RESUMO
AIM: To identify subtypes of developmental coordination disorder (DCD) in children. METHOD: Children with DCD diagnosed through comprehensive evaluation at Robert-Debré Children's University Hospital (Paris, France) were consecutively enrolled from February 2017 to March 2020. We performed an unsupervised hierarchical clustering based on principal component analysis using a large set of variables encompassing cognitive, motor, and visuospatial scores (Wechsler Intelligence Scale for Children, Fifth Edition; Developmental Neuropsychological Assessment, Second Edition; Movement Assessment Battery for Children, Second Edition). RESULTS: One hundred and sixty-four children with DCD were enrolled (median age 10 years 3 months; male:female ratio 5.56:1). We identified distinct subgroups with mixed visuospatial and gestural disorders, or with pure gestural disorders that predominantly impaired either speed or precision. Associated neurodevelopmental disorders, such as attention-deficit/hyperactivity disorder, did not influence the results of the clustering. Importantly, we identified a subgroup of children with marked visuospatial impairment with the lowest scores in almost all of the evaluated domains, and the poorest school performance. INTERPRETATION: The classification of DCD into distinct subgroups could be indicative of prognosis and provide critical information to guide patient management, taking into account the child's neuropsychological profile. Beyond this clinical interest, our findings also provide a relevant framework with homogeneous subgroups of patients for research on the pathogenesis of DCD. WHAT THIS PAPER ADDS: Unsupervised hierarchical clustering identified four subgroups of children with developmental coordination disorder. Two subgroups had combined visuospatial/gestural difficulties, and two had pure gestural disorders. Severe visuospatial impairment was associated with poor performance in most domains including school. Difficulties in the gestural-only clusters were predominantly either gestural precision or speed.
Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Transtornos das Habilidades Motoras , Humanos , Masculino , Criança , Feminino , Transtornos das Habilidades Motoras/diagnóstico , Transtornos das Habilidades Motoras/epidemiologia , Transtornos das Habilidades Motoras/complicações , Transtorno do Deficit de Atenção com Hiperatividade/complicações , Movimento , Análise por Conglomerados , FrançaRESUMO
INTRODUCTION: Many studies have shown that recollection process is impaired in patients with schizophrenia, whereas familiarity is generally spared. However, in these studies, the Receiver Operating Characteristic (ROC) presented is average ROC likely to mask individual differences. METHODS: In the present study using a face-recognition task, we computed the individual ROC of patients with schizophrenia and control participants. Each group was divided into two subgroups on the basis of the type of recognition processes implemented: recognition based on familiarity only and recognition based on familiarity and recollection. RESULTS: The recognition performance of the schizophrenia patients was below that of the control participants only when recognition was based solely on familiarity. For the familiarity-alone patients, the score obtained on the Scale for the Assessment of Positive Symptoms (SAPS) was correlated with the variance of the old-face familiarity. For the familiarity-recollection patients, the score obtained on the Scale for the Assessment of Negative Symptoms (SANS) was correlated with the decision criterion and with the old-face recollection probability. CONCLUSIONS: These results show that one cannot ascribe the impaired recognition observed in patients with schizophrenia to a recollection deficit alone. These results show that individual ROC can be used to distinguish between subtypes of schizophrenia and could serve as a basis for setting up specific cognitive remediation therapy for individuals with schizophrenia.
Assuntos
Face , Transtornos da Memória/diagnóstico , Transtornos da Memória/psicologia , Rememoração Mental , Reconhecimento Psicológico , Psicologia do Esquizofrênico , Adulto , Feminino , França , Humanos , Inteligência , Masculino , Pessoa de Meia-Idade , Curva ROC , EsquizofreniaRESUMO
Whether unconscious stimuli can modulate the preparation of a cognitive task is still controversial. Using a backward masking paradigm, we investigated whether the modulation could be observed even if the prime was made unconscious in 100% of the trials. In two behavioral experiments, subjects were instructed to initiate a phonological or semantic task on an upcoming word, following an explicit instruction and an unconscious prime. When the SOA between prime and instruction was sufficiently long (84 ms), primes congruent with the task set instruction led to speedier responses than incongruent primes. In the other condition (36 ms), no task set priming was observed. Repetition priming had the opposite tendency, suggesting the observed task set facilitation cannot be ascribed solely to perceptual repetition priming. Our results therefore confirm that unconscious information can modulate cognitive control for currently active task sets, providing sufficient time is available before the conscious decision.
Assuntos
Desempenho Psicomotor/fisiologia , Priming de Repetição/fisiologia , Estimulação Subliminar , Inconsciente Psicológico , Adulto , Atenção/fisiologia , Feminino , Humanos , Linguística , Masculino , Tempo de Reação/fisiologia , Semântica , Adulto JovemRESUMO
Patients with schizophrenia have pronounced deficits in face recognition memory that severely hamper their social skills. The functional mechanisms of these impairments remain unknown. According to the dual-process theory, recognition memory comprises two distinct components: recollection and familiarity. Studies using the Remember/Know procedure in patients with schizophrenia showed impairments in conscious recollection as measured by remember responses, but not in familiarity as measured by know responses. Unfortunately, none of these studies used face material. We investigated both recognition memory components using words and faces and the 'Remember/Know' procedure in 25 patients with schizophrenia and 24 control participants. In the same task, size congruency of stimuli was manipulated between the study and test phases to have a selective impact on know responses for faces. Patients reported fewer remember responses than controls. Size changes between the study and the test affected know responses in controls but not in patients. These results reveal that patients with schizophrenia are impaired in terms of their ability to recollect details about previously seen faces as they are for words.
Assuntos
Transtornos Cognitivos/etiologia , Estado de Consciência/fisiologia , Face , Transtornos da Memória/etiologia , Esquizofrenia/complicações , Vocabulário , Adulto , Análise de Variância , Transtornos Cognitivos/diagnóstico , Feminino , Humanos , Masculino , Transtornos da Memória/diagnóstico , Pessoa de Meia-Idade , Reconhecimento Visual de Modelos/fisiologia , Estimulação Luminosa/métodosRESUMO
Developmental coordination disorder. The diagnosis of dyspraxia or developmental coordination disorder is based on motor coordination skills significantly below the expected level for the age of the child, assessed by a validated and standardized motor skills scale. This deficit must have an impact on activities of daily life, leisure and academic achievement. It should not be secondary to a neurological condition. It is a common disorder with a prevalence around 5%. The diagnosis is based on questioning of the family and the child, a clinical examination and an evaluation with standardized tools of motor skills and writing. It requires the intervention of a doctor, if possible trained in neurodevelopmental disorders, and of an occupational therapist. Interventions should focus on activities that are essential to the child's daily and school life.
Trouble développemental de la coordination. Le diagnostic de dyspraxie ou trouble développemental de la coordination repose sur des compétences de coordination motrice nettement inférieures au niveau escompté pour l'âge de l'enfant, évaluées par une échelle de motricité validée et standardisée. Ce déficit doit avoir un impact sur les activités de la vie quotidienne, les loisirs et la vie scolaire. Il ne doit pas être secondaire à une affection neurologique motrice. Il s'agit d'un trouble fréquent dont la prévalence est évaluée à environ 5 %. Le diagnostic repose sur un interrogatoire précis de la famille et de l'enfant, un examen clinique et une évaluation avec des outils normés et standardisés de la motricité et de l'écriture. Il nécessite l'intervention d'un médecin, si possible formé aux troubles du neurodéveloppement, et d'un professionnel de la motricité (psychomotricien ou ergothérapeute). Au niveau thérapeutique, les interventions doivent être centrées sur les activités essentielles à la vie quotidienne et scolaire de l'enfant.
Assuntos
Transtornos das Habilidades Motoras , Criança , Família , Humanos , Atividades de Lazer , Transtornos das Habilidades Motoras/diagnóstico , Transtornos das Habilidades Motoras/epidemiologia , Transtornos das Habilidades Motoras/terapia , PrevalênciaRESUMO
Developmental coordination disorder (DCD) interferes with academic achievement and daily life, and is associated with persistent academic difficulties, in particular within mathematical learning. In the present study, we aimed to study numerical cognition using an approach that taps very basic numerical processes such as subitizing and counting abilities in DCD. We used a counting task and a subitizing task in forty 7-10 years-old children with or without DCD. In both tasks, children were presented with arrays of one to eight dots and asked to name aloud the number of dots as accurately and quickly as possible. In the subitizing task, dots were presented during 250â¯ms whereas in the counting task they stayed on the screen until the participants gave a verbal response. The results showed that children with DCD were less accurate and slower in the two enumeration tasks (with and without a time limit), providing evidence that DCD impairs both counting and subitizing. These impairments might have a deleterious impact on the ability to improve the acuity of the Approximate Number System through counting, and thus could play a role in the underachievement of children with DCD in mathematics.
Assuntos
Transtornos das Habilidades Motoras , Criança , Cognição , Escolaridade , Humanos , MatemáticaRESUMO
Using the Remember/Know procedure, we compared the impact of a reflective repetition by refreshing (i.e., briefly thinking of a just-seen item) and a perceptual repetition (i.e., seeing an item again) on subjective experience during recognition memory. Participants read aloud words as they appeared on a screen. Critical words were presented once (read condition), immediately repeated (repeat condition), or followed by a dot signalling the participants to think of and say the just-previous word (refresh condition). In Experiments 1 and 2, Remember responses benefited from refreshing a word (in comparison with reading it). In Experiment 2, this benefit disappeared when participants had to refresh one of three active items. Perceptual repetition increased Remember responses in Experiment 1, but not in Experiment 2 regardless of whether participants had just previously seen 1- or 3-items. These findings indicate that under some circumstances, reflective and perceptual repetition may have different consequences for later subjective experience during remembering, suggesting differences in their underlying functional mechanisms.
Assuntos
Acontecimentos que Mudam a Vida , Reconhecimento Psicológico , Adulto , Cognição , Feminino , Humanos , Masculino , Memória , Tempo de ReaçãoRESUMO
Developmental Coordination Disorder (DCD) is a disorder of motor coordination which interferes with academic achievement. Difficulties in mathematics have been reported. Performance in the number line task is very sensitive to atypical development of numerical cognition. We used a position-to-number task in which twenty 7-to-10years old children with DCD and 20 age-matched typically developing (TD) children had to estimate the number that corresponded to a hatch mark placed on a 0-100 number line. Eye movements were recorded. Children with DCD were less accurate and slower to respond than their peers. However, they were able to map numbers onto space linearly and used anchoring strategies as control. We suggest that the shift to a linear trend reflects the ability of DCD children to use efficient strategies to solve the task despite a possibly more imprecise underlying numerical acuity.
Assuntos
Aptidão/fisiologia , Cognição/fisiologia , Conceitos Matemáticos , Transtornos das Habilidades Motoras/psicologia , Análise de Variância , Estudos de Casos e Controles , Criança , Movimentos Oculares/fisiologia , Feminino , Humanos , Masculino , Testes Psicológicos , Percepção Espacial/fisiologia , Percepção Visual/fisiologiaRESUMO
The minimal cognitive operation of thinking of a just-seen stimulus (refreshing) was studied in 24 patients with schizophrenia and 24 normal controls. Verbal response times were measured when participants read a word, read a word immediately again, or refreshed a word just after it was no longer present. Patients showed equal priming as controls in reading a word for the second time and were slower than controls to say a word only in the refresh condition. On a surprise test, participants were asked to recognize the words they had seen previously and to give Remember, Know, or Guess responses according to whether they recognized words on the basis of conscious recollection, familiarity, or guessing. Although patients showed overall poorer recognition memory, the beneficial effect of refreshing on long-term memory accuracy and Remember responses was preserved, whereas they derived less benefit in familiarity from seeing an item twice than from refreshing it. These results suggest that although patients may have some difficulty engaging the refresh process, they show significant long-term memory benefits when induced to do so.
Assuntos
Transtornos Cognitivos/diagnóstico , Memória de Curto Prazo , Testes Neuropsicológicos/estatística & dados numéricos , Resolução de Problemas , Esquizofrenia/diagnóstico , Psicologia do Esquizofrênico , Pensamento , Aprendizagem Verbal , Adulto , Transtornos Cognitivos/psicologia , Feminino , Humanos , Masculino , Escalas de Graduação Psiquiátrica , Psicometria , Tempo de Reação , Leitura , Valores de Referência , Retenção Psicológica , Semântica , Comportamento VerbalRESUMO
At school, children with Developmental Coordination Disorder (DCD) struggle with mathematics. However, little attention has been paid to their numerical cognition abilities. The goal of this study was to better understand the cognitive basis for mathematical difficulties in children with DCD. Twenty 7-to-10 years-old children with DCD were compared to twenty age-matched typically developing children using dot and digit comparison tasks to assess symbolic and nonsymbolic number processing and in a task of single digits additions. Results showed that children with DCD had lower performance in nonsymbolic and symbolic number comparison tasks than typically developing children. They were also slower to solve simple addition problems. Moreover, correlational analyses showed that children with DCD who experienced greater impairments in the nonsymbolic task also performed more poorly in the symbolic tasks. These findings suggest that DCD impairs both nonsymbolic and symbolic number processing. A systematic assessment of numerical cognition in children with DCD could provide a more comprehensive picture of their deficits and help in proposing specific remediation.
Assuntos
Cognição , Transtornos das Habilidades Motoras/psicologia , Estudos de Casos e Controles , Criança , Desenvolvimento Infantil , Feminino , Humanos , Masculino , Matemática , Transtornos das Habilidades Motoras/fisiopatologiaRESUMO
OBJECTIVE: The influence of the emotional valence of words on conscious awareness was assessed in patients with schizophrenia. METHOD: The remember/know procedure was used to test 24 patients with schizophrenia and 24 normal comparison subjects. RESULTS: Patients' "remember" responses and conscious recollection were more frequent for emotional words than for neutral words. In contrast, the levels of "know" responses and familiarity were independent of emotional words. CONCLUSIONS: Patients with schizophrenia consciously recollected emotional words better than neutral words.
Assuntos
Emoções , Rememoração Mental , Psicologia do Esquizofrênico , Vocabulário , Adulto , Conscientização , Estado de Consciência , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Retenção PsicológicaRESUMO
Patients with schizophrenia (n = 24) matched with 24 normal subjects were presented with both words and pictures. On a recognition memory task, they were asked to give remember, know, or guess responses to items that were recognized on the basis of conscious recollection, familiarity, or guessing, respectively. Compared with normal subjects, patients exhibited a lower picture superiority effect selectively related to remember responses. Unlike normal subjects, they did not exhibit any word superiority effect in relation to guess responses; this explains why the overall picture superiority effect appeared to be intact. These results emphasize the need to take into account the subjective states of awareness when analyzing memory impairments in schizophrenia.
Assuntos
Transtornos da Memória/etiologia , Esquizofrenia/complicações , Percepção Visual , Adulto , Análise de Variância , Feminino , Humanos , Masculino , Transtornos da Memória/diagnóstico , Transtornos da Memória/epidemiologia , Distribuição Aleatória , Reconhecimento Psicológico , Inquéritos e Questionários , VocabulárioRESUMO
Episodic memories are characterized by a specific state of awareness, conscious recollection, which allows subjects to mentally relive past events. They are not a literal reproduction of the past but instead depend on constructive processes. Patients with schizophrenia exhibit a specific impairment of conscious recollection. The aim of this study was to investigate the role of constructive processes into defective conscious recollection of patients with schizophrenia. An experiential approach to false recognition and related states of awareness was used. Thirty patients with schizophrenia, who were matched with 30 normal subjects, studied lists of words semantically related to a non-presented theme word (critical lure). On a recognition memory task with both previously presented words and non presented critical lures, they were asked to give Remember, Know or Guess responses to items that were recognized on the basis of conscious recollection, familiarity or guessing, respectively. Patients with schizophrenia recognized fewer studied words and critical lures than normal subjects. This deficit was restricted to memories associated with conscious recollection as indicated by a decrease in Remember responses, but not Know and Guess responses. Our results indicate that patients with schizophrenia exhibit an impaired conscious recollection, whether memories are true or false. They provide evidence that schizophrenia impairs the mere construction of conscious recollection.
Assuntos
Transtornos da Memória/etiologia , Transtornos da Memória/psicologia , Esquizofrenia/complicações , Adulto , Estado de Consciência , Feminino , Humanos , Masculino , Repressão PsicológicaRESUMO
BACKGROUND: While chronic persecutory delusions are typically anchored into patients' everyday life situations, no investigation has ever looked at how situations associated with a feeling of persecution are recorded and later retrieved. METHOD: a diary methodology combined with a recognition task involving ten patients with schizophrenia who presented chronic persecutory delusions and ten control participants. Diaries of everyday persecutory events (Pe) and non-persecutory events (nPe) were kept. RESULTS: in both groups, 1) Pe were associated with higher anxiety scores than nPe, 2) Pe were experienced as less distinctive and more stereotyped than nPe, 3) the frequency of incorrect recognition of altered descriptions of Pe was higher than that of nPe. LIMITATIONS: because high levels of motivation are required of the diarists, our sample size was small. CONCLUSION: Memories of persecutory events were highly emotional and semanticized. they were frequently incorrectly recognized, suggesting the existence of bias resulting from interactions between their processing and persecutory delusions.
Assuntos
Delusões/fisiopatologia , Memória Episódica , Esquizofrenia/fisiopatologia , Adulto , Doença Crônica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reconhecimento Psicológico/fisiologiaRESUMO
Patients with schizophrenia experience a loss of temporal continuity or subjective fragmentation along the temporal dimension. Here, we develop the hypothesis that impaired temporal awareness results from a perturbed structuring of events in time-i.e., canonical neural dynamics. To address this, 26 patients and their matched controls took part in two psychophysical studies using desynchronized audiovisual speech. Two tasks were used and compared: first, an identification task testing for multisensory binding impairments in which participants reported what they heard while looking at a speaker's face; in a second task, we tested the perceived simultaneity of the same audiovisual speech stimuli. In both tasks, we used McGurk fusion and combination that are classic ecologically valid multisensory illusions. First, and contrary to previous reports, our results show that patients do not significantly differ from controls in their rate of illusory reports. Second, the illusory reports of patients in the identification task were more sensitive to audiovisual speech desynchronies than those of controls. Third, and surprisingly, patients considered audiovisual speech to be synchronized for longer delays than controls. As such, the temporal tolerance profile observed in a temporal judgement task was less of a predictor for sensory binding in schizophrenia than for that obtained in controls. We interpret our results as an impairment of temporal event structuring in schizophrenia which does not specifically affect sensory binding operations but rather, the explicit access to timing information associated here with audiovisual speech processing. Our findings are discussed in the context of curent neurophysiological frameworks for the binding and the structuring of sensory events in time.
Assuntos
Transtornos da Percepção/etiologia , Esquizofrenia/complicações , Percepção da Fala/fisiologia , Percepção do Tempo/fisiologia , Estimulação Acústica , Adulto , Análise de Variância , Estudos de Casos e Controles , Feminino , Humanos , Ilusões/fisiologia , Julgamento/fisiologia , Masculino , Pessoa de Meia-Idade , Estimulação Luminosa , Valor Preditivo dos Testes , Escalas de Graduação Psiquiátrica , Psicofísica , Tempo de ReaçãoRESUMO
Anomalous activations of the prefrontal cortex (PFC) and posterior cerebral areas have been reported in previous studies of working memory in schizophrenia. Several interpretations have been reported: e.g., neural inefficiency, the use of different strategies and differences in the functional organization of the cerebral cortex. To better understand these abnormal activations, we investigated the cerebral bases of a working memory component process, namely refreshing (i.e., thinking briefly of a just-activated representation). Fifteen patients with schizophrenia and 15 control subjects participated in this functional magnetic resonance imaging (fMRI) study. Participants were told that whenever they saw a word on the screen, they had to read it silently to themselves (read and repeat conditions), and when they saw a dot, they had to think of the just-previous word (refresh condition). The refresh condition (in comparison with the read condition) was associated with significantly increased activation in the left inferior frontal gyrus and significantly decreased connectivity within the prefrontal cortex and between the prefrontal and parietal cortices in patients with schizophrenia in comparison with control subjects. These results suggest that prefrontal dysfunctions in schizophrenia might be related to a defective ability to initiate (rather than to execute) specific cognitive processes.
Assuntos
Mapeamento Encefálico , Córtex Cerebral/fisiopatologia , Memória de Curto Prazo/fisiologia , Esquizofrenia/patologia , Adulto , Estudos de Casos e Controles , Córtex Cerebral/irrigação sanguínea , Feminino , Humanos , Processamento de Imagem Assistida por Computador , Imageamento por Ressonância Magnética , Masculino , Transtornos da Memória/etiologia , Transtornos da Memória/patologia , Vias Neurais/irrigação sanguínea , Vias Neurais/fisiopatologia , Testes Neuropsicológicos , Pacientes Ambulatoriais , Oxigênio , Esquizofrenia/complicações , Aprendizagem Verbal/fisiologia , Adulto JovemRESUMO
We explore the mechanisms sub-tending the re-organization and memorization of visual information by studying how these mechanisms fail in patients with schizophrenia. Several studies have suggested that patients have difficulties in organizing information in perception and memory. We explore to what extent prompting patients to group items influences memory performance. We distinguish automatic grouping from top-down grouping processes, which are especially involved in re-organizing information. The main task was to memorize pairs of figures. Following manipulation of proximity, pairs of figures were part of the same perceptual group (within-group pair, formed on the basis of automatic grouping) or belonged to different groups (between-group pairs, re-grouped through top-down processes). Prior to the memory task, subjects ran a perception task prompting them to prioritize either within-group or between-group pairs. Unlike patients, controls globally benefited from grouping by proximity in the memory task. In addition, the results showed that prioritizing between-group pairs had a deleterious effect in patients, but with a large decrement in memory performance in the case of within-group rather than between-group figures. This occurred despite preserved focalization on within-group figures, as shown by eye-movement recordings. The suggestion is that when patients are prompted to re-group separate items, they can do so, but the benefit derived from automatic grouping is then not only lost but also reversed. This suggests re-organizing visual information not only involves re-grouping separate items but also integrating these new groups in a unified representation, which is impaired in patients with schizophrenia.
Assuntos
Memória de Curto Prazo/fisiologia , Psicologia do Esquizofrênico , Percepção Visual/fisiologia , Adulto , Idade de Início , Atenção/fisiologia , Movimentos Oculares/fisiologia , Feminino , Humanos , Masculino , Estimulação Luminosa , Escalas de Graduação Psiquiátrica , Desempenho Psicomotor/fisiologia , Tempo de Reação/fisiologiaRESUMO
Investigations of memory impairment in schizophrenia have frequently revealed a strategic processing deficit at encoding. The authors studied an early encoding process, refreshing (in this case, thinking of a stimulus that has just-previously been presented), and its impact on recognition memory in schizophrenia. Following simultaneous presentation of three words or a single word in the top, middle, or bottom position of the screen, 25 patients with schizophrenia and 25 control participants saw and read a new word (read condition), or a word presented on the previous screen (repeat condition), or saw a dot indicating that they should think of and say the last word to have appeared in that position (refresh condition). Later, on a surprise test, participants were asked to recognize words seen previously and give a Remember, Know, or Guess response according to whether they recognized each on the basis of conscious recollection, familiarity, or guessing. The cognitive operation of refreshing was impaired in schizophrenia: patients were slower on 1-word trials and less accurate on 3-word trials to refresh a word, and their Remember responses did not benefit from refreshing.