del trastorno afectivo bipolar (TAB)en niños tropieza con los problemas de la validez del diagnóstico y la confusión con el trastorno de atención/ hiperactividad (TDAH). objetIvo. Determinar las características neuropsicológicas de niños y adolescentes de 6 y 16 años de edad con TAB tipo I (sin comorbilidad con TDAH), al compararse con un grupo control sin TAB y sin TDAH, emparejado por edad, sexo y escolaridad de la ciudad de Medellín-Colombia. MaterIales y Métodos. Para un estudio de diseño transversal se seleccionaron 41 niños y adolescentes, asignados a dos grupos: uno con diagnóstico de TAB (n = 20; edad 11 ± 2,7), y otro de controles sin TAB (n = 21, edad años 11.4 ± 2.53). 15 de los participantes de cada grupo eran de sexo masculino. Se aplicaron pruebas neuropsicológicas para la evaluación de la atención, la memoria y la función ejecutiva (FE). Se hicieron comparaciones no paramétricas entre los grupos. resultados. El grupo TAB mostró una ejecución significativamente más pobre (p< 0.001) en pruebas relacionadas con atención y funcionamiento ejecutivo. El tamaño del efecto de las variables con diferencias significativas fue de grande a completo (> 0,7). conclusIón. Los hallazgos sugieren que los niños y adolescentes con TAB (sin comorbilidad con TDAH) presentan alguna forma de deficiencia en el funcionamiento de circuitos prefrontales, relacionados con el control inhibitorio y la organización cognitiva.

Introduction. Accurate description of neuropsychological characteristics of children with affective bipolar disorder(BPD) ha been difficult because the diagnostic validity and the confusion with attention deficit/ hyperactive disorder (ADHD), has limited the accurate description of its neuropsychological characteristics. Objective. To determine the neuropsychological characteristics of children and adolescents, aged 6 to 16 years, with BPD type I (without ADHD comorbidity), compared with a control group without BPD neither ADHD, which were matched by sex and age, from Medellín-Colombia. Materials and methods. A cross-sectional study was designed, selected 41 children and adolescents, which were assignedto two groups: BPDs (n = 20; age: 11 ± 2,7), and controls (n = 21, age 11.4 ± 2.53). 15 participants were males, ineach group. Neuropsychological tasks to assess attention, memory and executive function (EF) were administered. Nonparametric comparisons between groups were done. Results. BPD group showed statistically significant poorer performances (p< 0,001) in tasks related with attention a EF. Effect sizes of the variables with statistic significant differences were larger to huge (> 0,7).Conclusions. Findings suggest that children and adolescents with BPD (without ADHD comorbidity) have some kind deficiency in prefrontal circuitries functioning, related to inhibitory control and cognitive organization.