A cortical study of the attention in military simulation tests. / Estudio cortical de la atencion en tests de simulacion militar.

INTRODUCTION: Attention is one of the most widely studied superior cerebral functions and base of many other cognitive processes. It is sometimes understood as concentration on a task or target. The level of execution of a task and the ability to process information are dependent on the state of cerebral activation of the subject. This brain activity can be recorded with the electroencephalogram (EEG). AIM: Attention is studied in states of rest and during the performance of tasks in military personnel, exploring the differences between two groups (cadets and officers/NCOs). SUBJECT AND METHODS: EEG signals have been recorded from 19 cadets and 17 officers of the General Military Academy and from the General Hospital of the Defense during military simulation tasks and in states of rest. Our team uses its own methodology of the dynamic systems and fractal techniques for the modeling and quantification of the EEG signals, in this case for the computation of the fractal dimension of the record of each derivation. The data obtained are subjected to a statistical study. RESULTS: Higher cortical global mean values were observed in the officers group. The dimension increases in both groups by raising the difficulty of the task in all areas of the brain except in the frontal zone. They highlight the significant differences between groups in the simulation task of driving combat vehicle in the central, parietal and temporal areas. CONCLUSIONS: The results obtained show that the two groups studied do not behave homogeneously in the same attention task that involves a video game.

TITLE: Estudio cortical de la atencion en tests de simulacion militar.Introduccion. La atencion es una de las funciones cerebrales superiores mas estudiadas en nuestros dias y la base de otros procesos cognitivos. En ocasiones se entiende como la concentracion en una tarea. El nivel de ejecucion de una tarea y la habilidad para procesar informacion son dependientes del estado de activacion cerebral, que puede registrarse mediante el electroencefalograma (EEG). Objetivo. Estudiar la atencion en estados de reposo y durante el desarrollo de tareas propias del personal militar, explorando las diferencias entre dos grupos (cadetes/mandos). Sujetos y metodos. Se han recogido señales de EEG de 19 cadetes y 17 oficiales de la Academia General Militar y del Hospital General de la Defensa durante tareas de simulacion militar y en estados de reposo. Nuestro equipo utiliza metodologia propia de sistemas dinamicos y tecnicas fractales para modelizar y cuantificar las señales del EEG, en este caso para el calculo de la dimension fractal del registro de cada derivacion. Los datos obtenidos en diversos estados cerebrales se someten a un estudio estadistico. Resultados. Se observan mayores valores de las medias globales corticales en el grupo de mandos. La dimension aumenta en ambos grupos al elevar la dificultad de la tarea en todas las areas cerebrales, salvo en la zona frontal. Destacan las diferencias significativas entre grupos en la tarea de simulacion de manejo de vehiculos de combate en las zonas central, parietal y temporal. Conclusiones. Los resultados obtenidos muestran que los dos grupos no se comportan de manera homogenea en la misma tarea de atencion que implica un videojuego.

[Perisylvian magnetoencephalografic impairments in patients with autism spectrum disorders]. / Alteraciones magnetoencefalograficas perisilvianas en pacientes con trastornos del espectro autista.

INTRODUCTION: The perisylvian areas, located around the Sylvian fissure, are constituted by frontal, temporal and parietal brain regions. These are connected forming specialized neural networks and play a primary role in the development of linguistic skills and social cognition. These areas are a possible neuronal substrate of cognitive and behavioral impairments in patients with autism spectrum disorders (ASD). AIM: To locate and quantify epileptiform activity sources through magnetoencephalography in frontal perisylvian areas in children with idiopathic ASD. PATIENTS AND METHODS: Sixty-eight children with idiopathic ASD were studied by magnetoencephalography. The children were classified into two groups: a group of 41 children with autistic disorder and a combined group of 27 children with Asperger syndrome and children with pervasive developmental disorder not otherwise specified. The sources of magnetoencephalografic epileptiform activity detected in the frontal perisylvian were localized and quantified. RESULTS: The amount of epileptiform activity in frontal perisylvian region was significantly higher in children with autistic disorder. CONCLUSIONS: The amount of epileptiform activity in frontal perisylvian areas differed significantly between children with autistic disorder and those with Asperger syndrome and pervasive developmental disorder not otherwise specified.

TITLE: Alteraciones magnetoencefalograficas perisilvianas en pacientes con trastornos del espectro autista.Introduccion. Las areas perisilvianas se situan alrededor de la cisura de Silvio y estan constituidas por regiones cerebrales frontales, temporales y parietales. Estas regiones estan conectadas formando redes neurales especializadas y desempeñan una funcion elemental en el desarrollo de las habilidades linguisticas y de la cognicion social. Estas areas son un posible sustrato neural de las alteraciones cognitivas y conductuales en los pacientes con trastornos del espectro autista (TEA). Objetivo. Localizar y cuantificar las fuentes de actividad epileptiforme mediante magnetoencefalografia en areas frontales perisilvianas en niños con TEA primario. Pacientes y metodos. Se estudio a 68 niños con TEA idiopatico mediante magnetoencefalografia. Se clasificaron en dos grupos: uno de 41 niños con trastorno autista y un grupo combinado de 27 niños con sindrome de Asperger y niños con trastorno generalizado del desarrollo no especificado. Se localizaron y se cuantificaron las fuentes de actividad epileptiforme magnetoencefalografica detectadas en las areas frontales perisilvianas. Resultados. La actividad epileptiforme en la region perisilviana frontal fue significativamente mayor en el grupo de niños con trastorno autista. Conclusiones. La localizacion y cantidad de actividad epileptiforme en areas frontales perisilvianas difirieron significativamente entre los niños con trastorno autista y aquellos con sindrome de Asperger y trastorno generalizado del desarrollo no especificado.

Response to methylphenidate by adult and pediatric patients with attention-deficit/hyperactivity disorder: the Spanish multicenter DIHANA study.

BACKGROUND: The purpose of this multicenter Spanish study was to evaluate the response to immediate-release methylphenidate by children and adults diagnosed with attention-deficit/hyperactivity disorder (ADHD), as well as to obtain information on current therapy patterns and safety characteristics. METHODS: This multicenter, observational, retrospective, noninterventional study included 730 patients aged 4-65 years with a diagnosis of ADHD. Information was obtained based on a review of medical records for the years 2002-2006 in sequential order. RESULTS: The ADHD predominantly inattentive subtype affected 29.7% of patients, ADHD predominantly hyperactive-impulsive was found in 5.2%, and the combined subtype in 65.1%. Overall, a significant lower Clinical Global Impression (CGI) score and mean number of DSM-IV TR (Diagnostic and Statistical Manual of Mental Disorders Fourth Edition, Text Revision) symptoms by subtype were found after one year of treatment with immediate-release methylphenidate; CGI decreased from 4.51 to 1.69, symptoms of inattention from 7.90 to 4.34, symptoms of hyperactivity from 6.73 to 3.39, and combined subtype symptoms from 14.62 to 7.7. Satisfaction with immediate-release methylphenidate after one year was evaluated as "very satisfied" or "satisfied" by 86.90% of the sample; 25.75% of all patients reported at least one adverse effect. At the end of the study, 41.47% of all the patients treated with immediate-release methylphenidate were still receiving it, with a mean time of 3.80 years on therapy. CONCLUSION: Good efficacy and safety results were found for immediate-release methylphenidate in patients with ADHD.

[Language processing in attention deficit hyperactivity disorder]. / Procesamiento del lenguaje en el trastornopor déficit de atención con hiperactividad.

INTRODUCTION: Attention deficit hyperactivity disorder (ADHD) is a heterogeneous condition and often coexists with other disorders that may go undetected, such as communication and language disorders. AIMS: The aim of this study was to evaluate semantic processing of language in children with ADHD by recording the N400 component of cognitive evoked potentials. SUBJECTS AND METHODS: The N400 component was recorded in visual mode while a semantic congruence/ incongruence task was being performed by a sample of 36 children with ADHD and 36 control children. RESULTS: Latency and amplitude of the N400 component were seen to increase and decrease, respectively, in all areas of the brains of the children with ADHD with respect to the children from the control group. CONCLUSIONS: These findings clearly reveal the existence of a deficit in the semantic processing of language in children with ADHD that is associated to their attentional dysfunction.

[Best practice guidelines for the early detection of Autistic Spectrum Disorders (I)]. / Guía de buena práctica para la detección temprana de los trastornos del espectro autista (I).

INTRODUCTION: The interest in early detection of Autism Spectrum Disorders (ASD) lies in the accumulated evidence of the fact that an early customized intervention for children with an ASD and their families leads to an improvement of the child's prognosis in most cases. OBJECTIVE: To establish criteria and procedures for early identification of children at risk of ASD and to facilitate full diagnostic assessment and prompt referral leading to adequate support. Early detection of ASD is extremely important, since early specific individualized treatment for the child and his or her family leads to long-term improvement in many children' prognosis. DEVELOPMENT: Firstly, a critical appraisal of the situation of early detection of ASD in Spain is made after reviewing the scarce bibliography available on current screening and diagnostic practices in the country. Data generated by questionnaires received from 646 Spanish families is also taken into account. Secondly, the Study Group of the Instituto de Salud Carlos III recommends the screening and early diagnosis process to be followed, describing the necessary steps, the public services involved and the available screening and diagnostic tools. CONCLUSIONS: The Study Group draws the main conclusions regarding the situation of ASD early detection in Spain, and makes a consensus proposal for the detection procedures, including routine developmental surveillance and identification of children at risk for ASD by using sensitive and specific assessment tools.

[The value of cognitive evoked potentials in assessing the effectiveness of methylphenidate treatment in children with attention deficit hyperactivity disorder]. / Utilidad de los potenciales evocados cognitivos en la valoración de la efectividad del tratamiento con metilfenidato en niños con trastorno de déficit de atención con hiperactividad.

AIM: To investigate the changes of the latency and amplitude of P300 in relation to methylphenidate (MPH) medication. SUBJECTS AND METHODS: 36 children with attention deficit hyperactivity disorder (ADHD) and 18 children as control group were tested with an auditory and visual oddball paradigm both before and 1.5 h after a single dose trial of MPH. RESULTS: MPH increased the amplitude and the latency of the visual and auditory P300 component In the ADHD group the latency of the P300 component was longer and the amplitude smaller than in the control group. CONCLUSION: These results suggests that MPH acts to improve processing of cognitive information in children with ADHD where no differences with normal children are present.