RESUMEN
Attention-deficit/hyperactivity disorder (ADHD) is a heritable, chronic, neurodevelopmental disorder with serious long-term repercussions. Despite being one of the most common cognitive disorders, the clinical diagnosis of ADHD is based on subjective assessments of perceived behaviors. Endophenotypes (neurobiological markers that cosegregate and are associated with an illness) are thought to provide a more powerful and objective framework for revealing the underlying neurobiology than syndromic psychiatric classification. Here, we present the results of applying genetic linkage and association analyses to neuropsychological endophenotypes using microsatellite and single nucleotide polymorphisms. We found several new genetic regions linked and/or associated with these endophenotypes, and others previously associated to ADHD, for example, loci harbored in the LPHN3, FGF1, POLR2A, CHRNA4 and ANKFY1 genes. These findings, when compared with those linked and/or associated to ADHD, suggest that these endophenotypes lie on shared pathways. The genetic information provided by this study offers a novel and complementary method of assessing the genetic causes underpinning the susceptibility to behavioral conditions and may offer new insights on the neurobiology of the disorder.
Asunto(s)
Trastorno por Déficit de Atención con Hiperactividad/genética , Endofenotipos/análisis , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Trastornos del Conocimiento/genética , Colombia , Etnicidad/genética , Femenino , Estudios de Asociación Genética/métodos , Ligamiento Genético/genética , Predisposición Genética a la Enfermedad/genética , Predisposición Genética a la Enfermedad/psicología , Humanos , Masculino , Repeticiones de Microsatélite/genética , Persona de Mediana Edad , Pruebas Neuropsicológicas , Linaje , Polimorfismo de Nucleótido Simple/genéticaRESUMEN
Objective: The aim of this study is to contrast the genetics of neuropsychological tasks in individuals from nuclear families clustering ADHD in a Caribbean community. Method: We recruited and clinically characterized 408 individuals using an extensive battery of neuropsychological tasks. The genetic variance underpinning these tasks was estimated by heritability. A predictive framework for ADHD diagnosis was derived using these tasks. Results: We found that individuals with ADHD differed from controls in tasks of mental control, visuospatial ability, visuoverbal memory, phonological and verbal fluency, verbal and semantic fluency, cognitive flexibility, and cognitive ability. Among them, tasks of mental control, visuoverbal memory, phonological fluency, semantic verbal fluency, and intelligence had a significant heritability. A predictive model of ADHD diagnosis using these endophenotypes yields remarkable classification rate, sensitivity, specificity, and precision values (above 80%). Conclusion: We have dissected new cognitive endophenotypes in ADHD that can be suitable to assess the neurobiological and genetic basis of ADHD.
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Trastorno por Déficit de Atención con Hiperactividad , Endofenotipos , Trastorno por Déficit de Atención con Hiperactividad/genética , Región del Caribe , Humanos , Pruebas Neuropsicológicas , SemánticaRESUMEN
INTRODUCTION: Alzheimer's disease (AD) is an important public health problem due to its disabling character and high individual, familial and social costs. The CERAD neuropsychological battery has been widely used for evaluation and diagnosis of the cognitive deficit associated with AD. This instrument has been adapted to the Colombian culture (CERAD-Col) for the Neurosciences Group. SUBJECTS AND METHODS: A study was carried out to establish the validity and reliability of the CERAD-Col in Colombian, Spanish-speaking individuals aged 50 years or more. It included 151 controls and 151 AD patients. Controls were selected from a convenience sample of 848 adults aged 50 years or more. The construct validity was determined in three ways: 1) factorial analysis; 2) correlation with the functional scales FAST and GDS (convergent-type validity) and, 3) comparison between the two groups. Internal consistency was determined by means of Cronbach's alpha coefficient. RESULTS: Three factors -memory, language and praxis- explained 88% of the total variance. Moderate but statistically significant correlations were found between neuropsychological tests and functional scales. Internal consistency and test-retest reproducibility were high. The AD group exhibited significantly lower scores (p < 0.05) than the control one. CONCLUSION: CERAD-Col is valid and reliable for the diagnosis of AD in Colombian Spanish-speaking population aged 50 years or more.
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Enfermedad de Alzheimer/psicología , Pruebas Neuropsicológicas , Anciano , Anciano de 80 o más Años , Enfermedad de Alzheimer/epidemiología , Colombia/epidemiología , Femenino , Humanos , Pruebas del Lenguaje , Masculino , Trastornos de la Memoria/epidemiología , Trastornos de la Memoria/psicología , Persona de Mediana Edad , Desempeño Psicomotor , Reproducibilidad de los ResultadosRESUMEN
INTRODUCTION: Specific developmental language disorder (SDLD) is a diagnostic entity in which language is expected to be the only cognitive function that is affected. Nevertheless, difficulties in other cognitive functions may also appear, either because the language disorder is an expression of an underlying condition or because the retarded language development gives rise to cognitive deficits in general. AIM: To determine whether there are any differences in the cognitive performance of children with SDLD and that of children who have developed normally. SUBJECTS AND METHODS: The study involved a sample of 51 children with SDLD, aged between 6 and 16 years, and 49 children in a control group, who were paired by chronological age, sex and socioeconomic level. Verbal cognitive capacity, attention, memory, visual-constructional and executive functioning were all evaluated. RESULTS: Statistically and clinically significant differences were found in the verbal-type skills, such as language comprehension and verbal cognitive capacity, which showed effect sizes of -1.31 and -1.33, respectively. In the other functions that were assessed, the performance of the SDLD group was slightly lower than that of the control group, but with no clinically significant differences. CONCLUSION: These findings show that the group of children with SDLD was well selected, since the only differences between the two groups involve linguistic aspects; moreover, this evidence supports the idea that language and other cognitive functions are relatively independent and that a language disorder would only generate an unspecific general effect in the other cognitive functions.
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Cognición/fisiología , Trastornos del Desarrollo del Lenguaje , Desarrollo del Lenguaje , Adolescente , Niño , Femenino , Humanos , Trastornos del Desarrollo del Lenguaje/diagnóstico , Trastornos del Desarrollo del Lenguaje/fisiopatología , Masculino , Pruebas NeuropsicológicasRESUMEN
INTRODUCTION: Available treatments for Alzheimer disease allow that early diagnosis become an important issue, because treatment only are useful during the earliest stage, especially during the mild cognitive impairment (MCI), when the most of the cognitive function is preserved. AIM: To observe the performance on a shortened version of a Semantic Cue Recall Memory Test (SCRMT) from a group of adult aged over 50 years old, living in Medellin city and with dementia of Alzheimer type (DAT). SUBJECTS AND METHODS: The sample was constituted by 30 patients with DAT, 30 with MCI, and 59 healthy controls, which were matched by socio economic strata and school achievement. The SCRMT was administered to the sample. For the analyses two groups of age (50-69 and over 70 years) were conformed. RESULTS: Comparisons statistically significant differences between the groups (p < 0.05). The scores were not significant affected by age. A combination of low scores with the presence of intrusions on the free, immediate cue, and delay cue recalls suggested the diagnosis of DAT, which allow recommending a complete neuropsychological assessment. Statistically significant differences were preserved when the groups were divided by age. The effect of the gender could not determine because the small size of the male sample. CONCLUSION: The shortened version of the SCMRT would appear be useful for the DAT diagnosis.
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Enfermedad de Alzheimer/fisiopatología , Memoria/fisiología , Pruebas Neuropsicológicas , Grupos de Población , Semántica , Adulto , Anciano , Enfermedad de Alzheimer/diagnóstico , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
INTRODUCTION: Phonological awareness problems have been reported in children with attention deficit/hyperactivity disorder (ADHD). However, other researches found that phonological awareness problem appear only in children with learning disabilities (LD). OBJECTIVE: To analyze the performance on phonological awareness tasks of children aged 7 to11 years with ADHD combined type (ADHD/+H), and inattentive type (ADHD/-H) compared with one control group. PATIENTS AND METHODS: A non-randomized sample consisting of 96 children of both genders was selected. Children were attending to school in Medellin, Colombia. The sample was classified into three groups of 32 participants: ADHD/+H, ADHD/-H and control. LD was excluded using a standardized questionnaire for teachers (CEPA). Groups were sorted using a T score (3) 60 for cases and T score pound 50 for controls on a standardized questionnaire with DSM-IV-ADHD criteria, and on an ADHD-DSM-IV checklist. The performances of the three groups on phonological awareness tasks, as auditory discrimination, visual recognition, sequential repetition, oral segmentation, syllable inversion, similar words reading and writing, and pseudo-words reading and writing, were compared. RESULTS: Differences between ADHD and control children on phonological awareness tasks scores were not found. CONCLUSION: Children with ADHD without LD performed similarly to controls on phonological awareness tasks.
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Trastorno por Déficit de Atención con Hiperactividad/fisiopatología , Concienciación , Discapacidades para el Aprendizaje/fisiopatología , Fonética , Trastorno por Déficit de Atención con Hiperactividad/diagnóstico , Niño , Femenino , Humanos , Discapacidades para el Aprendizaje/diagnóstico , Masculino , Pruebas Neuropsicológicas , Instituciones Académicas , Encuestas y CuestionariosRESUMEN
INTRODUCTION: It has been suggested that children with attention deficit/hyperactivity disorder (ADHD) have problems in attention and executive functions. A factor analysis showed that ADHD children had a different factor structure of the executive functions when they were compared with controls. AIM. To determine the factor structure of attention and executive functions in a group of ADHD children compared with a group of controls. SUBJECTS AND METHODS: 249 ADHD children and 372 controls of both genders, aged 6 to 11 years old, and from the different socio economic strata of Medellín city, were selected. Attention --Mental Control and Auditory Continuous Performance Test (ACPT)-- and executive functions --Phonologic and Semantic Verbal Fluency (FAS)--, and a shortened version of the Wisconsin Card Sorting Test (WCST) were assessed in both groups. Factor analyses were developed with principal components procedure were developed for each group and the total sample, using principal component procedure with orthogonal rotation. RESULTS: Stable factor structures were found for each group and for the total sample. The general factor structure was constituted by three independent factors: 1- Categorization, 2- Verbal fluency and verbal sustained attention, and 3- Cognitive flexibility. This factor structure explained 74.9% of the variance. CONCLUSION: The factor structures suggested that the components of attention and executive functions are similar for ADHD and control groups. The differences between groups would be quantitative.
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Trastorno por Déficit de Atención con Hiperactividad/fisiopatología , Trastorno por Déficit de Atención con Hiperactividad/psicología , Pruebas Neuropsicológicas , Niño , Análisis Factorial , Femenino , Humanos , MasculinoRESUMEN
INTRODUCTION: Executive function is a set of cognitive operations, which are sustained by the complex activities of the frontal lobe systems. Executive function is responsible for programming, establishing goals, classifying, executing, controlling, changing, monitoring and confronting all the mental activities. OBJECTIVE: To review and to actualize neuropsychological literature about executive function, its development, its structure, its theoretical model, its alterations in different neurological and neuropsychological disorders, and its clinical qualitative and quantitative assessments. CONCLUSION: Executive function is a multidimensional construct of the cognition, which is structured and modified through the development during childhood, and which is altered during different neurological and neuropsychological disorders, and which could be evaluated in a qualitative or quantitative approaches.
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Trastornos del Conocimiento/diagnóstico , Trastornos del Conocimiento/fisiopatología , Corteza Prefrontal/fisiopatología , Humanos , Pruebas NeuropsicológicasRESUMEN
INTRODUCTION: Prevalence of Conduct Disorder has been calculated between 4 to 10%. OBJECTIVE: To estimate the prevalence CD in Colombian adolescents, using a rating scale by self report. PATIENTS AND METHODS: 190 male adolescents from secondary school population, 12 to 16 year-old, were stratified and selected in a randomizing procedure, from Medellín, Colombia. A checklist including 14 diagnostic symptoms taken from the DSM-IV Criterion A for CD was constructed, with a scale of 0 = never to 3 = almost always (Reliability alpha coefficient: 0.86). Prevalences were calculated as follow: (1) codifying as 'Probable TDC' a T score over 60; (2) codifying as Adolescent Antisocial Behavior (AAB) having three or more answers qualified with 1 or more points, and (3) codifying as CD obtaining three or more answers qualified with 2 or 3 points. RESULTS: The most prevalent CD symptoms were 'staying out at night before 13 year-old' (10.5%), 'having been cruel to animals' (8.4%), 'having been cruel to people' (7.4%), 'having broken into someone else's house or car' (7.3%), and 'using weapon or other objects that can cause serious physical harm to others' (6.9%). The prevalence of 'Probable CD' was 13.7%; prevalence of AAB was 56.8% and prevalence of CD was 8.4%. It was not found significant differences between socioeconomic strata. CONCLUSION: The prevalence of CD in the studied sample was 8.4%, independent of the socioeconomic strata.
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Conducta del Adolescente , Trastorno de la Conducta/diagnóstico , Trastorno de la Conducta/epidemiología , Adolescente , Niño , Colombia/epidemiología , Manual Diagnóstico y Estadístico de los Trastornos Mentales , Análisis Factorial , Humanos , Masculino , Distribución Aleatoria , Reproducibilidad de los Resultados , Factores Socioeconómicos , Encuestas y CuestionariosRESUMEN
OBJECTIVE: To determine the reliability of a clinical quantitative instrument for assessing the symptoms of Defined Idiopathic Parkinson Disease (DIPD). PATIENTS AND METHODS: From 148 patients with parkinsonism syndrome, the best 62 EPID cases, according to Calne et al (1992), and Larsen et al (1994) criteria--37 males and 25 females--were selected. RESULTS: The age mean was 68.4 (7.4) year-old, the age of onset was 64 (7.2) years, the time of evolution was 4.3 (2.9) years. 98.4% of the sample was in 1 to 3 Hoehn and Yahr clinical state. Right parkinsonism score (RPS) was 8.2 (4.2), and left (LPS) was 6.7 (4.8). Significant differences between right and left tremor, rigidity and dyskinesia scores were found (ji-squared, p < 0.05). Total parkinsonism score (TPS) was 14 (6.9). Several significant and high correlated coefficients were found between most of the scale's components and Hoehn and Yahr clinical state, TPS, and time of evolution (r > 0.40, p < 0.0001). Total 21 items scale Cronbach's alpha coefficient was 0.92. A stepwise multiple regression model showed that rigidity, postural reflex disorder, and micrography were able to predict the Hoehn and Yahr clinical state (81.4%, p < 0.0001). A principal component analysis showed that akinesia explained more than 59% of the instrument variance, while micrography only explained 0.57% of the variance (100 time lesser). CONCLUSION: A reliability structure of the instrument was demonstrated for assessing parkinsonism symptoms in DIPD subjects.
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Enfermedad de Parkinson/diagnóstico , Anciano , Diagnóstico Diferencial , Femenino , Humanos , Masculino , Persona de Mediana Edad , Enfermedad de Parkinson Secundaria/diagnóstico , Reproducibilidad de los Resultados , Índice de Severidad de la EnfermedadRESUMEN
INTRODUCTION: Several studies have found neuropsychological and behavioral disorders in children with attention deficit/hyperactivity disorder (ADHD), which have been explained as an executive dysfunction. OBJECTIVE: To describe and compare children with ADHD and a control group. PATIENTS AND METHODS: 79 seven to eleven-year-old children were selected and grouped according to ADHD DSM IV criteria and the T scores on a ADHD checklist. They were classified as predominantly inattentive (n=19), combined (n=24) and control (n=36) groups. Age, gender, socio economic status and intellectual quotient (>85) were statistically controlled. Neuropsychological functions were assessed with a child neuropsychological battery, and the behavioral dimensions were evaluated with the BASC's questionnaires, Conner's parents (CPRS) and teachers (CTRS) rating scales, and with a questionnaire for oppositional defiant (ODD) and conduct (CD) disorders. RESULTS: Statistically significant differences were found (P<0.01) in neuropsychological variables of mental control, continuous auditory performance, Rey's complex figure evocation and the Stroop's test. There were significant differences in the most BASC's internalizing and externalizing dimensions, so for the parents as for the teachers and self report questionnaire, and in the dimensions of CPRS, CTRS, ODD and CD questionnaires. CONCLUSION: Children with ADHD showed difficulties in sustained and selective attention, visual memory, inhibitory control, and they had behavioral disorders similar to those informed by previous studies.
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Trastorno por Déficit de Atención con Hiperactividad/diagnóstico , Trastorno por Déficit de Atención con Hiperactividad/fisiopatología , Trastornos de la Conducta Infantil/diagnóstico , Trastornos de la Conducta Infantil/fisiopatología , Trastorno por Déficit de Atención con Hiperactividad/clasificación , Síntomas Conductuales , Niño , Trastornos de la Conducta Infantil/clasificación , Colombia , Femenino , Humanos , Masculino , Pruebas Neuropsicológicas , Encuestas y CuestionariosRESUMEN
INTRODUCTION: Several studies have proposed a multiple dimensional theoretical model for executive function. OBJECTIVE: To identify the factor structure of the executive function in a sample of young university students of different modalities of learning in their careers. METHODS: 100 participants of both sexes, age 16 to-21-year old and normal Full Scale IQ were selected in a randomized and representative approach from private universities of Medellin Colombia. They were student of verbal, visuospatial and mathematical careers. A executive function assessment battery were applied, which included: Wisconsin Card Sorting Test (WCST), Trail Making Test (TMT) A and B, verbal fluency test (FAS) by phonologic and semantic guides, and Stroop test. RESULTS: A structure of four factor was found, which explained 74.9% of variance. Factors were: 1. Organization and flexibility, which explained 26.6% of variance; 2. Processing speed, 19.7%; 3. Inhibitory control, 15.1%; and 4. Verbal fluency 13.4%. CONCLUSION: A multiple factor structure of the executive function in young university students was demonstrated.
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Modelos Psicológicos , Estudiantes/psicología , Pensamiento , Adolescente , Adulto , Colombia , Toma de Decisiones , Femenino , Humanos , Inteligencia , Juicio , Masculino , Memoria , Análisis Multivariante , Pruebas Neuropsicológicas , Corteza Prefrontal/fisiología , Distribución Aleatoria , Valores de Referencia , Universidades , Conducta VerbalRESUMEN
INTRODUCTION: Rating scales for post traumatic stress disorder (PTSD) should be consistents with DSM IV criteria, and should be validate for each culture. OBJECTIVE: To validate a PTSD checklist in a Colombian little town population, which was semi destructed by a guerrilla attack. PATIENTS AND METHODS: A stratified, representative and randomized sample of 202 adult participants, aged over 15 year old, was selected from San Joaquin (Santander Colombia) two year after an guerrilla attack. A structured interview (SCID I), based on DSM IV criteria, was developed with each member of the sample. 76 participants (37.6%) met criteria for PTSD, and 126 (62.4%) were classified as non PTSD. A rating checklist with 24 symptoms of PTSD was applied by self report. Each item of the scale was scored 1 to 4. RESULTS: PTSD checklist had a reliability Cronbach s alpha coefficient of 0.97. PTSD group scored 70.4 22.9, and non PTSD 37.2 13.7 (p< 0.0001) on the PTSD checklist. A discriminant analysis found that the scale had a correctly classification capability of 88.6% (p< 0.0001). Sensibility was found between 76.3% for a cut off point of 51 and 81.6% for cut off point of 45. Specificity changed between 71.4% for a cut off point of 45 and 84.4% for a cut off point of 51. CONCLUSION: Checklist for PTSD had a high reliability, good discriminant capability, and good sensibility and specificity.
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Tamizaje Masivo , Trastornos por Estrés Postraumático/diagnóstico , Encuestas y Cuestionarios , Adolescente , Adulto , Colombia/epidemiología , Humanos , Reproducibilidad de los Resultados , Sensibilidad y Especificidad , Trastornos por Estrés Postraumático/epidemiología , GuerraRESUMEN
INTRODUCTION: Prevalence of adolescents with conduct disorder (CD) has been calculated between 4 y 10%. OBJECTIVE: To estimate the prevalence of mental retardation in Colombian adolescent offenders, using the Wechsler Intelligence Scales for Children Revised (WISC R). PATIENTS AND METHODS: 106 male adolescent offenders with CD, aged 12 to 16 years, and attending to institutions of re education in Medell n Colombia were selected in a randomized approach. WISC R Hispanic version was administered to the sample, using 4 verbal (information, vocabulary, similarities and arithmetic) and 4 performance (Picture completion, block design, picture arrangement, and digit symbol) subtests for calculating verbal, performance and full scale IQs (VIQ, PIQ, and FSIQ), according to the manual instructions. RESULTS: 43 participants (40.6%) obtained a FSIQ < 70, then they were categorized as mild mental retardation. 34 offenders (32.1%) had a FSIQ between 70 and 84, then they were classified as people with borderline intellectual functioning, only 29 participants (27.4%) obtained a FSIQ over 85. CONCLUSION: 72.7% of the institutionalized adolescents offenders had low intellectual functioning, which may be interfere with the re education programs.
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Trastorno de la Conducta/complicaciones , Discapacidad Intelectual/epidemiología , Adolescente , Colombia/epidemiología , Manual Diagnóstico y Estadístico de los Trastornos Mentales , Educación Especial , Humanos , Discapacidad Intelectual/complicaciones , Pruebas de Inteligencia , Delincuencia Juvenil , Masculino , Distribución Aleatoria , Escalas de WechslerRESUMEN
INTRODUCTION: Early preclinical diagnosis is the greatest challenge faced by researchers into dementia. Cognitive, neuroanatomical, neurophysiological and genetic markers have been reported. One of the preclinical cognitive markers is anomia and it is often assessed using visual naming tests. AIMS: The aim of this study was to analyse the type of mistakes made in a visual naming test in a group of carriers and non-carriers of the E280A PS1 mutation. PATIENTS AND METHODS: The sample was made up of 91 participants who were genotyped for the E280A PS1 mutation and divided into three groups: non-carriers (n = 30), asymptomatic carriers (n = 39) and sick carriers (n = 22). Selection was performed using the Minimental and the Fast and EDG scales and mistakes in the CERAD naming test were classified. The types of mistakes taken into account were: no answer, visual, semantic, phonological, the whole for the part, and not related. RESULTS: There is a significant difference in the number of semantic errors between non-carriers and asymptomatic carriers; on comparing the three groups, no statistically significant differences were found in visual mistakes. CONCLUSIONS: Visual mistakes are a general characteristic, even in healthy subjects and, therefore, these errors did not provide any information that could be used to classify patients with or without dementia. Semantic mistakes can be considered as being a preclinical sign in familial Alzheimer's disease (FAD). Both visual and auditory naming tests must be applied when evaluating patients with FAD.
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Enfermedad de Alzheimer/genética , Anomia/genética , Proteínas de la Membrana/genética , Mutación , Pruebas Neuropsicológicas , Adulto , Enfermedad de Alzheimer/diagnóstico , Femenino , Heterocigoto , Humanos , Masculino , Persona de Mediana Edad , Presenilina-1RESUMEN
INTRODUCTION: Using a shortened rating scale, the prevalence of Attention Deficit Hyperactivity Disorder (ADHD) has been reported to be very higher in a Colombian population. However, these data require clinical confirmation. OBJECTIVE: To confirm clinically the prevalence of ADHD in Colombian children and adolescents. PATIENTS AND METHODS: A randomized sample of 4 to 17 year old children and adolescents--184 males and 157 females--was selected from the schools. Sample was stratified in two socioeconomic status: high (4, 5, 6) and low (1, 2, 3). Several parents' and teachers' rating scales for the diagnosis of ADHD, standardized and validated in the Colombian population, were applied to the sample. The diagnosis of ADHD was confirmed using a semi-structured psychiatric and neurological interview, and medical histories revisions. RESULTS: Analysis found that prevalence of ADHD is 17.1%. Distribution for ADHD types was: combined 9.4%, inattentive 6.7% and hyperactive-impulsive 1%. Prevalence for boys was significant higher (21.8%) than for girls (10.9%) (chi 2 = 11.8, p < 0.01). In male predominate combined type and in female inattentive. Higher prevalence was found in low socioeconomic strata. Preschool children have lower prevalence (6.2%) than school 6 to 11 year old children (22.6%) and adolescents (21.6%). CONCLUSION: A higher prevalence of ADHD was confirmed in Colombian population.
Asunto(s)
Trastorno por Déficit de Atención con Hiperactividad/epidemiología , Adolescente , Factores de Edad , Niño , Preescolar , Colombia/epidemiología , Femenino , Humanos , Masculino , Pruebas Neuropsicológicas , Prevalencia , Distribución Aleatoria , Muestreo , Factores Sexuales , Factores Socioeconómicos , Población UrbanaRESUMEN
INTRODUCTION: The definition of parkinsonian syndromes is based on clinical criteria. OBJECTIVE: To determine the frequency and management of parkinsonism, using criteria of inclusion and exclusion. PATIENTS AND METHODS: We selected 302 consecutive patients, 147 females and 155 males, with parkinsonism, age 66.8 (11.4) (range: 13-90), grades of education 7.5 (4.3) (range: 0-20). A structured and quantitative protocol was applied to the sample. RESULTS: The most frequent parkinsonian syndrome was the defined idiopathic Parkinson's disease with 132 participants (43.7%). Probably idiopathic Parkinson's disease was found in 60 cases (19.9%), and possible idiopathic Parkinson's disease in eight cases (2.6%); early onset Parkinson's disease in 10 cases (3.3%), juvenile Parkinson's disease in one case (0.3%), familial Parkinson's disease in five cases (1.7%); cortical Lewy body disease in 16 cases (5.4%), progressive supranuclear palsy in nine cases (3.3%), multiple systemic atrophy in eight cases (2.6%). Secondary Parkinson's disease was distributed as follow: vascular disease in 24 cases (8%), local lesion in 11 cases (3%), medications in 16 cases (5.3%), meningoencephalitis in one case (0.3%) and syphilis in one case (0.3%). Without medication was found 1.5% of sample, which was in Hoehn & Yarh's state I to II. In monotherapy was found 23.2%, with two medications 46.7%, with three 23.5% and with four drugs 5.1%. Levodopa was prescript to 70.9%, anticholinergic to 51.3%, MAO-B-I to 33.4%, amantadine to 33.1%, D2 stimulants to 18.5%, and COMT-I to 2.6%. CONCLUSION: Structured protocol for assessment of parkinsonian syndromes allows reliable diagnoses for clinical and epidemiological purposes.
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Trastornos Parkinsonianos/epidemiología , Adolescente , Adulto , Edad de Inicio , Anciano , Anciano de 80 o más Años , Encéfalo/patología , Áreas de Influencia de Salud , Colombia/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Atrofia de Múltiples Sistemas/patología , Trastornos Parkinsonianos/etiología , Prevalencia , Índice de Severidad de la EnfermedadRESUMEN
OBJECTIVE: To standardize and to determine the structural validity of a conduct disorder self report questionnaire in adolescents. PATIENTS AND METHODS: One hundred ninety, 12 to 16 year old male participants from the different socioeconomic status were randomized selected from educational institutions of Medellin City, Colombia. A quantitative self report questionnaire, with a discrete (0-3) item scored scale, based upon the DSM-IV criteria A symptoms for conduct disorder was applied to the sample. Reliability analysis using alpha item/scale Cronbach's coefficient was calculated, and a factor analysis with a maximum likelihood method of extraction and VARIMAX rotation was developed. RESULTS: The standard obtained scores defined the presence and distribution of the symptoms of conduct disorder in an adolescent normal population. Reliability alpha Cronbach's coefficient for 14 items was 0.86. Three stable factors, which explained 53.9% of the variance, were found. First factor was serious violation of rules and explained 32.9% of variance, second factor was violence, which explained 10.9%, and the third factor was cruelty which explained 10.1% of the structure (Goodness-of-fit chi 2 = 34.6; df 25; p = 0.09). Conduct disorder questionnaire had a strong internal consistency and multidimensional structure, which would allow that it could be used in clinical and epidemiological researches with adolescent population.
Asunto(s)
Trastorno de la Conducta/diagnóstico , Encuestas y Cuestionarios , Adolescente , Conducta del Adolescente/psicología , Niño , Análisis Factorial , Femenino , Humanos , Masculino , Escalas de Valoración Psiquiátrica , Reproducibilidad de los Resultados , Índice de Severidad de la EnfermedadRESUMEN
INTRODUCTION: The aim of this study was to analyze the influence of age, gender, socioeconomic status (SES), academic achievement (education), and type of occupation, on the performance of the Boston Diagnostic Aphasia Examination (BDAE) Spanish version. MATERIAL AND METHODS: The BDAE was administered to a group of 156, 19 to 60 years old, occupationally active normal subjects. RESULTS: A descriptive analysis showed that some subjects (1 to 3%) scored in the pathological range of the centiles and profiles of the BDAE. A MANOVA (p < 0.05) demonstrated a significant effect of education over most of the BDAE subtests. Females outperformed males on some reading and writing subtests. SES had an effect over body part identification and naming. Significant differences were observed between younger and middle age groups in confrontation naming, oral and word picture reading. The older group scored significantly lower than the younger group in serial writing and sentences to dictation. No differences were observed between the older and the middle groups. Only oral spelling was affected by the type of occupation but a significant interaction of occupation and level of education was found. CONCLUSIONS: Language tests are influenced by demographic variables, particularly education. Normal variability on the BDAE should be considered when dealing with clinical populations.
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Afasia/diagnóstico , Pruebas Neuropsicológicas , Adolescente , Adulto , Factores de Edad , Agrafia/diagnóstico , Escolaridad , Empleo , Femenino , Humanos , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Valores de Referencia , Reproducibilidad de los Resultados , Factores SocioeconómicosRESUMEN
AIM: This article presents an updated review about the definition, diagnostic criteria, classifications, etiology and the evolution of the specific language impairment (SLI). DEVELOPMENT: The specific language impairment is characterized by a developmental language delay and an impaired language, that persist over time and it is not explained by sensorial, motor and mental disabilities, neither by psycopathological disorders, socio-emotional deprivation, nor brain injury. The diagnosis is based on exclusional criteria. Some researchers propose different classifications considering the children performance in language comprehension and language production. Genetical linkage to the FOXP2 gen in the SPCH1 region of the chromosome 7 and to the chromosomes 13, 16 y 19 has been reported. The neuroimage studies have shown alterations in the volume and perfusion of some brain structures related to language. The manifestations of SLI may change during the development of the children and may disturb the self-esteem, the academic performance and the social abilities. CONCLUSIONS: The variability in the linguistic and cognitive performance, and the variety in the etiological findings in children with SLI, don't allow to settle the affected population as an homogeneous group. Different theoretical positions have emerged as a consequence of this condition.