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1.
Neuroepidemiology ; 2024 Jan 31.
Article in English | MEDLINE | ID: mdl-38295775

ABSTRACT

INTRODUCTION, twelve modifiable risk factors (RF) account for 40% of dementia cases worldwide. However, limited data exists on such factors in middle- and low-income countries. We aimed to estimate the population-attributable fractions (PAFs) for the 12 RF in Argentina, assessing changes over a decade, and exploring socioeconomic and sex influences. METHODS, we conducted cross-sectional analyses of the 12 RF from Argentinian surveys conducted in 2009, 2015, and 2018, including 96,321 people. We calculated PAFs, and stratified estimates based on sex and income. RESULTS, we estimated an overall PAF of 59.6%(95%CI=58.9%-60.3%). The largest PAFs were hypertension=9.3%(8.7%-9.9%), physical inactivity=7.4%(6.8%-8.2%), and obesity=7.4%(6.8%-7.9%). Men were more impacted by excessive alcohol, while women by isolation and smoking. Lower income linked to higher PAFs in education, hypertension, and obesity. DISCUSSION, Argentina has a higher PAF for dementia than the world population, with distinct RF distribution. PAF varied by sex and economic status, advocating tailored prevention strategies.

2.
Alzheimers Dement ; 20(7): 4625-4634, 2024 07.
Article in English | MEDLINE | ID: mdl-38824659

ABSTRACT

INTRODUCTION: Recent growth in the functionality and use of technology has prompted an increased interest in the potential for remote or decentralized clinical trials in dementia. There are many potential benefits associated with decentralized medication trials, but we currently lack specific recommendations for their delivery in the dementia field. METHODS: A modified Delphi method engaged an expert panel to develop recommendations for the conduct of decentralized medication trials in dementia prevention. A working group of researchers and clinicians with expertise in dementia trials further refined the recommendations. RESULTS: Overall, the recommendations support the delivery of decentralized trials in dementia prevention provided adequate safety checks and balances are included. A total of 40 recommendations are presented, spanning aspects of decentralized clinical trials, including safety, dispensing, outcome assessment, and data collection. DISCUSSION: These recommendations provide an accessible, pragmatic guide for the design and conduct of remote medication trials for dementia prevention. HIGHLIGHTS: Clinical trials of medication have begun adopting decentralized approaches. Researchers in the field lack guidance on what would be appropriate circumstances and frameworks for what would be appropriate circumstances and frameworks for the use of decentralized trial methods in dementia prevention. The present report provides consensus-based expert recommendations for decentralized clinical trials for dementia prevention.


Subject(s)
Clinical Trials as Topic , Consensus , Dementia , Humans , Dementia/prevention & control , Dementia/drug therapy , Delphi Technique , Research Design/standards
3.
Alzheimers Dement ; 20(6): 4331-4341, 2024 06.
Article in English | MEDLINE | ID: mdl-38706421

ABSTRACT

Ongoing assessment of patients with Alzheimer's disease (AD) in postapproval studies is important for mapping disease progression and evaluating real-world treatment effectiveness and safety. However, interpreting outcomes in the real world is challenging owing to variation in data collected across centers and specialties and greater heterogeneity of patients compared with trial participants. Here, we share considerations for observational postapproval studies designed to collect harmonized longitudinal data from individuals with mild cognitive impairment or mild dementia stage of disease who receive therapies targeting the underlying pathological processes of AD in routine practice. This paper considers key study design parameters, including proposed aims and objectives, study populations, approaches to data collection, and measures of cognition, functional abilities, neuropsychiatric status, quality of life, health economics, safety, and drug utilization. Postapproval studies that capture these considerations will be important to provide standardized data on AD treatment effectiveness and safety in real-world settings.


Subject(s)
Alzheimer Disease , Humans , Alzheimer Disease/therapy , Cognitive Dysfunction , Research Design , Quality of Life , Observational Studies as Topic , Disease Progression
4.
Alzheimers Dement ; 20(4): 2680-2697, 2024 04.
Article in English | MEDLINE | ID: mdl-38380882

ABSTRACT

INTRODUCTION: Amyloidosis, including cerebral amyloid angiopathy, and markers of small vessel disease (SVD) vary across dominantly inherited Alzheimer's disease (DIAD) presenilin-1 (PSEN1) mutation carriers. We investigated how mutation position relative to codon 200 (pre-/postcodon 200) influences these pathologic features and dementia at different stages. METHODS: Individuals from families with known PSEN1 mutations (n = 393) underwent neuroimaging and clinical assessments. We cross-sectionally evaluated regional Pittsburgh compound B-positron emission tomography uptake, magnetic resonance imaging markers of SVD (diffusion tensor imaging-based white matter injury, white matter hyperintensity volumes, and microhemorrhages), and cognition. RESULTS: Postcodon 200 carriers had lower amyloid burden in all regions but worse markers of SVD and worse Clinical Dementia Rating® scores compared to precodon 200 carriers as a function of estimated years to symptom onset. Markers of SVD partially mediated the mutation position effects on clinical measures. DISCUSSION: We demonstrated the genotypic variability behind spatiotemporal amyloidosis, SVD, and clinical presentation in DIAD, which may inform patient prognosis and clinical trials. HIGHLIGHTS: Mutation position influences Aß burden, SVD, and dementia. PSEN1 pre-200 group had stronger associations between Aß burden and disease stage. PSEN1 post-200 group had stronger associations between SVD markers and disease stage. PSEN1 post-200 group had worse dementia score than pre-200 in late disease stage. Diffusion tensor imaging-based SVD markers mediated mutation position effects on dementia in the late stage.


Subject(s)
Alzheimer Disease , Amyloidosis , Cerebral Small Vessel Diseases , Humans , Alzheimer Disease/diagnostic imaging , Alzheimer Disease/genetics , Alzheimer Disease/pathology , Cerebral Small Vessel Diseases/diagnostic imaging , Cerebral Small Vessel Diseases/genetics , Cerebral Small Vessel Diseases/complications , Diffusion Tensor Imaging , Magnetic Resonance Imaging , Mutation/genetics , Presenilin-1/genetics
5.
Alzheimers Dement ; 20(6): 4290-4314, 2024 06.
Article in English | MEDLINE | ID: mdl-38696263

ABSTRACT

Two of every three persons living with dementia reside in low- and middle-income countries (LMICs). The projected increase in global dementia rates is expected to affect LMICs disproportionately. However, the majority of global dementia care costs occur in high-income countries (HICs), with dementia research predominantly focusing on HICs. This imbalance necessitates LMIC-focused research to ensure that characterization of dementia accurately reflects the involvement and specificities of diverse populations. Development of effective preventive, diagnostic, and therapeutic approaches for dementia in LMICs requires targeted, personalized, and harmonized efforts. Our article represents timely discussions at the 2022 Symposium on Dementia and Brain Aging in LMICs that identified the foremost opportunities to advance dementia research, differential diagnosis, use of neuropsychometric tools, awareness, and treatment options. We highlight key topics discussed at the meeting and provide future recommendations to foster a more equitable landscape for dementia prevention, diagnosis, care, policy, and management in LMICs. HIGHLIGHTS: Two-thirds of persons with dementia live in LMICs, yet research and costs are skewed toward HICs. LMICs expect dementia prevalence to more than double, accompanied by socioeconomic disparities. The 2022 Symposium on Dementia in LMICs addressed advances in research, diagnosis, prevention, and policy. The Nairobi Declaration urges global action to enhance dementia outcomes in LMICs.


Subject(s)
Aging , Dementia , Developing Countries , Humans , Dementia/diagnosis , Dementia/therapy , Dementia/epidemiology , Brain , Congresses as Topic , Biomedical Research
6.
Alzheimers Dement ; 20(7): 5009-5026, 2024 07.
Article in English | MEDLINE | ID: mdl-38801124

ABSTRACT

INTRODUCTION: While Latin America (LatAm) is facing an increasing burden of dementia due to the rapid aging of the population, it remains underrepresented in dementia research, diagnostics, and care. METHODS: In 2023, the Alzheimer's Association hosted its eighth satellite symposium in Mexico, highlighting emerging dementia research, priorities, and challenges within LatAm. RESULTS: Significant initiatives in the region, including intracountry support, showcased their efforts in fostering national and international collaborations; genetic studies unveiled the unique genetic admixture in LatAm; researchers conducting emerging clinical trials discussed ongoing culturally specific interventions; and the urgent need to harmonize practices and studies, improve diagnosis and care, and use affordable biomarkers in the region was highlighted. DISCUSSION: The myriad of topics discussed at the 2023 AAIC satellite symposium highlighted the growing research efforts in LatAm, providing valuable insights into dementia biology, genetics, epidemiology, treatment, and care.


Subject(s)
Dementia , Humans , Dementia/therapy , Dementia/diagnosis , Dementia/genetics , Dementia/epidemiology , Latin America/epidemiology , Mexico/epidemiology , Alzheimer Disease/therapy , Alzheimer Disease/diagnosis , Alzheimer Disease/genetics , Biomedical Research , Congresses as Topic
7.
Brain ; 145(12): 4459-4473, 2022 12 19.
Article in English | MEDLINE | ID: mdl-35925685

ABSTRACT

The temporal evolutions and relative orderings of Alzheimer disease biomarkers, including CSF amyloid-ß42 (Aß42), Aß40, total tau (Tau) and phosphorylated tau181 (pTau181), standardized uptake value ratio (SUVR) from the molecular imaging of cerebral fibrillar amyloid-ß with PET using the 11C-Pittsburgh Compound-B (PiB), MRI-based hippocampal volume and cortical thickness and cognition have been hypothesized but not yet fully tested with longitudinal data for all major biomarker modalities among cognitively normal individuals across the adult lifespan starting from 18 years. By leveraging a large harmonized database from 8 biomarker studies with longitudinal data from 2609 participants in cognition, 873 in MRI biomarkers, 519 in PET PiB imaging and 475 in CSF biomarkers for a median follow-up of 5-6 years, we estimated the longitudinal trajectories of all major Alzheimer disease biomarkers as functions of baseline age that spanned from 18 to 103 years, located the baseline age window at which the longitudinal rates of change accelerated and further examined possible modifying effects of apolipoprotein E (APOE) genotype. We observed that participants 18-45 years at baseline exhibited learning effects on cognition and unexpected directions of change on CSF and PiB biomarkers. The earliest acceleration of longitudinal change occurred for CSF Aß42 and Aß42/Aß40 ratio (with an increase) and for Tau, and pTau181 (with a decrease) at the next baseline age interval of 45-50 years, followed by an accelerated increase for PiB SUVR at the baseline age of 50-55 years and an accelerated decrease for hippocampal volume at the baseline age of 55-60 years and finally by an accelerated decline for cortical thickness and cognition at the baseline age of 65-70 years. Another acceleration in the rate of change occurred at the baseline age of 65-70 years for Aß42/Aß40 ratio, Tau, pTau181, PiB SUVR and hippocampal volume. Accelerated declines in hippocampal volume and cognition continued after 70 years. For participants 18-45 years at baseline, significant increases in Aß42 and Aß42/Aß40 ratio and decreases in PiB SUVR occurred in APOE ɛ4 non-carriers but not carriers. After age 45 years, APOE ɛ4 carriers had greater magnitudes than non-carriers in the rates of change for all CSF biomarkers, PiB SUVR and cognition. Our results characterize the temporal evolutions and relative orderings of Alzheimer disease biomarkers across the adult lifespan and the modification effect of APOE ɛ4. These findings may better inform the design of prevention trials on Alzheimer disease.


Subject(s)
Alzheimer Disease , Humans , Adult , Adolescent , Young Adult , Middle Aged , Aged , Aged, 80 and over , Alzheimer Disease/genetics , Longevity , tau Proteins , Positron-Emission Tomography , Amyloid beta-Peptides , Biomarkers , Apolipoproteins E/genetics , Peptide Fragments , Longitudinal Studies
8.
Alzheimers Dement ; 19(7): 2923-2932, 2023 07.
Article in English | MEDLINE | ID: mdl-36640138

ABSTRACT

BACKGROUND: Comparisons of late-onset Alzheimer's disease (LOAD) and autosomal dominant AD (ADAD) are confounded by age. METHODS: We compared biomarkers from cerebrospinal fluid (CSF), magnetic resonance imaging, and amyloid imaging with Pittsburgh Compound-B (PiB) across four groups of 387 cognitively normal participants, 42 to 65 years of age, in the Dominantly Inherited Alzheimer Network (DIAN) and the Adult Children Study (ACS) of LOAD: DIAN mutation carriers (MCs) and non-carriers (NON-MCs), and ACS participants with a positive (FH+) and negative (FH-) family history of LOAD. RESULTS: At baseline, MCs had the lowest age-adjusted level of CSF Aß42 and the highest levels of total and phosphorylated tau-181, and PiB uptake. Longitudinally, MC had similar increase in PiB uptake to FH+, but drastically faster decline in hippocampal volume than others, and was the only group showing cognitive decline. DISCUSSION: Preclinical ADAD and LOAD share many biomarker signatures, but cross-sectional and longitudinal differences may exist.


Subject(s)
Alzheimer Disease , Adult , Humans , Middle Aged , Alzheimer Disease/diagnostic imaging , Alzheimer Disease/genetics , Alzheimer Disease/cerebrospinal fluid , Amyloid beta-Peptides/cerebrospinal fluid , Biomarkers/cerebrospinal fluid , Cognition , Cross-Sectional Studies , Parents , Positron-Emission Tomography
9.
Mult Scler ; 28(8): 1267-1276, 2022 07.
Article in English | MEDLINE | ID: mdl-34931933

ABSTRACT

BACKGROUND: Multiple sclerosis (MS) is commonly associated with decision-making, neurocognitive impairments, and mood and motivational symptoms. However, their relationship may be obscured by traditional scoring methods. OBJECTIVES: To study the computational basis underlying decision-making impairments in MS and their interaction with neurocognitive and neuropsychiatric measures. METHODS: Twenty-nine MS patients and 26 matched control subjects completed a computer version of the Iowa Gambling Task (IGT). Participants underwent neurocognitive evaluation using an expanded version of the Brief Repeatable Battery. Hierarchical Bayesian Analysis was used to estimate three established computational models to compare parameters between groups. RESULTS: Patients showed increased learning rate and reduced loss-aversion during decision-making relative to control subjects. These alterations were associated with: (1) reduced net gains in the IGT; (2) processing speed, executive functioning and memory impairments; and (3) higher levels of depression and current apathy. CONCLUSION: Decision-making deficits in MS patients could be described by the interplay between latent computational processes, neurocognitive impairments, and mood/motivational symptoms.


Subject(s)
Gambling , Multiple Sclerosis , Bayes Theorem , Decision Making , Gambling/complications , Gambling/psychology , Humans , Multiple Sclerosis/complications , Neuropsychological Tests
10.
Alzheimers Dement ; 18(5): 1047-1066, 2022 05.
Article in English | MEDLINE | ID: mdl-35297561

ABSTRACT

INTRODUCTION: We conducted a systematic review and meta-analysis of the cognitive effects of coronavirus disease 2019 (COVID-19) in adults with no prior history of cognitive impairment. METHODS: Searches in Medline/Web of Science/Embase from January 1, 2020, to December 13, 2021, were performed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.  A meta-analysis of the Montreal Cognitive Assessment (MoCA) total score comparing recovered COVID-19 and healthy controls was performed. RESULTS: Oof 6202 articles, 27 studies with 2049 individuals were included (mean age = 56.05 years, evaluation time ranged from the acute phase to 7 months post-infection). Impairment in executive functions, attention, and memory were found in post-COVID-19 patients.  The meta-analysis was performed with a subgroup of 290 individuals and showed a difference in MoCA score between post-COVID-19 patients versus controls (mean difference = -0.94, 95% confidence interval [CI] -1.59, -0.29; P = .0049). DISCUSSION: Patients recovered from COVID-19 have lower general cognition compared to healthy controls up to 7 months post-infection.


Subject(s)
COVID-19 , Cognitive Dysfunction , Adult , Cognition , Cognitive Dysfunction/etiology , Executive Function , Humans , Infant
11.
Alzheimers Dement ; 17(4): 653-664, 2021 04.
Article in English | MEDLINE | ID: mdl-33226734

ABSTRACT

INTRODUCTION: A growing number of dominantly inherited Alzheimer's disease (DIAD) cases have become known in Latin American (LatAm) in recent years. However, questions regarding mutation distribution and frequency by country remain open. METHODS: A literature review was completed aimed to provide estimates for DIAD pathogenic variants in the LatAm population. The search strategies were established using a combination of standardized terms for DIAD and LatAm. RESULTS: Twenty-four DIAD pathogenic variants have been reported in LatAm countries. Our combined dataset included 3583 individuals at risk; countries with highest DIAD frequencies were Colombia (n = 1905), Puerto Rico (n = 672), and Mexico (n = 463), usually attributable to founder effects. We found relatively few reports with extensive documentation on biomarker profiles and disease progression. DISCUSSION: Future DIAD studies will be required in LatAm, albeit with a more systematic approach to include fluid biomarker and imaging studies. Regional efforts are under way to extend the DIAD observational studies and clinical trials to Latin America.


Subject(s)
Alzheimer Disease , Genes, Dominant/genetics , Genetic Heterogeneity , Genetic Predisposition to Disease , Phenotype , Alzheimer Disease/epidemiology , Alzheimer Disease/genetics , Humans , Latin America/epidemiology , Mutation/genetics
12.
Alzheimer Dis Assoc Disord ; 34(1): 54-58, 2020.
Article in English | MEDLINE | ID: mdl-31464690

ABSTRACT

INTRODUCTION: Rapidly progressive dementia (RPD) is a broadly defined clinical syndrome. Our aim was to describe clinical and ancillary study findings in patients with RPD and evaluate their diagnostic performance for the identification of nonchronic neurodegenerative rapidly progressive dementia (ncnRPD). METHODS: We reviewed clinical records and ancillary methods of patients evaluated for RPD at our institution in Buenos Aires, Argentina from 2011 to 2017. We compared findings between chronic neurodegenerative RPD and ncnRPD and evaluated the diagnostic metrics using receiver operating characteristic curves. RESULTS: We included 104 patients with RPD, 29 of whom were chronic neurodegenerative RPD and 75 of whom were ncnRPD. The 6-month time to dementia cutpoint had a sensitivity of 89% and specificity of 100% for ncnRPD, with an area under the receiver operating characteristic curve of 0.965 (95% confidence interval=0.935-0.99; P<0.001). A decision tree that included time to dementia, brain magnetic resonance imaging, and cerebrospinal fluid analysis identified ncnRPD patients with a sensitivity of 100%, specificity of 79%, positive predictive value of 93%, and negative predictive value of 100% overall. DISCUSSION: RPD is a clinical syndrome that comprises different diagnoses, many of them for treatable diseases. Using the time to dementia, brain magnetic resonance imaging, and cerebrospinal fluid analysis when triaging these patients could help identify those diseases that need to be studied more aggressively.


Subject(s)
AIDS Dementia Complex/diagnosis , Disease Progression , Limbic Encephalitis/diagnosis , Neurodegenerative Diseases/diagnosis , Prion Diseases/diagnosis , Aged , Aged, 80 and over , Argentina , Diagnosis, Differential , Female , Humans , Magnetic Resonance Imaging , Male , Middle Aged , Referral and Consultation , Retrospective Studies , Sensitivity and Specificity
13.
Int Psychogeriatr ; 32(11): 1377-1381, 2020 11.
Article in English | MEDLINE | ID: mdl-32729446

ABSTRACT

COVID-19 pandemic in Argentina has affected the care of older adults with dementia deeply. Our objective was to study how the obligatory social isolation affected stress caregiver and burden of care of family members of subjects living with dementia in the community after the initial 4 weeks of quarantine in our setting. We did a questionnaire survey among 80 family caregivers of persons with Alzheimer's disease (AD) or related dementia collected on April 2020. We designed a visual analog scale to test the level of the burden of care. Characteristics of people with dementia and their caregivers were analyzed with descriptive (mean, standard deviation, frequency and percent) and inferential statistics (chi-square test). The sample included older adults (mean age: 80.51 ± 7.65) with different stages of dementia. Family was the primary provider of care in 65%. Overall, COVID-19 confinement increased stress caregiver independently of the dementia stage, but those caring for severe cases had more stress compared to milder forms of the disease. Other findings were that half of the subjects with dementia experienced increased anxiety and that most family members discontinued all sort of cognitive and physical therapies. Family members' main concerns were for severe dementia cases, fear of absence of the paid caregiver during the epidemic, and for mild cases fear of spreading the disease while assisting patients with instrumental activities. A partnership between departments of public health, care workers and families must be planned to guarantee continuity of care during these unique COVID-19 times.


Subject(s)
COVID-19 , Caregiver Burden/psychology , Caregivers/psychology , Cost of Illness , Dementia/psychology , Family/psychology , Quarantine/psychology , Social Isolation/psychology , Stress, Psychological , Adult , Aged , Aged, 80 and over , Anxiety , Argentina , Female , Humans , Male , Middle Aged , Pandemics , SARS-CoV-2 , Surveys and Questionnaires
14.
Alzheimers Dement ; 16(11): 1504-1514, 2020 11.
Article in English | MEDLINE | ID: mdl-32808747

ABSTRACT

INTRODUCTION: Microstructural alterations as assessed by diffusion tensor imaging (DTI) are key findings in both Alzheimer's disease (AD) and small vessel disease (SVD). We determined the contribution of each of these conditions to diffusion alterations. METHODS: We studied six samples (N = 365 participants) covering the spectrum of AD and SVD, including genetically defined samples. We calculated diffusion measures from DTI and free water imaging. Simple linear, multivariable random forest, and voxel-based regressions were used to evaluate associations between AD biomarkers (amyloid beta, tau), SVD imaging markers, and diffusion measures. RESULTS: SVD markers were strongly associated with diffusion measures and showed a higher contribution than AD biomarkers in multivariable analysis across all memory clinic samples. Voxel-wise analyses between tau and diffusion measures were not significant. DISCUSSION: In memory clinic patients, the effect of SVD on diffusion alterations largely exceeds the effect of AD, supporting the value of diffusion measures as markers of SVD.


Subject(s)
Alzheimer Disease/diagnostic imaging , Alzheimer Disease/pathology , Brain/diagnostic imaging , Brain/pathology , Cerebral Small Vessel Diseases/diagnostic imaging , Cerebral Small Vessel Diseases/pathology , Adult , Aged , Diffusion Magnetic Resonance Imaging , Female , Humans , Male , Middle Aged
15.
Eur Eat Disord Rev ; 27(6): 692-699, 2019 11.
Article in English | MEDLINE | ID: mdl-31496005

ABSTRACT

OBJECTIVE: Previous studies have shown theory of mind (ToM) is affected in patients with anorexia nervosa (AN). There has also been growing interest in the study of endophenotypes in psychiatric disorders, since they allow better understanding of genetic mechanisms underlying different conditions, making them potential targets for future treatment. The goal of this study was to investigate whether ToM inefficiencies observed in patients with AN, are shared by unaffected first-degree relatives. METHOD: Performance on two ToM tasks (Reading the Mind in the Eyes and Faux Pas Test) were compared in 17 unaffected first-degree relatives of AN patients and in 17 healthy individuals matched for age and level of education. Depression, anxiety, obsessive compulsive, and eating disorder symptoms were also assessed and correlated with ToM and clinical/demographic variables. RESULTS: Significant differences between groups were observed in all ToM tasks, with relatives of AN patients showing poorer performance. ToM assessment did not correlate with any clinical or demographic variable. CONCLUSIONS: The preliminary results of this study suggest unaffected first-degree relatives of AN patients display similar patterns of difficulty in ToM as reported previously for AN patients, supporting the hypothesis that ToM inefficiencies are a familial trait in this condition.


Subject(s)
Anorexia Nervosa/therapy , Family/psychology , Theory of Mind/physiology , Adult , Anorexia Nervosa/genetics , Anorexia Nervosa/psychology , Case-Control Studies , Female , Humans , Middle Aged
16.
Vertex ; XXX(144): 85-96, 2019.
Article in Spanish | MEDLINE | ID: mdl-31968018

ABSTRACT

Alzheimer's disease is the most frequent cause of cognitive disorders and dementia in older adults and is considered a new epi- demic. Due to its different cognitive, behavioral and functional manifestations, the detection, and diagnosis of patients with Alzheimer's Disease Dementia can represent a challenge. In this Clinical Practice Recommendation, management are given with levels based on the best scientific evidence available. Likewise, indications for study, or referral to a higher level of sanitary assistance are presented, according to the complexity of each clinical case. In this way, a set of practical recommendations of support is provided for decision making by health professionals at each sanitary level, from primary care to medical specialists. Through an operational and dynamic approach, this recommendations propose a global strategy based on evidence for patients, family members and health agents involved in this pathology, of great social relevance.


Subject(s)
Alzheimer Disease , Cognition Disorders , Dementia , Aged , Alzheimer Disease/diagnosis , Alzheimer Disease/therapy , Argentina , Hospitals, Group Practice , Humans
17.
Actas Esp Psiquiatr ; 46(1): 1-11, 2018 Jan.
Article in English | MEDLINE | ID: mdl-29417976

ABSTRACT

OBJECTIVE: To describe the relationship between neuropsychological variables and serum cortisol levels as a measure of physiological stress in patients with fibromyalgia. METHODOLOGY: A sample of 60 women was intentionally selected: 30 with Fibromyalgia diagnosis and 30 with normal controls. Cortisol levels were determined using two blood samples (AM and PM) and a neuropsychological and emotional battery was applied with a standardized protocol in Colombian population to evaluate different cognitive domains. Comparative and correlational non-parametric analyzes were performed, a multiple regression analysis to determine influences between variables. RESULTS: Significant differences between the study groups in the neuropsychological variables (attention, memory, language, visual-constructive praxis and executive functions (EF), (p<0.05) were found, obtaining better scores in the control group. Significant correlations between the cortisol profile, with false acknowledgments of Rey auditory- verbal learning test, and with perseverative errors of the Wisconsin test were found. Multiple regression analysis predicts the influence of memory and EF variables on the cortisol profile in an 88.7%. CONCLUSIONS: The findings show that, in patients with FM, there are neuropsychological alterations, mainly in executive functioning (cognitive flexibility) and episodic memory (evocation and storage). Likewise, executive dysfunction is related to physiological stress reciprocally and in turn are conditioned by emotional alterations such as symptoms of depression, which supports the neurophysiological model that compromises the hypothalamic-pituitary-adrenal axis and the prefrontal cortex, rich in corticosteroid receptors.


Subject(s)
Fibromyalgia/blood , Fibromyalgia/complications , Hydrocortisone/blood , Mental Disorders/blood , Mental Disorders/etiology , Nervous System Diseases/blood , Nervous System Diseases/etiology , Case-Control Studies , Cross-Sectional Studies , Female , Humans , Middle Aged
18.
Neurobiol Learn Mem ; 142(Pt A): 146-153, 2017 Jul.
Article in English | MEDLINE | ID: mdl-28347877

ABSTRACT

Consolidated memory can be again destabilized by the presentation of a memory cue (reminder) of the previously acquired information. During this process of labilization/restabilization memory traces can be either impaired, strengthened or updated in content. Here, we study if a consolidated memory can be updated by linking one original cue to two different outcomes and whether this process was modulated by the GABAergic system. To aim that, we designed two experiments carried out in three consecutive days. All participants learned a list of non-sense syllable pairs on day 1. On day 2 the new information was introduced after the reminder or no-reminder presentation. Participants were tested on day 3 for the updated or original list (Exp. 1). In Exp. 2 we tested whether this new information was incorporated by an inhibitory process mediated by the GABAergic system. For that, participants retrieved the original information before being taken Clonazepam 0.25mg (GABAA agonist) or Placebo pill. We found that the groups that received the reminder correctly recalled the old and new information. However, the no reminder groups only correctly recalled the original information. Furthermore, when testing occurred in the presence of Clonazepam, the group that received the reminder plus the new information showed an impaired original memory performance compared to the group that received only Clonazepam (without reminder) or the reminder plus Placebo pill. These results show that new information can be added to a reactivated declarative memory in humans by linking one cue to two different outcomes. Furthermore, we shed light on the mechanisms of memory updating being the GABAergic system involved in the modulation of the old and new information expression.


Subject(s)
Clonazepam/pharmacology , GABA Modulators/pharmacology , Memory Consolidation/drug effects , Memory/drug effects , Adolescent , Adult , Cues , Female , Humans , Male , Young Adult
19.
Dement Geriatr Cogn Disord ; 43(1-2): 1-14, 2017.
Article in English | MEDLINE | ID: mdl-27889770

ABSTRACT

BACKGROUND: Most studies examining episodic memory in Alzheimer disease (AD) have focused on patients' impaired ability to remember information. This approach provides only a partial picture of memory deficits since other factors involved are not considered. OBJECTIVE: To evaluate the recognition memory performance by using a yes/no procedure to examine the effect of discriminability and response bias measures in amnestic mild cognitive impairment (a-MCI), AD dementia, and normal-aging subjects. METHODS: We included 43 controls and 45 a-MCI and 51 mild AD dementia patients. Based on the proportions of correct responses (hits) and false alarms from the Rey Auditory Verbal Learning Test (RAVLT), discriminability (d') and response bias (C) indices from signal detection theory (SDT) were calculated. RESULTS: Results showed significant group differences for d' (F (2) = 83.26, p < 0.001), and C (F (2) = 6.05, p = 0.00). The best predictors of group membership were delayed recall and d' scores. The d' measure correctly classified subjects with 82.98% sensitivity and 91.11% specificity. CONCLUSIONS: a-MCI and AD dementia subjects exhibit less discrimination accuracy and more liberal response bias than controls. Furthermore, combined indices of delayed recall and discriminability from the RAVLT are effective in defining early AD. SDT may help enhance diagnostic specificity.


Subject(s)
Alzheimer Disease/diagnosis , Alzheimer Disease/psychology , Cognitive Dysfunction/diagnosis , Cognitive Dysfunction/psychology , Discrimination, Psychological , Memory Disorders/diagnosis , Memory Disorders/psychology , Neuropsychological Tests , Recognition, Psychology , Aged , Aged, 80 and over , Aging/psychology , Cross-Sectional Studies , Female , Humans , Male , Memory, Episodic , Mental Recall , Middle Aged , Psychomotor Performance
20.
Vertex ; 28(136): 468-478, 2017 Nov.
Article in Spanish | MEDLINE | ID: mdl-29522609

ABSTRACT

The first step from the neuropsychology in Argentina was in 1883 with the thesis of Antonio Piñeiro about the brain localization of the language and vision disorders, only few years after Broca. The aim of this work has been to describe the development of the neuropsychology in Argentina and its relation with the psychology, neurology and psychiatry. The first period was into the neurology with its French school in?uence. In 1907, Jose Ingeniero published in French his book about "amusia", Cristofredo Jakob the "folia neurobiologica" where he described the organization of the human brain, Vicente Dimitri in 1933 his book "aphasia" and Bernardo de Quiros in 1959 his works about dyslexia. The psychiatry at the hospices with the German influence from Jakob developed to the modern neuropsychiatry with Juan Carlos Goldar. The argentine school of psychology by the holism and the psychoanalysis influence do not accept the neuropsychology until 1960 where was included at the school of psychology from the university of Buenos Aires (UBA) with the first linguistics works of Juan Azcoaga. At the 80, began the North American influence of the neurology with authors like Carlos Mangone (dementia), Ramon Leiguarda (apraxia), Sergio Starkstein (depression and apathy) and Ricardo Allegri (memory and Alzheimer). In 1982 the Argentine Neuropsychological Society was founded and in 1987 was the working group of dementia from the Argentine Neurological Society. At this moment, Aldo Ferreres organized the chair of neuropsychology at the school of psychology (UBA). Nowadays, the growing as discipline is in context of the psychology, neurology and psychiatry in the way of the recent cognitive neurosciences.


Subject(s)
Cognitive Neuroscience/history , Neuropsychology/history , Argentina , History, 19th Century , History, 20th Century , History, 21st Century
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