Inducing Cough Reflex by Capsaicin Spray Stimulation in Patients with Acquired Brain Injury: A Preliminary Test and Proof of Concept.

Individuals with acquired brain injuries (ABIs) may experience various complications related to poor coughing or impaired cough reflex (including risk of aspiration pneumonia or respiratory infections). For this reason, cough assessment is an important component in the clinical evaluation since patients with ABI are not able to cough voluntarily due to severe motor deficits. When voluntarily coughing is not possible, it is essential for clinical practices to find a quick and minimally invasive way to induce a cough reflex. In the present study, we evaluated the cough reflex in ABI patients using a new method based on a capsaicin spray stimulation test. In total, 150 healthy controls demographically matched with 50 ABI patients were included in this study. Clinical observations demonstrated robust cough response in both healthy controls and ABI patients, as well as the safety and tolerability of capsaicin spray stimulation. ABI patients with dysphagia were characterized by slower and delayed cough responses. Further studies are needed to validate this feasible, less-invasive, and simple-to-comprehend technique in inducing cough reflex. According to this preliminary evidence, we believe that this test might be translated into a simple and effective treatment to improve reflexive cough modulation in ABI patients.

Transient Worsening of Dysphagia and Dysarthria after Treatment with Botulinum Toxin in Patients with Acquired Brain Injury.

Although botulinum toxin is widely considered an effective and safe treatment for a variety of neurological conditions (such as disabling spasticity), local or systemic adverse effects have often been reported. This study describes three cases of patients with severe acquired brain injury who were receiving speech therapy for recovering dysphagia and dysarthria but showed worsening of these symptoms after receiving BoNT treatment for motor spasticity. To increase clinicians' knowledge of these adverse effects, we present our cases and explore their significance to avoid major complications such as aspiration pneumonia.

Applicability of the "An Object and Action Naming Battery" in Brazilian Portuguese / Aplicabilidade da "Bateria de Nomeacao de Objetos e Verbos" no Portugues Brasileiro

PURPOSE: To verify the performance of a sample of Brazilian subjects in the "An Object and Action Naming Battery" (OANB), according to schooling; and to describe the main error types in nouns and verbs naming. METHODS: The OANB was applied in 100 healthy subjects, divided in two groups (GI: four to eight years of schooling; and GII: above nine years). RESULTS: There were correct answers for 97.6% for nouns and 98.0% for verbs. There were statistically significant differences between the groups in the number of correct answers for nouns and verbs (p<0.0001) and in the proportion of semantic errors for verbs (p=0.0160), with less educated subjects performing poorer than higher educated ones. CONCLUSION: The OANB may be used in adult Brazilian Portuguese native speakers. The group with higher education had higher scores; both groups had a higher proportion of "semantic errors" for verbs and nouns. .

OBJETIVO: Verificar o desempenho de sujeitos brasileiros na Bateria de Nomeação de Objetos e Verbos (BNOV), de acordo com a escolaridade; e descrever os principais tipos de erro na nomeação de verbos e substantivos. MÉTODOS: A BNOV foi aplicada em 100 sujeitos normais, divididos em dois grupos (GI: quatro a oito anos de escolaridade; e GII: acima de nove anos). RESULTADOS: Houve índice total de acertos de 97,6% para os substantivos e 98,0% para verbos. Foram verificadas diferenças estatisticamente significantes entre os grupos no número de acertos para substantivos e verbos (p<0,0001) e na proporção de ocorrência de erros semânticos para verbos (p=0,0160), registrando-se pior desempenho entre os sujeitos menos escolarizados. CONCLUSÃO: A BNOV é adequada para uso em adultos falantes do Português Brasileiro. O grupo com maior escolaridade apresentou maior número de "acertos"; ambos os grupos tiveram maior proporção de "erros semânticos" para verbos e substantivos. .

Relação entre a medida de independência funcional e o Core Set da Classificação Internacional de Funcionalidade, Incapacidade e Saúde para acidente vascular encefálico / The Relationship between the Functional Independence Measure and the International Classification of Functioning, Disability, and Health Core Set for stroke

Para a avaliação da funcionalidade do paciente com acidente vascular encefálico (AVE) existem diversos instrumentos, entre eles a Medida de Independência Funcional (MIF). A partir da aprovação da Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF) foi desenvolvido o Core Set para indivíduos com AVE, o qual passou a considerar os componentes da CIF para o entendimento da funcionalidade e da incapacidade física destas pessoas. Objetivo: foi estabelecer uma relação entre a MIF e o Core Set da CIF para pacientes com sequelas de AVE. Método: considerando as descrições das atividades da MIF e as definições das categorias da CIF, foram selecionadas as categorias do Core Set da CIF para pessoas com AVE relacionados às tarefas avaliadas pela MIF. Foi considerado o que contemplava cada atividade da MIF, a descrição detalhada e as definições de cada categoria da CIF. Foi proposta uma relação entre os indicadores quantitativos e qualitativos da CIF e as escalas e níveis de função da MIF. Estabeleceu-se uma relação inversa entre a escala da MIF e os qualificadores da CIF, pois quanto menor a escala da MIF maior o comprometimento, já para a CIF, quanto menor o qualificador menor o comprometimento. Resultados: das 130 categorias de segundo nível utilizadas no Core Set 27 (20,8%) foram relacionadas às atividades da MIF, sendo oito (29,6%) dos componentes das funções do corpo, 17 (63%) das atividades e participação e dois (7,4%) dos fatores ambientais. Para as 10 categorias que fazem parte da versão abreviada deste Core Set, apenas cinco foram relacionadas às atividades da MIF. Conclusão: o presente estudo evidenciou que a escala MIF está centrada no indivíduo, não correlacionando fatores externos que influenciam na realização das atividades. A escala CIF possui parâmetros adequados e permite uma visão biopsicossocial do indivíduo, abrangendo desde as disfunções e deficiências dos indivíduos acometidos com por AVE até a influência destes fatores nas...

The Functional Independence Measure (FIM) is one of many instruments available for assessing the functionality of stroke patients. However, with the approval of the International Classification of Functioning, Disability, and Health (ICF), the Core Set that was developed for stroke patients, a new tool for understanding functionality and disability of these patients is available. Objective: to establish a relationship between the FIM and the ICF Core Set for stroke. Four researchers of different health care backgrounds, all working in the field of rehabilitation, considered the descriptions of the activities of the FIM and the definitions of the ICF categories. Method: they selected the categories of the ICF Core Set for stroke, which could be related to the tasks assessed by the FIM. Once the relationship was established, the researchers came to a consensus for the inclusion or exclusion of those categories. Results: From the 130 second-level categories used in the Core Set, 27 (20.8%) were related to the activities of FIM, eight (29.6%) regarded the bodily functions component (b), 17 (63%) concerned activity and participation (d), and two (7.4%) considered environmental factors (e). As for the 10 categories that are part of the Brief Core Set for stroke, only five were related to the activities of FIM. Conclusion: the FIM is focused on the individual, while the ICF is concerned not only with the dysfunctions and disabilities of the patient, but also considers these factors within social activities, as well as environmental influences, either as a facilitator or a barrier to functional independence.

Applicability of the "An Object and Action Naming Battery" in Brazilian Portuguese.

PURPOSE: To verify the performance of a sample of Brazilian subjects in the "An Object and Action Naming Battery" (OANB), according to schooling; and to describe the main error types in nouns and verbs naming. METHODS: The OANB was applied in 100 healthy subjects, divided in two groups (GI: four to eight years of schooling; and GII: above nine years). RESULTS: There were correct answers for 97.6% for nouns and 98.0% for verbs. There were statistically significant differences between the groups in the number of correct answers for nouns and verbs (p<0.0001) and in the proportion of semantic errors for verbs (p=0.0160), with less educated subjects performing poorer than higher educated ones. CONCLUSION: The OANB may be used in adult Brazilian Portuguese native speakers. The group with higher education had higher scores; both groups had a higher proportion of "semantic errors" for verbs and nouns.

Habilidade de nomeação: diferenciação entre objetos e verbos na afasia / Naming abilities: differentiation between objects and verbs in aphasia

Cognitive Neuropsychology aims to understand the processing mechanisms of normal and injured brain, by means of functional architectural models of information processing. Naming is one of the most important abilities in linguistic processing. Naming of different semantic and grammatical categories differ in their lexical properties and have distinct neuroanatomical substrates. We reviewed literature data on the differences between nouns and verbs in aphasic subjects reported by scientific publications in the form of indexed articles. Studies on naming abilities tended to emphasize the differentiation between nouns and verbs both in their lexical properties and neuroanatomical substrates. Functional neuroimaging studies have improved the state of knowledge regarding category-specific naming abilities, but further studies on different types of aphasia and the use of naming abilities in different contexts are warranted.

A Neuropsicologia Cognitiva busca compreender o funcionamento cerebral através de modelos de arquiteturas funcionais do processamento da informação. A nomeação constitui uma das tarefas mais importantes no processamento da linguagem. A nomeação de diferentes categorias semânticas e gramaticais difere em suas propriedades lexicais e possui substratos neuroanatômicos distintos. Revisamos dados da literatura sobre a diferenciação da habilidade de nomeação de categorias específcas e seus substratos neurais em afásicos, por meio de publicações científicas em forma de artigos indexados. Estudos sobre as habilidades de nomeação enfatizam a distinção entre substantivos e verbos, em suas propriedades lexicais e substratos neuroanatômicos. Pesquisas com exames de neuroimagem funcional tem contribuído para o avanço do conhecimento da nomeação, porém ainda são necessários estudos que relacionem diferentes categorias semânticas nas diferentes afasias e contextos lingüísticos.

Naming abilities: Differentiation between objects and verbs in aphasia.

Cognitive Neuropsychology aims to understand the processing mechanisms of normal and injured brain, by means of functional architectural models of information processing. Naming is one of the most important abilities in linguistic processing. Naming of different semantic and grammatical categories differ in their lexical properties and have distinct neuroanatomical substrates. We reviewed literature data on the differences between nouns and verbs in aphasic subjects reported by scientific publications in the form of indexed articles. Studies on naming abilities tended to emphasize the differentiation between nouns and verbs both in their lexical properties and neuroanatomical substrates. Functional neuroimaging studies have improved the state of knowledge regarding category-specific naming abilities, but further studies on different types of aphasia and the use of naming abilities in different contexts are warranted.

A Neuropsicologia Cognitiva busca compreender o funcionamento cerebral através de modelos de arquiteturas funcionais do processamento da informação. A nomeação constitui uma das tarefas mais importantes no processamento da linguagem. A nomeação de diferentes categorias semânticas e gramaticais difere em suas propriedades lexicais e possui substratos neuroanatômicos distintos. Revisamos dados da literatura sobre a diferenciação da habilidade de nomeação de categorias específcas e seus substratos neurais em afásicos, por meio de publicações científicas em forma de artigos indexados. Estudos sobre as habilidades de nomeação enfatizam a distinção entre substantivos e verbos, em suas propriedades lexicais e substratos neuroanatômicos. Pesquisas com exames de neuroimagem funcional tem contribuído para o avanço do conhecimento da nomeação, porém ainda são necessários estudos que relacionem diferentes categorias semânticas nas diferentes afasias e contextos lingüísticos.