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1.
J Bodyw Mov Ther ; 27: 628-633, 2021 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-34391298

RESUMEN

OBJECTIVE: To evaluate the effectiveness of an intervention with dual task based on trail making test on gait, cognition and daily activities execution in individuals with Parkinson's disease. DESIGN: Randomized controlled trial. METHODOLOGY: 10 individuals with Parkinson's Disease (PD) were divided into dual task group (DTG) and control group (CG). Were realized 16 dual task (DT) training sessions based on the Trail Making Test (TMT) for DTG and a conventional training protocol for CG. Pre and post intervention assessments used the 6 minute walk test (T6), TMT, Katz Index and Falls Efficacy Scale (FES). RESULTS: Comparing the difference between pre and post intervention values between groups, there was no significant difference for T6 (p=0,36). In TMT there was a significant difference (p=0,03), showing shorter times for DTG. The tests used for time values in the Katz index tasks showed an important difference for the DTG (P=0,02). As for the results of the FES, they did not show pre and post changes in the DTG (0,45) and in the CG (p= 0,29) and not even between the groups (p=0,45). CONCLUSION: The proposed intervention was able to promote improvements in the performance of daily life activities, learning adaptations and retention of motor and cognitive aspects, which may reflect positively in the daily lives of patients with PD and, consequently, greater autonomy to perform these types of activities.


Asunto(s)
Enfermedad de Parkinson , Accidentes por Caídas , Cognición , Marcha , Humanos , Prueba de Secuencia Alfanumérica
2.
NeuroRehabilitation ; 48(2): 195-208, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33664157

RESUMEN

BACKGROUND: The burden of post-stroke cognitive impairment, as well as affective disorders, remains persistently high. With improved stroke survival rates and increasing life expectancy, there is a need for effective interventions to facilitate remediation of neurocognitive impairments and post-stroke mood disorders. OBJECTIVE: To investigate the effects of Therapeutic Instrumental Music Performance (TIMP) training with and without Motor Imagery on cognitive functioning and affective responding in chronic post-stroke individuals. METHODS: Thirty chronic post-stroke, community-dwelling participants were randomized to one of three experimental arms: (1) 45 minutes of active TIMP, (2) 30 minutes of active TIMP followed by 15 minutes of metronome-cued motor imagery (TIMP+cMI), (3) 30 minutes of active TIMP followed by 15 minutes of motor imagery without cues (TIMP+MI). Training took place three times a week for three weeks, using a selection of acoustic and electronic instruments. Assessments, administered at two baselines and post-training, included the Trail Making Test (TMT) - Part B to assess mental flexibility, the Digit Span Test (DST) to determine short-term memory capacity, the Multiple Affect Adjective Checklist - Revised (MAACL-R) to ascertain current affective state, and the General Self-Efficacy Scale (GSE) to assess perceived self-efficacy. The Self-Assessment Maniqin (SAM) was also administered prior to and following each training session. RESULTS: Thirty participants completed the protocol, ten per arm [14 women; mean age = 55.9; mean time post-stroke = 66.9 months]. There were no statistically significant differences between pooled group baseline measures. The TIMP+MI group showed a statistically significant decrease in time from pre-test 2 to post-test on the TMT. The TIMP group showed a significant increase on MAACL sensation seeking scores, as well as on the Valence and Dominance portions of the SAM; TIMP+cMI showed respective increases and decreases in positive and negative affect on the MAACL, and increases on the Valence, Dominance, and Arousal portions of the SAM. No statistically significant association between cognitive and affective measures was obtained. CONCLUSIONS: The mental flexibility aspect of executive functioning appears to be enhanced by therapeutic instrumental music training in conjunction with motor imagery, possibly due to multisensory integration and consolidation of representations through motor imagery rehearsal following active practice. Active training using musical instruments appears to have a positive impact on affective responding; however, these changes occurred independently of improvements to cognition.


Asunto(s)
Cognición/fisiología , Imágenes en Psicoterapia/métodos , Musicoterapia/métodos , Rehabilitación de Accidente Cerebrovascular/métodos , Accidente Cerebrovascular/terapia , Adulto , Anciano , Señales (Psicología) , Función Ejecutiva/fisiología , Femenino , Humanos , Imágenes en Psicoterapia/tendencias , Masculino , Persona de Mediana Edad , Música/psicología , Musicoterapia/tendencias , Accidente Cerebrovascular/psicología , Rehabilitación de Accidente Cerebrovascular/psicología , Prueba de Secuencia Alfanumérica , Resultado del Tratamiento
3.
Vasc Health Risk Manag ; 16: 367-377, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33061398

RESUMEN

BACKGROUND: High-intensity statin is recommended in high-risk type 2 diabetes (T2D); however, statin dose dependently increases the risk of developing new-onset diabetes, can potentially worsen glycemic control in T2D, and may cause cognitive impairment. This study aimed to investigate the effect of statin intensification on glucose homeostasis and cognitive function in T2D. MATERIALS AND METHODS: T2D patients who were taking simvastatin ≤20 mg/day were randomized to continue taking the same dosage of simvastatin (low-dose simvastatin group; LS, n=63) for 12 weeks, or to change to atorvastatin 40 mg/day for 6 weeks, and if tolerated, atorvastatin was increased to 80 mg/day for 6 weeks (high-dose atorvastatin group; HS, n=62). Fasting plasma glucose (FPG), glycated hemoglobin (HbA1c), plasma insulin, homeostatic model assessment of insulin resistance (HOMA-IR) and of ß-cell function (HOMA-B), cognitive functions using Montreal Cognitive Assessment (MoCA), and Trail Making Test (TMT) were assessed at baseline, 6 weeks, and 12 weeks. RESULTS: Mean age of patients was 58.8±8.9 years, and 72% were female. Mean baseline FPG and HbA1c were 124.0±27.5 mg/dl and 6.9±0.8%, respectively. No differences in baseline characteristics between groups were observed. Change in HbA1c from baseline in the LS and HS groups was -0.1% and +0.1% (p=0.03) at 6 weeks, and -0.1% and +0.1% (p=0.07) at 12 weeks. There were no significant differences in FPG, fasting plasma insulin, HOMA-B, HOMA-IR, MoCA score, or TMT between groups at 6 or 12 weeks. CONCLUSION: Switching from low-dose simvastatin to high-dose atorvastatin in T2D resulted in a slight increase in HbA1c (0.1%) without causing cognitive decline.


Asunto(s)
Atorvastatina/administración & dosificación , Glucemia/efectos de los fármacos , Cognición/efectos de los fármacos , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Sustitución de Medicamentos , Inhibidores de Hidroximetilglutaril-CoA Reductasas/administración & dosificación , Simvastatina/administración & dosificación , Anciano , Atorvastatina/efectos adversos , Biomarcadores/sangre , Glucemia/metabolismo , Diabetes Mellitus Tipo 2/sangre , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/psicología , Femenino , Hemoglobina Glucada/metabolismo , Homeostasis , Humanos , Inhibidores de Hidroximetilglutaril-CoA Reductasas/efectos adversos , Masculino , Pruebas de Estado Mental y Demencia , Persona de Mediana Edad , Simvastatina/efectos adversos , Tailandia , Factores de Tiempo , Prueba de Secuencia Alfanumérica , Resultado del Tratamiento
4.
Hear Res ; 392: 107982, 2020 07.
Artículo en Inglés | MEDLINE | ID: mdl-32454368

RESUMEN

It has been hypothesized that noise-induced cochlear synaptopathy in humans may result in functional deficits such as a weakened middle ear muscle reflex (MEMR) and degraded speech perception in complex environments. Although relationships between noise-induced synaptic loss and the MEMR have been demonstrated in animals, effects of noise exposure on the MEMR have not been observed in humans. The hypothesized relationship between noise exposure and speech perception has also been difficult to demonstrate conclusively. Given that the MEMR is engaged at high sound levels, relationships between speech recognition in complex listening environments and noise exposure might be more evident at high speech presentation levels. In this exploratory study with 41 audiometrically normal listeners, a combination of behavioral and physiologic measures thought to be sensitive to synaptopathy were used to determine potential links with speech recognition at high presentation levels. We found decreasing speech recognition as a function of presentation level (from 74 to 104 dBA), which was associated with reduced MEMR magnitude. We also found that reduced MEMR magnitude was associated with higher estimated lifetime noise exposure. Together, these results suggest that the MEMR may be sensitive to noise-induced synaptopathy in humans, and this may underlie functional speech recognition deficits at high sound levels.


Asunto(s)
Oído Medio/inervación , Pérdida Auditiva Provocada por Ruido/psicología , Audición , Ruido/efectos adversos , Reconocimiento en Psicología , Reflejo , Inteligibilidad del Habla , Percepción del Habla , Estimulación Acústica , Adulto , Audiometría de Tonos Puros , Cognición , Comprensión , Femenino , Pérdida Auditiva Provocada por Ruido/etiología , Pérdida Auditiva Provocada por Ruido/fisiopatología , Humanos , Masculino , Persona de Mediana Edad , Prueba de Secuencia Alfanumérica , Adulto Joven
5.
J Alzheimers Dis ; 74(1): 65-77, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32176647

RESUMEN

BACKGROUND: Cerebrovascular disease is a common cause of dementia in older adults, and potentially preventable with early intervention. Oxylipins are produced from the oxidation of long-chain polyunsaturated fatty acids (PUFA) possessing potent vascular effects. Oxylipins generated from the cytochrome P450 pathway are enzymatically converted to diols by soluble epoxide hydrolase (sEH); sEH products have been associated with small vessel ischemic disease. Little is known about oxylipins' impact on markers of dementia risk. OBJECTIVE: An exploratory examination of the association between omega-6 and omega-3 derived oxylipins, brain MRI, and cognition. METHODS: Thirty-seven non-demented participants with controlled hypertension (mean age 65.6 years) were enrolled in a dementia prevention study investigating fish oil and lipoic acid on preserving cognitive function. Baseline associations between plasma oxylipins, white matter hyperintensity (WMH), and Trails-B were examined using linear regression. P450-derived diol/epoxide ratio was an indirect measure of sEH activity. RESULTS: Omega-6 derived 9-HODE was associated with increased WMH (p = 0.017) and reduced grey matter volume (p = 0.02). Omega-6 P450-derived diol/epoxide ratio 9,10-DiHOME/9,10-EpOME was associated with increased WMH (p = 0.035) and poorer performance on Trails-B (p = 0.05); ratio14,15-DHET/14,15-EET was associated with increased WMH (p = 0.045). Omega-3 P450-derived diol/epoxide ratio 19,20-DiHDPE/19,20-EpDPE was associated with increased WMH (p = 0.04) and poorer performance on Trails-B (p = 0.04). Arachidonic acid was associated with better performance on Trails-B (p = 0.012); Omega-3 derived 16,17-EpDPE was associated with decreased WMH (p = 0.005). CONCLUSIONS: With the exception of arachidonic acid, it was specific oxylipin products, not their parent PUFAs, that were associated with unfavorable and favorable MRI and cognitive markers of dementia risk.


Asunto(s)
Cognición/efectos de los fármacos , Función Ejecutiva , Ácidos Grasos Omega-3/química , Ácidos Grasos Omega-6/química , Hipertensión/diagnóstico por imagen , Hipertensión/psicología , Oxilipinas/efectos adversos , Sustancia Blanca/diagnóstico por imagen , Anciano , Encéfalo/diagnóstico por imagen , Estudios de Cohortes , Estudios Transversales , Femenino , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Desempeño Psicomotor/efectos de los fármacos , Prueba de Secuencia Alfanumérica
6.
Biol Psychol ; 146: 107725, 2019 09.
Artículo en Inglés | MEDLINE | ID: mdl-31276756

RESUMEN

Cognitive changes with aging have been connected to deficiency in early-stage cortical repetition suppression (RS) and mismatch negativity (MMN). Here, we intended to investigate age-associated alterations of auditory RS and MMN by using a roving standard paradigm, and examine their relations to cognitive performances. Twenty-two young and 22 elderly adults were recorded with a magnetoencephalography. The Chinese Version Verbal Learning Test (CVVLT) and Trail Making Test (TMT) were administered to the older group. Compared to the younger, the elderly exhibited reduced magnitudes of P50m RS in temporal region, and of N100m RS in fronto-temporo-parietal networks. Weaker MMNm responses were also observed. Moreover, practice time of TMT B-A was significantly negatively correlated to magnitude of RS in frontal areas. These findings suggested an age-related decline of early-stage auditory information processing. Conclusively, in the elderly, frontal lobe plays a role in the modulation of automatic cortical filtering and competence of attentional shifting.


Asunto(s)
Envejecimiento/psicología , Cognición/fisiología , Pruebas Neuropsicológicas , Estimulación Acústica , Adulto , Anciano , Femenino , Lóbulo Frontal/fisiología , Humanos , Magnetoencefalografía , Masculino , Procesos Mentales , Persona de Mediana Edad , Red Nerviosa/fisiología , Lóbulo Parietal/fisiología , Lóbulo Temporal/fisiología , Prueba de Secuencia Alfanumérica , Aprendizaje Verbal , Adulto Joven
7.
Exp Aging Res ; 45(1): 41-56, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30633644

RESUMEN

Background/Study context: Posture and gait are complex sensorimotor functions affected by age. These difficulties are particularly apparent when performing cognitively demanding tasks. Characterizing the functional organization of brain networks involved in these associations remains a challenge because of the incompatibility of brain imagery techniques with gross body movements. The present study aimed at testing whether resting-state functional connectivity of sensorimotor networks is associated with posture and gait performance recorded offline, in young and older adults. METHODS: Young (n = 12, mean = 24.1 y/o) and older (n = 14, mean = 65.6 y/o) healthy adults were tested for stability of their posture and gait. Four hours later, anatomical and functional brain imaging data were collected with Magnetic Resonance Imaging (MRI). Bilateral precentral and postcentral gyri were used as seeds in a graph theory analysis focused on global and local efficiency. The possible association between these data and posture and gait performance was examined. RESULTS: Both samples presented similar sensorimotor graphs, but with different global and local efficiencies (small world properties). The association between the networks' graph measures and posture and gait performance also differed across groups: local efficiency was correlated with gait stability in challenging conditions in older adults, but not in young adults. CONCLUSION: This exploratory study suggests that combining analyses of functional networks and offline body movement may provide important information about motor function. In older adults, the association between graph properties of the sensorimotor network and gait performance in challenging conditions may be indicative of compensatory processes. Prospective studies involving more subjects with a larger age range are warranted.


Asunto(s)
Envejecimiento/fisiología , Envejecimiento/psicología , Marcha/fisiología , Red Nerviosa/crecimiento & desarrollo , Red Nerviosa/fisiología , Postura/fisiología , Anciano , Mapeo Encefálico , Cognición/fisiología , Humanos , Imagen por Resonancia Magnética , Masculino , Pruebas Neuropsicológicas , Estudios Prospectivos , Prueba de Secuencia Alfanumérica , Adulto Joven
8.
Hear Res ; 371: 53-65, 2019 01.
Artículo en Inglés | MEDLINE | ID: mdl-30500619

RESUMEN

Understanding cortical processing of spectrally degraded speech in normal-hearing subjects may provide insights into how sound information is processed by cochlear implant (CI) users. This study investigated electrocorticographic (ECoG) responses to noise-vocoded speech and related these responses to behavioral performance in a phonemic identification task. Subjects were neurosurgical patients undergoing chronic invasive monitoring for medically refractory epilepsy. Stimuli were utterances /aba/ and /ada/, spectrally degraded using a noise vocoder (1-4 bands). ECoG responses were obtained from Heschl's gyrus (HG) and superior temporal gyrus (STG), and were examined within the high gamma frequency range (70-150 Hz). All subjects performed at chance accuracy with speech degraded to 1 and 2 spectral bands, and at or near ceiling for clear speech. Inter-subject variability was observed in the 3- and 4-band conditions. High gamma responses in posteromedial HG (auditory core cortex) were similar for all vocoded conditions and clear speech. A progressive preference for clear speech emerged in anterolateral segments of HG, regardless of behavioral performance. On the lateral STG, responses to all vocoded stimuli were larger in subjects with better task performance. In contrast, both behavioral and neural responses to clear speech were comparable across subjects regardless of their ability to identify degraded stimuli. Findings highlight differences in representation of spectrally degraded speech across cortical areas and their relationship to perception. The results are in agreement with prior non-invasive results. The data provide insight into the neural mechanisms associated with variability in perception of degraded speech and potentially into sources of such variability in CI users.


Asunto(s)
Corteza Auditiva/fisiología , Percepción del Habla/fisiología , Estimulación Acústica , Adulto , Corteza Auditiva/anatomía & histología , Implantes Cocleares , Electrocorticografía , Femenino , Ritmo Gamma/fisiología , Humanos , Masculino , Persona de Mediana Edad , Fonética , Espectrografía del Sonido , Acústica del Lenguaje , Lóbulo Temporal/anatomía & histología , Lóbulo Temporal/fisiología , Prueba de Secuencia Alfanumérica , Adulto Joven
9.
Epilepsy Behav ; 86: 102-107, 2018 09.
Artículo en Inglés | MEDLINE | ID: mdl-30017834

RESUMEN

PURPOSE: The study aimed to examine the relationship between frontal lobe functions and interictal electroencephalography (EEG) discharge characteristics of patients with juvenile myoclonic epilepsy (JME). METHOD: Thirty patients with JME who had EEG with asymmetrical generalized discharge (aEEG), 15 patients with JME who had EEG with symmetrical generalized discharge (sEEG), and 15 healthy controls were included in the study. To evaluate attention, the digit span and Corsi block tests were used; to evaluate memory, we applied verbal and visual memory tests; to evaluate frontal lobe functions, we used clock drawing, verbal fluency, the Stroop test, trail making, mental control, and antisaccadic eye movement tests as well as the continuous performance (CPT) tests. ETHICAL CONSIDERATIONS: The research was approved by the Research Ethics Committee of the Bakirkoy Research and Training Hospital for Psychiatry, Neurology, Neurosurgery, with protocol number: 41340010/4891-262, date: 05.02.2013. RESULTS: The mean age of the 45 patients with JME was 22.89 ±â€¯6.77 years, and 34 (75.6%) were female. The age at onset of seizures and disease duration of the patients with JME was 15.56 ±â€¯4.06 years (range, 9-26 years) and 7.20 ±â€¯5.59 years (range, 1-25 years), respectively. All patients were under valproate (VPA) treatment, and the mean VPA dosage was 783.33 ±â€¯379.14 mg/day. Patients with JME scored worse than the control group in attention, memory, and frontal lobe functions. In patients with aEEG, scores of attention, memory, and frontal lobe function tests were lower than in patients with sEEG; however, with the exception of CPT, they were not statistically significant. CONCLUSION: Cognitive functions in JME have been shown to be impaired. Furthermore, we concluded that the frontal lobe cognitive functions may be worse in patients with aEEG than in patients with sEEG. Further studies in patients with JME with aEEG abnormalities may lead to a better understanding of the pathophysiology of JME.


Asunto(s)
Cognición , Electroencefalografía , Lóbulo Frontal/fisiopatología , Epilepsia Mioclónica Juvenil/fisiopatología , Epilepsia Mioclónica Juvenil/psicología , Adolescente , Adulto , Edad de Inicio , Anticonvulsivantes/uso terapéutico , Atención , Función Ejecutiva , Movimientos Oculares , Femenino , Humanos , Masculino , Memoria , Epilepsia Mioclónica Juvenil/tratamiento farmacológico , Pruebas Neuropsicológicas , Test de Stroop , Prueba de Secuencia Alfanumérica , Ácido Valproico/uso terapéutico , Conducta Verbal , Adulto Joven
10.
Adv Mind Body Med ; 32(3): 4-11, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-31370032

RESUMEN

OBJECTIVE: Many activities within our daily lives require us to stand upright while concurrently performing a cognitive task (ie, dual tasking). The "costs" of dual tasking can present as a detriment to either task, or even both. Evidence supports that tai chi (TC), a mind-body exercise, improves both postural control and cognition. The purpose of this study was to (1) determine whether long-term TC training reduces dual-task costs to standing postural control, and (2) determine whether it characterizes the relationship between these costs and cognition in aging adults with and without long-term TC training. METHODS: Twenty-six TC experts (age 63 ± 8 y, TC experience 24 ± 11 y) and 60 controls (TC naïve: age 64 ± 8 y) were studied. Center-of-pressure sway speed and elliptical area were recorded during quiet and dual-task standing. In addition, postural sway speed and range were analyzed in the anterior-posterior and medial-lateral direction. Dual-task cost was calculated as the percent change in center-of-pressure outcomes from quiet to dual-task conditions. Cognition was assessed with the digit span (verbal memory), trail making test (working memory and task switching ability), category naming (semantic verbal fluency), and F-A-S test (phonemic verbal fluency). RESULTS: TC experts had significantly lower dual-task costs to postural control in elliptical area (16.1 vs 110.4%, 95% confidence interval [CI], -94.27 to -0.07) compared with TC-naïves. TC experts also performed better on the digit span (23.5 vs 19.2; 95% CI, 0.68 to 3.59), trail making test A (28.5 vs 32.6 s; 95% CI, -3.83 to -0.21), and category naming (46.2 vs 41.3, 95%, CI 0.80 to 4.09), compared with TC naïves. There was not a clear significant association between better cognitive functioning and lower dual-task costs for either groups. These group differences and associations were independent of age, body mass index, education, and physical activity level. CONCLUSIONS: These observations suggest cognitive-motor benefits from TC and the need for future controlled trials.


Asunto(s)
Cognición , Equilibrio Postural , Taichi Chuan , Anciano , Envejecimiento/fisiología , Envejecimiento/psicología , Estudios de Casos y Controles , Femenino , Humanos , Masculino , Memoria a Corto Plazo , Persona de Mediana Edad , Prueba de Secuencia Alfanumérica
11.
Int J Geriatr Psychiatry ; 33(2): 271-278, 2018 02.
Artículo en Inglés | MEDLINE | ID: mdl-28401595

RESUMEN

OBJECTIVES: In a randomised controlled trial, we investigated whether a cognitive training based on rhythm-music and music improvisation exercises had positive effects on executive functions in older participants. METHODS: Thirty-five residents in a guest home with mild-moderate cognitive impairment and healthy ageing were randomly assigned to an experimental group (n = 18) featuring cognitive music training composed of 12 bi-weekly 70-min sessions, and a control group (n = 17) attended 12 bi-weekly 45-min sessions of gymnastic activities offered by the institute. A neuropsychological test battery was administered at baseline and at the end of treatment, including the Mini-Mental State Examination, verbal fluency test, Trail Making Test A, attentional matrices test and clock-drawing test. RESULTS: Pre-test and post-test comparison showed a significant improvement for the experimental group reflected in the Mini-Mental State Examination (F(1,33) = 13.906; p < 0.001; pη2  = 0.296), verbal fluency test (VFL) (F(1,33) = 6.816; p < 0.013; pη2  = 0.171), and clock-drawing test (F(1,29) = 16.744; p < 0.001; pη2  = 0.366), while the control group did not show any significant improvements. In addition, there was a tendency towards significance for the Trail Making Test A (F(1,20) = 3.268; p < 0.086; pη2  = 0.140). Regarding the attentional matrices test, no significant differences were found for the experimental group (F(1,29) = 2.833; p < 0.103; pη2  = 0.089), while the control group had a significant performance reduction (F(1,29) = 3.947; p < 0.050; pη2  = 0.120). CONCLUSION: The use of a cognitive protocol based on music-rhythmic exercises and music improvisation exercises is associated with improved cognitive functions in older people with mild-moderate cognitive impairment regardless of the individual's degree of cognitive reserve. Copyright © 2017 John Wiley & Sons, Ltd.


Asunto(s)
Trastornos del Conocimiento/terapia , Musicoterapia/métodos , Anciano , Anciano de 80 o más Años , Atención/fisiología , Escalas de Valoración Psiquiátrica Breve , Cognición/fisiología , Trastornos del Conocimiento/fisiopatología , Disfunción Cognitiva/terapia , Función Ejecutiva/fisiología , Femenino , Humanos , Masculino , Pruebas Neuropsicológicas , Prueba de Secuencia Alfanumérica
12.
Brain ; 140(4): 1100-1106, 2017 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-28335012

RESUMEN

Working memory impairment is prevalent in brain injured patients across lesion aetiologies and severities. Unfortunately, rehabilitation efforts for this impairment have hitherto yielded small or no effects. Here we show in a randomized actively controlled trial that working memory performance can be effectively restored by suggesting to hypnotized patients that they have regained their pre-injury level of working memory functioning. Following four 1-h sessions, 27 patients had a medium-sized improvement relative to 22 active controls (Bayes factors of 342 and 37.5 on the two aggregate outcome measures) and a very large improvement relative to 19 passive controls (Bayes factor = 1.7 × 1013). This was a long-term effect as revealed by no deterioration following a 6.7 week no-contact period (Bayes factors = 7.1 and 1.3 in favour of no change). To control for participant-specific effects, the active control group was crossed over to the working memory suggestion and showed superior improvement. By the end of the study, both groups reached a performance level at or above the healthy population mean with standardized mean differences between 1.55 and 2.03 relative to the passive control group. We conclude that, if framed correctly, hypnotic suggestion can effectively improve working memory following acquired brain injury. The speed and consistency with which this improvement occurred, indicate that there may be a residual capacity for normal information processing in the injured brain.


Asunto(s)
Lesiones Encefálicas/psicología , Lesiones Encefálicas/terapia , Hipnosis/métodos , Memoria a Corto Plazo , Adulto , Anciano , Lesiones Traumáticas del Encéfalo/psicología , Lesiones Traumáticas del Encéfalo/terapia , Función Ejecutiva , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pruebas Neuropsicológicas , Desempeño Psicomotor , Accidente Cerebrovascular/psicología , Accidente Cerebrovascular/terapia , Rehabilitación de Accidente Cerebrovascular/métodos , Prueba de Secuencia Alfanumérica , Resultado del Tratamiento , Escalas de Wechsler
13.
J Music Ther ; 53(3): 279-307, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-27235114

RESUMEN

BACKGROUND: People with acquired brain injury (ABI) are highly susceptible to disturbances in executive functioning (EF), and these effects are pervasive. Research studies using music therapy for cognitive improvement in this population are limited. OBJECTIVE: The purpose of this study was to determine the feasibility of a Musical Executive Function Training (MEFT) intervention to address task-shifting skills in adults with ABI and to obtain preliminary evidence of intervention effect on task shifting. METHODS: Fourteen participants were randomly assigned to one of three groups: a music therapy intervention group (MTG), a singing group (SG), or the no-intervention control group (CG). The SG and MTG met for one hour a day for five days. Feasibility measures included participant completion rates and intervention fidelity. Potential benefits were measured using the Trail Making Test and the Paced Auditory Serial Addition Task as a pre- and posttest measure. RESULTS: Participant completion rates and interventionist fidelity to the protocol supported feasibility. One-way ANOVA of the pre- and posttest group differences revealed a trend toward improvement in the MTG over the SG. CONCLUSIONS: Feasibility and effect size data support a larger trial of the MEFT protocol.


Asunto(s)
Lesiones Encefálicas/rehabilitación , Función Ejecutiva , Musicoterapia/métodos , Música , Adulto , Anciano , Análisis de Varianza , Lesiones Encefálicas/complicaciones , Estudios de Factibilidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Prueba de Secuencia Alfanumérica , Resultado del Tratamiento
14.
Clin Neurol Neurosurg ; 117: 12-21, 2014 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-24438798

RESUMEN

OBJECTIVE: Approximately 97% of the right-handers has left hemisphere language dominance. Within the language dominant hemisphere Broca's area is of crucial importance for a variety of linguistic functions. As a result, tumour resection in and around Broca's area is controversial. However, studies showed that by means of Direct Electrical Stimulation (DES) tumour resection in this region can be safely performed. We report unexpected anatomoclinical findings in a right-handed patient who underwent tumour resection in the left prefrontal lobe. METHODS: Language functions in this right-handed patient were extensively examined in the pre-, intra-, and postoperative phase by means of a standardised battery of neurolinguistic and neurocognitive tests. Results obtained in the pre- and postoperative phase are compared. In addition, intraoperative DES findings and postoperative functional Magnetic Resonance Imaging (fMRI) and Diffusion Tensor Imaging (DTI) results are reported. RESULTS: Tumour resection near Broca's area was safely performed since no positive language sites were found during intraoperative DES. Since no linguistic deficits occurred in the pre-, intra-, or postoperative phase, atypical language dominance was suspected. Neuropsychological investigations, however, disclosed permanent executive dysfunction. Postoperative fMRI and DTI confirmed right cerebral language dominance as well as a crossed cerebro-cerebellar functional link with the left cerebellar hemisphere. DISCUSSION: Atypical right hemisphere language dominance in this right-handed patient is reflected by: (1) the total absence of language problems in the pre-, intra- and postoperative phase, (2) absence of positive stimulation sites during DES, (3) a clearly more pronounced arcuate fasciculus in the right cerebral hemisphere (DTI), (4) a crossed functional connection between the right cerebrum and the left cerebellum (fMRI). Two hypothetical explanations for the pattern of crossed cerebral language dominance are put forward: (1) preoperative brain plasticity mechanisms inducing a shift of language functions to the right hemisphere or (2) right hemisphere language dominance as a maturational variant. This case with atypical cerebral language dominance shows that although DES is the 'gold standard' to identify eloquent language regions and their pathways, fMRI and DTI are important adjuncts to guide surgery, to identify language lateralisation and to study anatomoclinical correlations.


Asunto(s)
Dominancia Cerebral/fisiología , Lateralidad Funcional/fisiología , Lenguaje , Adulto , Mapeo Encefálico , Neoplasias Encefálicas/fisiopatología , Neoplasias Encefálicas/psicología , Neoplasias Encefálicas/cirugía , Imagen de Difusión Tensora , Terapia por Estimulación Eléctrica , Femenino , Glioma/fisiopatología , Glioma/psicología , Glioma/cirugía , Humanos , Procesamiento de Imagen Asistido por Computador , Pruebas del Lenguaje , Imagen por Resonancia Magnética , Pruebas Neuropsicológicas , Procedimientos Neuroquirúrgicos , Convulsiones/complicaciones , Prueba de Secuencia Alfanumérica , Escalas de Wechsler
15.
Appl Psychophysiol Biofeedback ; 38(1): 17-28, 2013 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-22903518

RESUMEN

EEG-biofeedback has been reported to reduce symptoms of autism spectrum disorders (ASD) in several studies. However, these studies did not control for nonspecific effects of EEG-biofeedback and did not distinguish between participants who succeeded in influencing their own EEG activity and participants who did not. To overcome these methodological shortcomings, this study evaluated the effects of EEG-biofeedback in ASD in a randomized pretest-posttest control group design with blinded active comparator and six months follow-up. Thirty-eight participants were randomly allocated to the EEG-biofeedback, skin conductance (SC)-biofeedback or waiting list group. EEG- and SC-biofeedback sessions were similar and participants were blinded to the type of feedback they received. Assessments pre-treatment, post-treatment, and after 6 months included parent ratings of symptoms of ASD, executive function tasks, and 19-channel EEG recordings. Fifty-four percent of the participants significantly reduced delta and/or theta power during EEG-biofeedback sessions and were identified as EEG-regulators. In these EEG-regulators, no statistically significant reductions of symptoms of ASD were observed, but they showed significant improvement in cognitive flexibility as compared to participants who managed to regulate SC. EEG-biofeedback seems to be an applicable tool to regulate EEG activity and has specific effects on cognitive flexibility, but it did not result in significant reductions in symptoms of ASD. An important finding was that no nonspecific effects of EEG-biofeedback were demonstrated.


Asunto(s)
Encéfalo/fisiopatología , Trastornos Generalizados del Desarrollo Infantil/terapia , Respuesta Galvánica de la Piel/fisiología , Neurorretroalimentación/métodos , Adolescente , Niño , Trastornos Generalizados del Desarrollo Infantil/fisiopatología , Trastornos Generalizados del Desarrollo Infantil/psicología , Femenino , Humanos , Masculino , Prueba de Secuencia Alfanumérica , Resultado del Tratamiento
16.
Int J Audiol ; 52(1): 14-22, 2013 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-23088164

RESUMEN

OBJECTIVE: The aim was to investigate the relationship between cognitive ability and frequency compressed speech recognition in listeners with normal hearing and normal cognition. DESIGN: Speech-in-noise recognition was measured using Institute of Electrical and Electronic Engineers sentences presented over earphones at 65 dB SPL and a range of signal-to-noise ratios. There were three conditions: unprocessed, and at frequency compression ratios of 2:1 and 3:1 (cut-off frequency, 1.6 kHz). Working memory and cognitive ability were measured using the reading span test and the trail making test, respectively. STUDY SAMPLE: Participants were 15 young normally-hearing adults with normal cognition. RESULTS: There was a statistically significant reduction in mean speech recognition from around 80% when unprocessed to 40% for 2:1 compression and 30% for 3:1 compression. There was a statistically significant relationship between speech recognition and cognition for the unprocessed condition but not for the frequency-compressed conditions. CONCLUSIONS: The relationship between cognitive functioning and recognition of frequency compressed speech-in-noise was not statistically significant. The findings may have been different if the participants had been provided with training and/or time to 'acclimatize' to the frequency-compressed conditions.


Asunto(s)
Cognición , Reconocimiento en Psicología , Percepción del Habla , Estimulación Acústica , Adulto , Análisis de Varianza , Audiometría del Habla , Femenino , Humanos , Masculino , Memoria , Ruido/efectos adversos , Enmascaramiento Perceptual , Detección de Señal Psicológica , Prueba de Secuencia Alfanumérica
17.
Clin Neurol Neurosurg ; 111(10): 889-92, 2009 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-19733961

RESUMEN

We report a 48-year-old patient with neuro-Behcet's disease who presented with the combination of severe memory impairment and frontal/executive dysfunction. The clinical feature mimicked that of diencephalic amnesic syndrome. The MRI and SPECT findings supported the notion that the thalamus and related subcortical-frontal connection was responsible for this patient's problem.


Asunto(s)
Amnesia/etiología , Amnesia/psicología , Síndrome de Behçet/psicología , Lóbulo Frontal/patología , Amnesia/diagnóstico por imagen , Atención/fisiología , Síndrome de Behçet/diagnóstico por imagen , Encéfalo/patología , Cisteína/análogos & derivados , Función Ejecutiva/fisiología , Lóbulo Frontal/diagnóstico por imagen , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Pruebas Neuropsicológicas , Compuestos de Organotecnecio , Radiofármacos , Tomografía Computarizada de Emisión de Fotón Único , Prueba de Secuencia Alfanumérica
18.
J Med Food ; 12(3): 643-8, 2009 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-19627215

RESUMEN

It has been reported that brain factor-7 (BF-7) extracted from Bombyx mori improves cognitive functions in normal juveniles and adults as well as cognitively impaired patients. Clinical studies with normal children evaluated the role of BF-7 on brain function in these patients. The objective of this study was to improve cognitive functions of normal schoolchildren with BF-7. Forty-six normal healthy children were divided into two treatment groups: BF-7 (9.9 +/- 1.18 years old; 9 boys, 14 girls) and placebo (9.8 +/- 1.03 years old; 10 boys, 13 girls). The Color Trails Making Test was used to measure the efficacy of BF-7 on cognition and attention. Results showed that BF-7 reduced the response time by an average of 23% for the Color Trails Making Test. Moreover, BF-7 improved the accuracy of the task around twofold. The results reveal that BF-7 improves brain function for attention and cognitive flexibility in children.


Asunto(s)
Atención/efectos de los fármacos , Bombyx , Cognición/efectos de los fármacos , Proteínas de Insectos/farmacología , Proteínas del Tejido Nervioso/farmacología , Nootrópicos/farmacología , Animales , Bombyx/química , Niño , Femenino , Humanos , Proteínas de Insectos/aislamiento & purificación , Masculino , Proteínas del Tejido Nervioso/aislamiento & purificación , Nootrópicos/aislamiento & purificación , Tiempo de Reacción , Valores de Referencia , Prueba de Secuencia Alfanumérica
19.
J Altern Complement Med ; 14(6): 655-61, 2008 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-18637761

RESUMEN

BACKGROUND: The wide use of herbal plants and essential oils for the prevention and treatment of diseases dates back to ancient times. However, the scientific basis for the beneficial effects of such plants and oils has not been precisely clarified. OBJECTIVE: The purpose of this study was to evaluate the effects of aromatherapy body treatment on healthy subjects. DESIGN: We compared the physiologic and psychologic effects of aromatherapy body treatment (E), massage treatment with carrier oil alone (C), and rest in healthy adults. SUBJECTS: Seven (7) female and 6 male volunteers participated as subjects. INTERVENTIONS: Each subject underwent 3 trials, in which the Advanced Trail Making Test (ATMT) was given as a stress-inducing task before and after 1 of 3 treatments. OUTCOME MEASURES: The State Anxiety Inventory (SAI), the Visual Analog Scale, and the Face Scale were used to assess anxiety, feelings, and mood, respectively. RESULTS: After the treatments, the SAI score and the feelings of fatigue were decreased, the positive and comfortable feelings were increased, and mood improved significantly in C and E. Furthermore, significant declines in the feelings of mental and total fatigue were maintained even after the second ATMT in E. On the other hand, the cortisol concentration in the saliva did not show significant changes in any of the trials. Secretory immunoglobulin A levels in the saliva increased significantly after all treatments. CONCLUSIONS: We conclude that massage treatments, irrespective of the presence of essential oils, are more advantageous than rest in terms of psychologic or subjective evaluations but not in terms of physiologic or objective evaluations. Furthermore, as compared to massage alone, the aromatherapy body treatment provides a stronger and continuous relief from fatigue, especially fatigue of mental origin.


Asunto(s)
Trastornos de Ansiedad/psicología , Trastornos de Ansiedad/terapia , Aromaterapia , Estado de Salud , Prueba de Secuencia Alfanumérica , Adulto , Trastornos de Ansiedad/diagnóstico , Femenino , Humanos , Hidrocortisona/análisis , Inmunoglobulina A/análisis , Masculino , Saliva/química , Índice de Severidad de la Enfermedad , Encuestas y Cuestionarios , Resultado del Tratamiento
20.
J S C Med Assoc ; 104(8): 255-7, 2008 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-19326614

RESUMEN

We explored tasks of cognitive and physical performance in 20 older adult subjects after a 10 week Tai chi program in older adults using a pre-to-post test design. Improvement post intervention was seen in two cognitive measures of executive function and several physical performance measures. Preliminary findings in this non-controlled study suggest the possibility of beneficial effects of Tai chi on cognitive executive function in older adults and support the need to pursue this hypothesis in a randomized controlled trial.


Asunto(s)
Cognición , Taichi Chuan , Análisis y Desempeño de Tareas , Factores de Edad , Anciano , Anciano de 80 o más Años , Análisis de Varianza , Femenino , Evaluación Geriátrica , Humanos , Masculino , Pruebas Neuropsicológicas , Taichi Chuan/métodos , Factores de Tiempo , Prueba de Secuencia Alfanumérica
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