Women with Myocardial Infarction Present Subtle Cognitive Difficulties on a Neuropsychological Battery After Exposure to a Social Stressor.

Objective: Myocardial infarction (MI) is the primary cause of mortality and morbidity in women, but its sequelae remain largely understudied. Given the heart-brain relationship, our study aimed to further understand stress's impact on regulating cognitive function post-MI. Specifically, our study evaluated the effect of stress induced using the Trier Social Stress Test (TSST), on neuropsychological function in women who have or have not experienced MI. Methodology: To do so, women (mean age = 59.41 yrs) with (WHxMI = 13) or without () a history of MI were exposed to the TSST prior to completion of a series of standardized neuropsychological tests: the Montreal Cognitive Assessment (MoCA), Control Oral Word Association (COWA), Rey Complex Figure and Recognition (RCFT), Trail Making Test (TMT), and Auditory Consonant Triagrams (ACT). Results: Our findings support MI to be associated with impairments in working memory affecting immediate recall of ACT, as well as visuospatial impairments in the RCFT copy trial, marked by poorer drawing accuracy and incorrect placement of figure elements. Overall, WHxMI required more time to complete the neuropsychological assessment (WHxMI 166.57 ± 12, 155.00 ± 6.57; p < 0.01). Conclusion: Together, these findings support cognitive impairments noted following a social stressor to remain subtle in WHxMI. Our study highlights the need for the development of more sensitive tools to screen for neuropsychological impairments in women with MI and the importance of assessing performance in a variety of testing conditions.

Contribution of Obstructive Sleep Apnoea to Cognitive Functioning of Males With Coronary Artery Disease: A Relationship With Endocrine and Inflammatory Biomarkers.

Introduction: Our exploratory study aimed to determine whether obstructive sleep apnoea (OSA) could affect cognitive functioning in males with coronary artery disease (CAD), and whether such impact could be associated with changes in thyroid hormones and inflammatory marker regulation on cognitive functioning. Method: We evaluated different endocrine and inflammatory biomarkers, including free triiodothyronine [fT3], free tetraiodothyronine [fT4], N-terminal pro-B-type natriuretic peptide [NT-pro-BNP], and high-sensitivity C-reactive protein [hs-CRP] serum levels in 328 males ( x ¯ = 57 ± 10 years), undergoing cardiac rehabilitation after an acute coronary event. Participants underwent full-night polysomnography and were classified in mild/non-OSA (n = 253) and OSA (n = 75) according to an apnoea-hypopnoea index ≥ 15 event/h. Cognitive functioning testing included the Digit Span Test, Digit Symbol Test (DSST), and Trail Making Test. Analyses of variance assessed the impact of OSA on cognitive functioning and possible relationships of fT3/fT4, NT-pro-BNP and with hs-CRP on cognitive measures. Results: Significant group (OSA, mild/non-OSA) × NT-pro-BNP (<157.0 vs. ≥157.0, ng/L) interactions were found for the DSST raw score (F (2,324) = 3.58, p = 0.014). Decomposition of interactions showed that the DSST scores of the OSA group with NT-pro-BNP ≥ 157.0 ng/L (M = 33.2; SD = 8.1) were significantly lower, p = 0.031, than those of the mild/non-OSA with NT-pro-BNP < 157.0 ng/L (M = 37.7; SD = 8.9). Conclusion: These findings indicate that males with OSA and clinically elevated NT-pro-BNP levels experienced inferior psychomotor performance compared to those without OSA and reduced NT-pro-BNP levels.

Argentinean Psycholinguistic Picture Naming Test in color.

Color has demonstrated to have an influence on picture naming tasks. Objects with high color diagnosticity are recalled faster than objects with low value. That is why the Argentinean Psycholinguistic Picture Naming Test in color (PAPDIC in Spanish) was designed. The items and semantic cues were built considering local psycholinguistic norms. A series of psychometric analyses were performed on a sample of patients with focal brain damage with (n = 11) and without (n = 14) aphasia, a sample of patients with degenerative disease (n = 46) and two samples of healthy participants (young n = 27, old n = 50). Evidence of convergent validity was obtained through the correlation with the brief Boston Naming Test (r = 0.871; p < .001); of criteria validity by means of contrasted groups analysis (t = 4.059, p < .001), and through the ROC curve analysis (AUC = 0.993). Scores' reliability was explored by means of an internal consistency analysis (KR20 = 0.905). These results indicate that the PAPDIC is a promising color naming test which can be applied in the field of clinical neuropsychology to identify anomia. This test has several advantages in comparison with the available naming tests in Argentina.

Predictive value of baseline cognitive functioning on health-related quality of life in individuals with coronary artery disease: a 5-year longitudinal study.

AIMS: Emerging studies suggest an association exists between coronary artery disease (CAD) and the development of neurodegenerative diseases, with CAD acting as a precursor. Our study aimed to investigate the relationship between baseline measures of cognitive functioning and long-term health-related quality of life (HRQoL) in individuals with CAD with specification to Type D personality traits and sex. METHODS AND RESULTS: This prospective observational cohort study consisted of 864 participants (mean age 58 SD = 9 years, 74.0% men) with CAD after acute coronary syndrome. Baseline characteristics included comprehensive cognitive testing, measures of sociodemographic and clinical factors, and psychological assessment scales, such as Type D personality scale and the Hospital Anxiety and Depression scale. The Minnesota Living with Heart Failure Questionnaire assessed participants' HRQoL, conducted through phone interviews at baseline, every 6 months for up to 2 years, and after 5 years. Cognitive functioning correlated with HRQoL at all time intervals over the 5-year follow-up. Regarding sex and Type D personality, significant differences emerged in associations between impaired cognitive functioning at baseline and HRQoL measured over the period of 5 years. Men participants with characteristics of Type D personality were especially vulnerable to impaired cognitive functioning affecting the 5-year quality of life. CONCLUSION: Men with CAD who obtained scores indicating characteristics of Type D personality were significantly more likely to have lower baseline cognitive functions and long-term HRQoL outcomes. This information could inform healthcare practitioners to screen for personality characteristics and closely follow-up those at a greater risk.

PAPDI: Prueba Argentina Psicolingüística de Denominación de Imágenes.: Segunda parte: Estudio de sus propiedades psicométricas / PAPDI: Argentinean Psycholinguistic Image Naming Test.: Second part: Study of psychometric properties

En el presente trabajo se detallan los análisis realizados con el fin de estudiar las propiedades psicométricas la Prueba Argentina Psicolingüística de Denominación de Imágenes (PAPDI). La misma cuenta con dos cualidades que representan un valor agregado frente a las pruebas actualmente disponibles en nuestro país: a) los estímulos fueron seleccionados controlando las variables que afectan las etapas de análisis visual y de representación conceptual de la imagen del objeto y se manipularon las variables que afectan la selección y recuperación de la etiqueta léxica, en base a valores normativos de población argentina; y b) las claves semánticas se elaboraron de acuerdo con normas de producción de atributos semánticos también recolectadas en nuestro país. En este trabajo se analizaron las propiedades psicométricas mediante el estudio de pacientes con demencia tipo Alzheimer, con lesiones cerebrales focales y participantes sin patología neurológica. Se buscaron evidencias de validez de criterio mediante el análisis de grupos contrastados y la correlación con el test de Boston. A su vez, se estudió la confiabilidad de las puntuaciones por dos métodos: consistencia interna y test-retest. También se analizó la capacidad de discriminación entre pacientes con y sin anomia mediante curvas ROC. Se estudiaron además los efectos de las variables manipuladas, se realizó un análisis cualitativo de los errores y se examinó el desempeño en función del uso de las claves. Los resultados de los análisis aportan evidencia de que presenta cualidades psicométricas sumamente aceptables para su uso en nuestra población.

In the current paper we present the psychometric analysis of the Argentinean Psycholinguistic Image Naming Test (PAPDI). This test has two characteristics that makes it different from those currently available in our country: a) the stimuli has been chosen and ordered controlling certain psycholinguistic variables proven to have influence on this task, such as Visual Complexity, Image Agreement, Image Variability, Familiarity, Name Agreement, Age of Acquisition and Frequency of Use, following Argentinean normative data base; and b) semantic cues were elaborated according to semantic feature production norms also from Argentina. We present here the psychometric analysis of its properties. There were analyzed through the study of patients with Alzheimer Disease (n = 25) and focal brain lesions (n = 27) and healthy partici-pants (n = 125). On the first place, in order to study criteria validity a group comparison analysis was carried out. On the one hand Alzheimer Disease patients were compared with healthy participants. On the other hand, two focal brain damaged patients were compared: with and without aphasia. Convergent validity was also studied through the correlation with Boston naming test. In the third place, scores reliability was studied through two methods: internal consistency analysis, for Alzheimer, focal and healthy groups, and test-retest for focal brain damage group. Forth, it was analyzed the capacity to discriminate between patient with and without aphasia through ROC curves analysis. The respective sensitivity and specificity values to detect anomia were established. Fifth, the demographic variables´ influence was analyzed through a regression analysis. Moreover, there were analyzed the effects of two psycholinguistic variables that were taken into account to order the images but were not normalized: Lexical Frequency and Age of Acquisition. Finally, type of errors and response to cues were studied for focal brain damaged patients. The results indicated that the PAPDI presents acceptable psychometric properties to be used as a tool in neuropsychological assessment. It showed evidence of internal and external validity and it was observed scores reliability through internal consistency and test-retest. A suggested cutting point was established to detect anomia. Furthermore a main influence of educational level was reported. There were also detected effects of Lexical Frequency and Age of Acquisition which were observed for Alzheimer and aphasic patients groups. Moreover it was illustrated the response profile analysis for aphasic and nonaphasic focal brain damaged patients regarding a proposed taxonomy of error types. It was also studied the response to semantic and phonological cues and it was observed that both contributed to improve patients´ performance.

Prueba Argentina Psicolingüística de Denominación de Imágenes (PAPDI): Construcción y desarrollo (Primera parte)* / Argentinean Psycholinguistic Image Naming Test (PAPDI): Design and development (First part)

En la primera parte de este trabajo se presenta la construcción y el desarrollo de la Prueba Argentina Psicolingüística de Denominación de Imágenes (PAPDI). La misma tiene dos características que la diferencian de las pruebas actualmente disponibles en nuestro medio: (a) Los estímulos fueron seleccionados controlando las variables que afectan las etapas de análisis visual y reconocimiento de la imagen (Complejidad visual y Concordancia con la imagen) y el conocimiento conceptual (Variabilidad de la Imagen y Familiaridad) del dibujo del objeto también se manipularon las variables (Frecuencia léxica y Edad de adquisición) que afectan la etapa que busca evaluar la prueba: activación, selección y recuperación de la etiqueta léxica. Los índices que operacionalizan a las variables son dependientes de la cultura y de la lengua de dónde se obtengan, por ello se tomaron sus valores de normas argentinas. (b) Las claves semánticas han sido elaboradas cuidadosamente, siguiendo las normas de producción de atributos semánticos también recolectadas en nuestro país, ya que el uso de las mismas permite generar hipótesis más precisas acerca de la localización del déficit. Por lo tanto, se presenta el proceso de construcción y desarrollo de la prueba mostrando cómo se tuvieron en cuenta estas particularidades, cuáles variables han sido controladas y cuáles manipuladas, y su justificación. Por último, los resultados de la prueba piloto permitieron seleccionar 30 ítems y la constitución de la versión final de la prueba, que es lo suficientemente breve para su uso en la clínica y de libre acceso.

In the current paper, first part, we present the design and development of the Argentinean Psycholinguistic Image Naming Test (PAPDI). This test has two characteristics that make it different from those currently available in our country: (a) the stimuli have been selected by controlling the variables that affect the stages of visual analysis and image recognition (Visual Complexity and Image Agreement) and conceptual knowledge (Image Variability and Familiarity) of the drawing of the object; and the variables (Frequency of Use and Age of Acquisition) that affect the stage that seeks to evaluate the test were manipulated: activation, selection and retrieval of the lexical label (phonological form of the name), to generate a gradient of difficulty in the items of the test. However, the variable Naming Agreement, that also affects this stage, was controlled to selected pictures with only one predominating name. The quantification of these factors by means of specific variables is influenced by the cultural and linguistic context from which they were obtained, consequently we took their values from Argentinean normative data base and (b) semantic cues were elaborated according to semantic feature production norms also from Argentina. The phonological cues corresponded to the first syllable of the object's name. Their use allows to generate more precise hypotheses about the location of the deficit and allows to infer relevant information about the cognitive profile. Therefore, the process of construction and development of the test is presented, showing how these particularities were taken into consideration, which variables were controlled and which were manipulated, and their justification. For the design of the test 62, black and white pictures were originally selected from the 400 pictures taken from Cycowicz's set (of frequent use in Experimental Psychology and Neuropsychology). They correspond to concrete concepts from different semantic categories belonging to both living andnon living domains. The criteria used to include those images were that they were moderately complex (in quantity of lines and details), moderately familiar and that they had a mean image variability value. They had to have a medium to high concordance degree between the mental image and its corresponding representation. Besides, these images had to have a naming agreement superior to 80%. To conform the first version of the test, the 62 images selected were ordered according to the variable Age of Acquisition and each image was assigned its corresponding semantic and phonological cues. The former were extracted from the Argentinean norms considering the most relevant features. The second consisted on the word´s first syllable. A pilot study with healthy population (n = 50), of different ages, both sexes and three educational levels, was carried out through which 30 images were selected that constituted the test´s final version. The deleted items were: figures that did not evokea univocal response, that is, they were easily confused with other objects; figures that had more than one acceptable answer although not all were correct; and items that presented a ceiling effect where the scores accumulated in high scores and did not allow to discriminate the participants' ability to select, retrieve and produce a word (only 25 and 30% of the items were retained). In the test´s final version, the items were reordered according to the Age of Acquisition and Frequency values and their difficulty in naming (following the percentage of successes in the spontaneous response). And images that were contain in another naming tests were deleted. The test is short enough for use in the clinic and freely accessible. The second part of the paper presents the psychometric studies that provide evidence of their relevance and validity.

Validación de la PAPDI a color en pacientes con anomia / Validation of the color PAPDI in patients with anomie

INTRODUCCIÓN La presente investigación se propuso estudiar las propiedades psicométricas de la versión a color de una prueba de denominación recientemente desarrollada a nivel local, la PAPDI, en una muestra de pacientes con anomia. OBJETIVOS Analizar las propiedades psicométricas de la versión a color de la PAPDI, en población con anomia. MÉTODOS El grupo clínico estuvo conformado por 43 pacientes, 17 con enfermedad neurodegenerativa y 26 con lesión neurológica focal, mientras que el normativo estuvo formado por 34 participantes sin patología neurológica. Se administró una batería neuropsicológica incluyendo pruebas de evaluación de lenguaje y memoria semántica. RESULTADOS Se obtuvo evidencia de validez externa de la prueba a partir de la correlación con la versión abreviada del TDB, (coeficiente rho de Spearman = .813; p < .001). ). El análisis de confiabilidad se evaluó mediante análisis de consistencia interna de los ítems (método Kuder-Richardson = 0,924). Se generó un análisis de regresión, estudiando la influencia de variables demográficas, sin observarse efecto significativo de ninguna de ellas (sexo, edad, educación). Se hizo un análisis de curvas ROC para determinar su capacidad de discriminación y se obtuvo un área bajo la curva de 0,976 (IC 95% 0,944-1). El punto de corte sugerido es de 26, con una Sensibilidad de 0,84 y una Especificidad de 1. DISCUSIÓN La versión a color de la PAPDI mostró mejores propiedades psicométricas que la versión en blanco y negro, siendo útil para evaluar pacientes con fallas en la denominación

Activation of CRHR1 receptors regulates social and depressive-like behaviors and expression of BDNF and TrkB in mesocorticolimbic regions following global cerebral ischemia.

Increased HPA axis activation and CRH release characterize the brain's response to global cerebral ischemia. Recently, CRH via activation of CRH type 1 receptors (CRHR1) has been shown to regulate Brain Derived Neurotrophic Factor (BDNF) secretion and emotional behavior. The current study investigates the impact of CRHR1 blockade on BDNF/TrkB signaling expression in the mesolimbic circuitry, and social and depressive-like behavior following global ischemia. Adult male Wistar rats were injected with Antalarmin (2µg/µl) or a vehicle 30min prior to 10min global cerebral ischemia (4VO model) or sham occlusion. The Three Chamber Social Approach Test (SIT) assessed sociability and preference for social novelty, and the novelty suppressed feeding test (NSFT), forced swim test (FST), and sucrose preference test characterized anxiety and depression. Corticosterone levels and organ (thymus, seminal and adrenal glands) weights were determined as additional physiological indices of stress. Immunohistochemistry, Western blot and Rt-PCR were used to assess BDNF and TrkB receptor levels in subregions of the medial prefrontal cortex (mPFC), nucleus accumbens (NAc) and ventral tegmental area (VTA) 30days post-ischemia. Our findings indicate reduced BDNF and TrkB protein and mRNA expression in the mPFC post-ischemia, while heightened levels were found in the NAc. Ischemia increased immobility in the FST and reduced sucrose preference and led to reduced latency to feed in the NSFT and heightened sociability and social novelty preference in the SIT. Antalarmin treatment normalized post-ischemic biochemical/behavioral changes. Our findings support lasting effects of CRHR1 activation on brain plasticity markers, likely playing a role in emotional impairments following cardio- or cerebro-vascular accidents.

Prevalence of autism spectrum disorders in relatives of patients with selective immunoglobulin A deficiency.

BACKGROUND: An association of selective IgA (immunoglobulin A) deficiency in individuals with autism has been previously described. The objective of this study was to examine the incidence of autism spectrum disorders (ASD) in children and siblings of selective IgA deficient patients. OBJECTIVE: to assess the likelihood of parents with the most common type of primary immunodeficiency (selective IgA deficiency) having children with ASD and to investigate the occurrence of ASD in siblings of the immunodeficient patients. METHODS: A study was conducted in 31 selective IgA deficient patients and 62 age and gender-matched controls. Children and siblings of IgA deficient patients and controls were screened for an ASD (autism spectrum disorder) using a standard questionnaire. RESULTS: Only one patient in the IgA deficient group had classical autism. Three children in that group (10.3%) had an ASD compared to only one in the control group (1.6%) and this difference was statistically significant. In terms of siblings, there was a higher occurrence of an ASD in the IgA deficient group than in the control group, but the difference was not statistically significant. A high incidence of allergies (71%) was documented in IgA deficient patients. All individuals with allergies had food sensitivities. There was a predominance of the male gender in cases identified with an ASD in all groups. CONCLUSIONS: A lower prevalence of ASD was observed in the IgA deficient group, as compared to other reports. The study suggests that screening for an ASD seems appropriate for children of IgA deficient patients.