Funções neuropsicológicas de meninas privadas de liberdade em unidade socioeducativa / Neuropsychological functions of girls deprived of liberty in socio-educational unit / Funciones neuropsicológicos de niñas privadas de libertad en unidad socioeducativa

OBJETIVO: A avaliação neuropsicológica tem alta relevância na adolescência e em situação de conflito com a lei, com privação de liberdade em instituições socioeducativas, pode auxiliar, compondo abordagens psicossociais que identifiquem as funções neuropsicológicas, situando-as a partir da historicidade do indivíduo. Deste modo, para compreender esse problema, foi objetivo desse estudo avaliar e descrever as funções neuropsicológicas de adolescentes meninas privadas de liberdade em instituição socioeducativa. MÉTODOS: As participantes foram 19 meninas avaliadas com os instrumentos: Barratt Scale, Inventário de Expressão de Raiva, teste Wisconsin de classificação de cartas, protocolo neuropsicológico, questionário para uso de drogas e Hare Psychopathy Checklist Revised. RESULTADOS: O uso de drogas na vida ocorreu em 80,0% dos casos. Verificaram-se altos escores de impulsividade total (M=75,8, DP=5,4), traço de raiva (M=24,5, DP=7,3) e respostas perseverativas (M =38,5, DP =19,9). Em conjunto com PCL-R total (M=17,5, DP=3,6) e com QI total (M=79,1, DP=16,2), esses níveis auxiliaram na caracterização das funções de autocontrole. CONCLUSÕES: Os dados foram interpretados como indicativos de baixo funcionamento executivo, altos níveis de raiva, de impulsividade, de uso de drogas e de traços de psicopatia. Foram relatadas adversidades durante a infância, o que pode ter contribuído para um desempenho prejudicado nas funções cognitivas e emocionais dessas meninas.

OBJECTIVE: Neuropsychological assessment is highly relevant in adolescence and in situations of conflict with the law, with deprivation of liberty in socio-educational institutions, it can help, composing psychosocial approaches that identify neuropsychological functions, situating them based on the individual's historicity. Therefore, to understand this problem, the objective of this study was to evaluate and describe the neuropsychological functions of adolescent girls deprived of liberty in a socio-educational institution. METHODS: The participants were 19 girls evaluated with the following instruments: Barratt Scale, Anger Expression Inventory, Wisconsin Card Sorting Test, Neuropsychological protocol, drug use questionnaire and Hare Psychopathy Checklist Revised. RESULTS: Lifetime drug use occurred in 80.0% of cases. There were high scores for total impulsivity (M=75.8, SD=5,4), trait anger (M=24.5, SD=7.3) and perseverative responses (M=38.5, SD=19.9). Together with total PCL-R (M=17.5, SD=3.6) and total IQ (M=79.1, SD=16), these levels helped to characterize self-control functions. CONCLUSIONS: The data were interpreted as indicating low executive functioning, high levels of anger, impulsivity, drug use and psychopathic traits. Adversities were reported during childhood, which may have contributed to impaired performance in the cognitive and emotional functions of these girls.

OBJETIVO: La evaluación neuropsicológica es de gran relevancia en la adolescencia y en las situaciones de conflicto con la ley, con privación de libertad en instituciones socioeducativas, puede ayudar, componiendo enfoques psicosociales que identifiquen funciones neuropsicológicas, las situando en función de la historicidad del individuo. Por tanto, para comprender esta problemática, el objetivo de este estudio fue evaluar y describir las funciones neuropsicológicas de niñas adolescentes privadas de libertad en una institución socioeducativa. MÉTODOS: Las participantes fueron 19 niñas evaluadas con los siguientes instrumentos: Escala de Barratt, Inventario de Expresión de Ira, Test de clasificación de cartas de Wisconsin, protocolo neuropsicológico, cuestionario de consumo de drogas y Lista de Verificación de Psicopatía de Hare Revisada. RESULTADOS: El consumo de drogas durante la vida ocurrió en el 80,0% de los casos. Hubo puntuaciones altas en impulsividad total (M = 75,8, DE = 5,4), rasgo de ira (M = 24,5, DE = 7,3) y respuestas perseverativas (M = 38,5, DE = 19,9). Junto con el PCL-R total (M=17,5, DE=3,6) y el CI total (M=79,1, DE=16,2), estos niveles ayudaron a caracterizar las funciones de autocontrol. CONCLUSIONES: Se interpretó que los datos indicaban un bajo funcionamiento ejecutivo, altos niveles de ira, impulsividad, consumo de drogas y rasgos psicopáticos. Se informaron adversidades durante la infancia, que pueden haber contribuido al deterioro del desempeño en las funciones cognitivas y emocionales de estas niñas.

Ejecución neuropsicológica y carga de enfermedad en sujetos en riesgo de desarrollar enfermedad de Huntington / Neuropsychological performance and disease burden in individuals at risk of developing Huntington disease

Introducción La enfermedad de Huntington (EH) es un trastorno neurodegenerativo y hereditario. Gracias al diagnóstico predictivo se han descrito características clínicas incipientes en la fase prodrómica. Objetivo Comparar la ejecución en tareas cognitivas de portadores (PEH) del gen de la huntingtina y no portadores (NPEH) y observar la variabilidad en la ejecución, dependiendo de la carga de la enfermedad y cercanía a la etapa manifiesta (edad de inicio de los síntomas). Método Los 146 participantes de un Programa de Diagnóstico Predictivo de EH (PDP-EH) fueron divididos en PEH (41,1%) y NPEH (58,9%). Mediante fórmulas matemáticas se obtuvo la carga de enfermedad y cercanía a la etapa manifiesta en el grupo PEH y se correlacionó con la ejecución neuropsicológica. Resultados Se observaron diferencias significativas entre los grupos con las pruebas Mini-Mental State Examination (MMSE), Stroop-B, SDMT y fluidez fonológica. En el grupo PEH se observaron correlaciones entre la carga de enfermedad con la MMSE, Stroop-B y SDMT. El grupo «Cerca» de la etapa manifiesta es el que obtuvo la puntuación más baja en las pruebas MMSE, Stroop-B, Stroop-C, SDMT y fluidez verbal semántica. De acuerdo al MANCOVA, el efecto MMSE evidencia diferencias estadísticamente significativas entre carga de la enfermedad y la cercanía de inicio de los síntomas. Conclusiones Se observa un nivel menor de desempeño en el grupo PEH con probabilidad de inicio cercano de la fase manifiesta en pruebas que evalúan la velocidad de procesamiento y atención. La disfunción cognitiva prefrontal se altera de manera precoz varios años antes del diagnóstico motor de la EH. (AU)

Introduction Huntington disease (HD) is a hereditary neurodegenerative disorder. Thanks to predictive diagnosis, incipient clinical characteristics have been described in the prodromal phase. Objective To compare performance in cognitive tasks of carriers (HDC) and non-carriers (non-HDC) of the huntingtin gene and to analyse the variability in performance as a function of disease burden and proximity to the manifest stage (age of symptom onset). Method A sample of 146 participants in a predictive diagnosis of HD programme were divided into the HDC (41.1%) and non-HDC groups (58.9%). Mathematical formulae were used to calculate disease burden and proximity to the manifest stage in the HDC group; these parameters were correlated with neuropsychological performance. Results Significant differences were observed between groups in performance on the Mini-Mental State Examination (MMSE), Stroop-B, Symbol-Digit Modalities Test (SDMT), and phonological fluency. In the HDC group, correlations were observed between disease burden and performance on the MMSE, Stroop-B, and SDMT. The group of patients close to the manifest stage scored lowest on the MMSE, Stroop-B, Stroop-C, SDMT, and semantic verbal fluency. According to the multivariate analysis of covariance, the MMSE effect shows statistically significant differences in disease burden and proximity to onset of symptoms. Conclusions Members of the HDC group close to the manifest phase performed more poorly on tests assessing information processing speed and attention. Prefrontal cognitive dysfunction appears early, several years before the motor diagnosis of HD. (AU)

Neuronorma Colombia: aportes y características metodológicas / Neuronorma Colombia: Contributions and methodological characteristics

Introducción Al realizar una evaluación neuropsicológica, es necesario contar con datos normativos adecuados; la calidad metodológica de los estudios que los proponen garantiza que las conclusiones sean confiables y válidas. Se presentan las características metodológicas del Proyecto Neuronorma Colombia con el fin de analizar sus aportes y limitaciones. Método Se exponen las características de la muestra normativa, los criterios de inclusión y exclusión, el análisis estadístico de los datos, el procedimiento para la obtención de datos normativos y los instrumentos utilizados. Resultados Se presentan algunos perfiles gráficos de ejecución de casos clínicos, a partir de la Unidad de Trabajo Neuronorma, con el fin de ilustrar la interpretación de los resultados obtenidos al evaluar pacientes con la batería Neuronorma Colombia. Discusión y conclusiones Existen ventajas metodológicas del estudio: su carácter multicéntrico y conormalizado y disponer de la Unidad de Trabajo Neuronorma, que permite obtener perfiles gráficos del desempeño del paciente, herramienta fundamental para el diagnóstico y la investigación. Se presentan los hallazgos de investigaciones posteriores realizadas a partir de los datos normativos propuestos, que son evidencia de la utilidad de la batería. Se discute el aporte de este estudio, en el contexto de sus antecedentes inmediatos. (AU)

Introduction Availability of adequate normative data is essential when performing neuropsychological evaluation; good methodological quality of the studies that propose these data ensures that their conclusions are reliable and valid. We present the methodological characteristics of the Neuronorma Colombia Project in order to analyse its contributions and limitations. Method We present the characteristics of the normative sample, inclusion and exclusion criteria, statistical analysis, the procedure for obtaining normative data, and the instruments used. Results We present graphical profiles of patient performance, based on the Neuronorma Work Unit, to illustrate the interpretation of the results obtained when evaluating patients with the Neuronorma Colombia Battery. Discussion and conclusions Our study presents several methodological advantages, such as its multicentre, co-normalised design and the availability of the Neuronorma Work Unit, which allows the creation of graphical profiles of patient performance, a fundamental tool for diagnosis and research. We present the findings of subsequent research based on the proposed normative data, which demonstrate the value of the battery. The contribution of this study is discussed in the context of its immediate background. (AU)

Diferencias neuropsicológicas en la enfermedad de Alzheimer en función de la edad de presentación / Neuropsychological differences in Alzheimer's disease depending on the age of onset

Introducción La enfermedad de Alzheimer (EA) es la forma más común de demencia entre las personas mayores. La enfermedad de Alzheimer de inicio precoz (EAIP) se ha definido como una demencia debido a EA que se presenta antes de la edad arbitrariamente establecida de 65 años. De los pacientes con EA precoz, 50% debutan con síntomas atípicos y muestran alteraciones neuropsicológicas diferentes de aquellos pacientes que debutan más tarde. Estas atipias conllevan un retraso en el diagnóstico y en el inicio del tratamiento. Métodos Seleccionamos retrospectivamente 359 pacientes con diagnóstico de probable demencia por EA. Subdividimos a los pacientes en tres grupos atendiendo a la edad de aparición de la enfermedad: EAIP, menores de 65 años; EA de inicio tardío (EAIT; entre 65 y 80); y EA de inicio muy tardío (EAIMT; definido como edad de inicio mayor de 80 años) y comparamos sus resultados neuropsicológicos. Resultados Los pacientes de EA con una edad de inicio más joven puntuaron peor en atención, función ejecutiva y habilidades visuoespaciales, mientras que los pacientes de mayor edad puntuaron peor en tareas de memoria y lenguaje. Los pacientes de inicio muy tardío se diferenciaron de los de inicio tardío en un mayor deterioro de la fluidez semántica y la denominación. Conclusión Aunque la edad de 65 años podría corresponder a un punto de separación arbitrario entre la forma precoz y la forma de inicio más tardío de la EA, nuestro estudio demuestra que existen diferencias significativas entre estos grupos desde un punto de vista neuropsicológico. Sin embargo, estas diferencias parecen seguir una tendencia lineal con la edad, en lugar de representar cuadros clínicos fundamentalmente distintos. (AU)

Introduction Early-onset Alzheimer's disease (EOAD) has been defined as a dementia due to AD presenting before the arbitrarily established age of 65 (as opposed to late-onset Alzheimer's disease or LOAD). There is still little research about other age sub-groups, the use of so-called senile dementia has been banished, usually including it within the late-onset Alzheimer's dementia. To the extent of our knowledge, there are no studies comparing the neuropsychological features of very-late-onset patients with early and late-onset ones. Methods We retrospectively selected 359 patients with a diagnosis of probable AD dementia. We subdivided patients into three groups attending to the age of onset of the disease: early-onset AD (EOAD; younger than 65 years old), late-onset AD (LOAD; between 65 and 80) and very-late-onset AD (VLOAD; defined here as onset age older than 80), and then we compared their neuropsychological results. Results AD patients with a younger age at onset scored worse on attention, executive function and visuospatial skills, while older-onset patients scored worse in memory tasks and language. Patients with a very-late-onset differed from the late-onset ones in a greater impairment of semantic fluency and naming. Conclusion Although the point of separation between EOAD and later-onset forms of EA at the age of 65 is an arbitrary one, our study shows that there are significant differences between these groups from a neuropsychological point of view. However, these differences do seem to follow a linear trend with age, rather than representing fundamentally distinct clinical pictures. (AU)

Efectos del tratamiento con andrógenos sobre la neurocognición en adolescentes transgénero de mujer a hombre / Androgen treatment effects on neurocognition in female-to-male transgender adolescents

Introducción Se ha planteado la hipótesis de que la neurocognición en personas transgénero durante el tratamiento hormonal cruzado podría aproximarse a la del género subjetivo. Sin embargo, la investigación sobre este tema ha producido resultados inconsistentes y, hasta donde sabemos, ningún estudio ha investigado los cambios neurocognitivos en adolescentes transgénero de mujer a hombre (FM) tratados con andrógenos. Sujetos y métodos Quince adolescentes transgénero FM (14-17 años) se sometieron a pruebas neuropsicológicas para examinar los efectos de los andrógenos en sus habilidades visuoespaciales, memoria verbal, velocidad de procesamiento y funciones ejecutivas. Utilizamos un diseño longitudinal en el que se evaluó a 10 participantes dos veces, antes y después de recibir, durante 12 meses, tratamiento con testosterona. Este grupo también se comparó con cinco adolescentes transgénero FM sin tratamiento con andrógenos. Resultados Los participantes evaluados antes y después de 12 meses de tratamiento con andrógenos mejoraron significativamente en velocidad de procesamiento en una tarea visuoespacial (prueba de la figura compleja de Rey-Osterrieth) y en una tarea visual (Stroop), en una tarea de memoria verbal (test de aprendizaje verbal España-Complutense) y en interferencia (Stroop), y exhibieron un menor control de la impulsividad (test de percepción de diferencias revisado). Los adolescentes que recibieron tratamiento con andrógenos mostraron un peor control de la impulsividad cognitiva que los adolescentes que no recibieron tratamiento con andrógenos. Conclusiones Los resultados indican que los andrógenos influyen en la memoria verbal, la interferencia cognitiva, el control de la impulsividad y la velocidad de procesamiento. (AU)

INTRODUCTION It has been hypothesized that cognitive and memory-related brain function in transgender during cross-sex hormonal treatment might be activated towards that of the subjective gender. However, research on this topic has produced inconsistent results, and to the best of our knowledge no studies have investigated neurocognitive changes in androgen-treated female-to-male (FM) transgender adolescents. SUBJECTS AND METHODS A total of 15 FM transgender adolescents (14-17 years) underwent neuropsychological testing in order to examine the effects of androgen on visuo-spacial abilities, verbal memory language, processing speed and executive functions. We used a longitudinal design in which 10 participants were tested twice, before and after receiving 12 months of testosterone treatment. This group was also compared with 5 FM transgender adolescents off-androgen treatment. RESULTS Participants tested before and after 12 months of androgen treatment improved significantly on processing speed in a visuo-spatial (Rey-Osterrieth complex figure test) and in a visuo-oral task (Stroop), their performance on a verbal memory task (TAVEC) and on interference (Stroop) and they exhibited lower impulsivity control (CARAS-R). On-androgen treatment adolescents exhibited worse cognitive impulsivity control than off-androgen treatment adolescents. CONCLUSIONS The results indicate that androgen has an influence on immediate verbal memory, cognitive interference, impulsivity control and processing speed. (AU)

Trastorno por déficit de atención e hiperactividad: perfil neuropsicológico y estudio de su impacto en las funciones ejecutivas y académicas / Attention deficit hyperactivity disorder: Neuropsychological profile and study of its impact on executive functions and academic performance

Introducción: El objetivo del presente estudio es describir el perfil neuropsicológico de los pacientes con trastorno por déficit de atención con hiperactividad (TDAH) y su impacto en las funciones ejecutivas y académicas. Pacientes y métodos: Se realizó un estudio analítico, observacional y retrospectivo. La muestra estuvo compuesta por 24 sujetos con diagnóstico de TDAH (6-15 años) sin tratamiento farmacológico y 24 controles (7-15 años) sin TDAH. Se realizó una evaluación neuropsicológica completa que abarcase los principales dominios cognitivos, así como la evaluación mediante cuestionarios a padres y profesores del funcionamiento ejecutivo y sintomatología psicopatológica. Resultados: El perfil cognitivo del grupo con TDAH se caracteriza por presentar puntuaciones globales (incluidas funciones ejecutivas y habilidades académicas) dentro del rango de la normalidad (puntuaciones z entre −1 y 1), aunque significativamente menores que las del grupo. Más de la mitad de los sujetos (58%) con TDAH presentan trastornos específicos de aprendizaje de manera comórbida. Por otro lado, los profesores tienden a informar de más dificultades de tipo ejecutivo cuando los sujetos son varones. Conclusiones: En nuestro grupo de estudio los pacientes diagnosticados con TDAH se caracterizan por presentar un rendimiento cognitivo dentro de la normalidad, aunque con menores puntuaciones que los controles. Los cuestionarios de conducta proporcionan información muy valiosa sobre el funcionamiento en entornos fuera de la consulta, pero pueden presentar sesgos al predominar los síntomas externalizantes. La evaluación neuropsicológica es una herramienta útil que puede facilitar el diagnóstico del TDAH y dar una respuesta eficaz a las características y a las necesidades de los pacientes y sus familias.(AU)

Introduction: The aim of the study was to describe the neuropsychological profile of patients with attention deficit hyperactivity disorder (ADHD) and the impact of the disorder on executive functioning and academic performance. Patients and methods: We conducted a retrospective observational and analytical study. The sample consisted of 24 children with a diagnosis of ADHD (aged 6-15 years) without pharmacological treatment and 24 controls without ADHD (aged 7-15 years). A comprehensive neuropsychological evaluation was carried out, encompassing major cognitive domains, in addition to assessment of executive functioning and psychopathological symptoms through the administration of questionnaires to parents and teachers. Results: The cognitive profile of the ADHD group was characterized by overall scores (including executive functions and academic abilities) in the normal range (z scores between −1 and 1), although significantly lower compared to the control group. Over half of the patients with ADHD (58%) had associated specific learning disorders. Furthermore, teachers tended to report executive function difficulties more frequently in male students. Conclusions: In the study sample, the group of patients with ADHD exhibited cognitive performance within the normal range, although with lower scores compared to controls. Behavioural rating scales provide valuable information about functioning outside the clinic, but may yield biased results on account of the focus on externalising symptoms. The neuropsychological evaluation is a useful tool that can facilitate the diagnosis of ADHD and an effective response to the needs and characteristics of patients and families.(AU)

Neuronorma Colombia: aportes y características metodológicas / Neuronorma Colombia: Contributions and methodological characteristics

Introducción Al realizar una evaluación neuropsicológica, es necesario contar con datos normativos adecuados; la calidad metodológica de los estudios que los proponen garantiza que las conclusiones sean confiables y válidas. Se presentan las características metodológicas del Proyecto Neuronorma Colombia con el fin de analizar sus aportes y limitaciones. Método Se exponen las características de la muestra normativa, los criterios de inclusión y exclusión, el análisis estadístico de los datos, el procedimiento para la obtención de datos normativos y los instrumentos utilizados. Resultados Se presentan algunos perfiles gráficos de ejecución de casos clínicos, a partir de la Unidad de Trabajo Neuronorma, con el fin de ilustrar la interpretación de los resultados obtenidos al evaluar pacientes con la batería Neuronorma Colombia. Discusión y conclusiones Existen ventajas metodológicas del estudio: su carácter multicéntrico y conormalizado y disponer de la Unidad de Trabajo Neuronorma, que permite obtener perfiles gráficos del desempeño del paciente, herramienta fundamental para el diagnóstico y la investigación. Se presentan los hallazgos de investigaciones posteriores realizadas a partir de los datos normativos propuestos, que son evidencia de la utilidad de la batería. Se discute el aporte de este estudio, en el contexto de sus antecedentes inmediatos. (AU)

Introduction Availability of adequate normative data is essential when performing neuropsychological evaluation; good methodological quality of the studies that propose these data ensures that their conclusions are reliable and valid. We present the methodological characteristics of the Neuronorma Colombia Project in order to analyse its contributions and limitations. Method We present the characteristics of the normative sample, inclusion and exclusion criteria, statistical analysis, the procedure for obtaining normative data, and the instruments used. Results We present graphical profiles of patient performance, based on the Neuronorma Work Unit, to illustrate the interpretation of the results obtained when evaluating patients with the Neuronorma Colombia Battery. Discussion and conclusions Our study presents several methodological advantages, such as its multicentre, co-normalised design and the availability of the Neuronorma Work Unit, which allows the creation of graphical profiles of patient performance, a fundamental tool for diagnosis and research. We present the findings of subsequent research based on the proposed normative data, which demonstrate the value of the battery. The contribution of this study is discussed in the context of its immediate background. (AU)

Diferencias neuropsicológicas en la enfermedad de Alzheimer en función de la edad de presentación / Neuropsychological differences in Alzheimer's disease depending on the age of onset

Introducción La enfermedad de Alzheimer (EA) es la forma más común de demencia entre las personas mayores. La enfermedad de Alzheimer de inicio precoz (EAIP) se ha definido como una demencia debido a EA que se presenta antes de la edad arbitrariamente establecida de 65 años. De los pacientes con EA precoz, 50% debutan con síntomas atípicos y muestran alteraciones neuropsicológicas diferentes de aquellos pacientes que debutan más tarde. Estas atipias conllevan un retraso en el diagnóstico y en el inicio del tratamiento. Métodos Seleccionamos retrospectivamente 359 pacientes con diagnóstico de probable demencia por EA. Subdividimos a los pacientes en tres grupos atendiendo a la edad de aparición de la enfermedad: EAIP, menores de 65 años; EA de inicio tardío (EAIT; entre 65 y 80); y EA de inicio muy tardío (EAIMT; definido como edad de inicio mayor de 80 años) y comparamos sus resultados neuropsicológicos. Resultados Los pacientes de EA con una edad de inicio más joven puntuaron peor en atención, función ejecutiva y habilidades visuoespaciales, mientras que los pacientes de mayor edad puntuaron peor en tareas de memoria y lenguaje. Los pacientes de inicio muy tardío se diferenciaron de los de inicio tardío en un mayor deterioro de la fluidez semántica y la denominación. Conclusión Aunque la edad de 65 años podría corresponder a un punto de separación arbitrario entre la forma precoz y la forma de inicio más tardío de la EA, nuestro estudio demuestra que existen diferencias significativas entre estos grupos desde un punto de vista neuropsicológico. Sin embargo, estas diferencias parecen seguir una tendencia lineal con la edad, en lugar de representar cuadros clínicos fundamentalmente distintos. (AU)

Introduction Early-onset Alzheimer's disease (EOAD) has been defined as a dementia due to AD presenting before the arbitrarily established age of 65 (as opposed to late-onset Alzheimer's disease or LOAD). There is still little research about other age sub-groups, the use of so-called senile dementia has been banished, usually including it within the late-onset Alzheimer's dementia. To the extent of our knowledge, there are no studies comparing the neuropsychological features of very-late-onset patients with early and late-onset ones. Methods We retrospectively selected 359 patients with a diagnosis of probable AD dementia. We subdivided patients into three groups attending to the age of onset of the disease: early-onset AD (EOAD; younger than 65 years old), late-onset AD (LOAD; between 65 and 80) and very-late-onset AD (VLOAD; defined here as onset age older than 80), and then we compared their neuropsychological results. Results AD patients with a younger age at onset scored worse on attention, executive function and visuospatial skills, while older-onset patients scored worse in memory tasks and language. Patients with a very-late-onset differed from the late-onset ones in a greater impairment of semantic fluency and naming. Conclusion Although the point of separation between EOAD and later-onset forms of EA at the age of 65 is an arbitrary one, our study shows that there are significant differences between these groups from a neuropsychological point of view. However, these differences do seem to follow a linear trend with age, rather than representing fundamentally distinct clinical pictures. (AU)

Neuropsychological performance and disease burden in individuals at risk of developing Huntington disease.

INTRODUCTION: Huntington disease (HD) is a hereditary neurodegenerative disorder. Thanks to predictive diagnosis, incipient clinical characteristics have been described in the prodromal phase. OBJECTIVE: To compare performance in cognitive tasks of carriers (HDC) and non-carriers (non-HDC) of the huntingtin gene and to analyse the variability in performance as a function of disease burden and proximity to the manifest stage (age of symptom onset). METHOD: A sample of 146 participants in a predictive diagnosis of HD programme were divided into the HDC (41.1%) and non-HDC groups (58.9%). Mathematical formulae were used to calculate disease burden and proximity to the manifest stage in the HDC group; these parameters were correlated with neuropsychological performance. RESULTS: Significant differences were observed between groups in performance on the Mini-Mental State Examination (MMSE), Stroop-B, Symbol-Digit Modalities Test (SDMT), and phonological fluency. In the HDC group, correlations were observed between disease burden and performance on the MMSE, Stroop-B, and SDMT. The group of patients close to the manifest stage scored lowest on the MMSE, Stroop-B, Stroop-C, SDMT, and semantic verbal fluency. According to the multivariate analysis of covariance, the MMSE effect shows statistically significant differences in disease burden and proximity to onset of symptoms. CONCLUSIONS: Members of the HDC group close to the manifest phase performed more poorly on tests assessing information processing speed and attention. Prefrontal cognitive dysfunction appears early, several years before the motor diagnosis of HD.

Attention deficit hyperactivity disorder: Neuropsychological profile and study of its impact on executive functions and academic performance.

INTRODUCTION: The aim of the study was to describe the neuropsychological profile of patients with attention deficit hyperactivity disorder (ADHD) and the impact of the disorder on executive functioning and academic performance. PATIENTS AND METHODS: We conducted a retrospective observational and analytical study. The sample consisted of 24 children with a diagnosis of ADHD (aged 6-15 years) without pharmacological treatment and 24 controls without ADHD (aged 7-15 years). A comprehensive neuropsychological evaluation was carried out, encompassing major cognitive domains, in addition to assessment of executive functioning and psychopathological symptoms through the administration of questionnaires to parents and teachers. RESULTS: The cognitive profile of the ADHD group was characterized by overall scores (including executive functions and academic abilities) in the normal range (z scores between -1 and 1), although significantly lower compared to the control group. Over half of the patients with ADHD (58%) had associated specific learning disorders. Furthermore, teachers tended to report executive function difficulties more frequently in male students. CONCLUSIONS: In the study sample, the group of patients with ADHD exhibited cognitive performance within the normal range, although with lower scores compared to controls. Behavioural rating scales provide valuable information about functioning outside the clinic, but may yield biased results on account of the focus on externalising symptoms. The neuropsychological evaluation is a useful tool that can facilitate the diagnosis of ADHD and an effective response to the needs and characteristics of patients and families.

[Neuropsychological differences in Alzheimer's disease depending on the age of onset]. / Diferencias neuropsicológicas en la enfermedad de Alzheimer en función de la edad de presentación.

INTRODUCTION: Early-onset Alzheimer's disease (EOAD) has been defined as a dementia due to AD presenting before the arbitrarily established age of 65 (as opposed to late-onset Alzheimer's disease or LOAD). There is still little research about other age sub-groups, the use of so-called senile dementia has been banished, usually including it within the late-onset Alzheimer's dementia. To the extent of our knowledge, there are no studies comparing the neuropsychological features of very-late-onset patients with early and late-onset ones. METHODS: We retrospectively selected 359 patients with a diagnosis of probable AD dementia. We subdivided patients into three groups attending to the age of onset of the disease: early-onset AD (EOAD; younger than 65 years old), late-onset AD (LOAD; between 65 and 80) and very-late-onset AD (VLOAD; defined here as onset age older than 80), and then we compared their neuropsychological results. RESULTS: AD patients with a younger age at onset scored worse on attention, executive function and visuospatial skills, while older-onset patients scored worse in memory tasks and language. Patients with a very-late-onset differed from the late-onset ones in a greater impairment of semantic fluency and naming. CONCLUSION: Although the point of separation between EOAD and later-onset forms of EA at the age of 65 is an arbitrary one, our study shows that there are significant differences between these groups from a neuropsychological point of view. However, these differences do seem to follow a linear trend with age, rather than representing fundamentally distinct clinical pictures.

Neuronorma Colombia: contributions and methodological characteristics.

INTRODUCTION: Availability of adequate normative data is essential when performing neuropsychological evaluation; good methodological quality of the studies that propose these data ensures that their conclusions are reliable and valid. We present the methodological characteristics of the Neuronorma Colombia Project in order to analyse its contributions and limitations. METHOD: We present the characteristics of the normative sample, inclusion and exclusion criteria, statistical analysis, the procedure for obtaining normative data, and the instruments used. RESULTS: We present graphical profiles of patient performance, based on the Neuronorma Work Unit, to illustrate the interpretation of the results obtained when evaluating patients with the Neuronorma Colombia Battery. DISCUSSION AND CONCLUSIONS: Our study presents several methodological advantages, such as its multicentre, co-normalised design and the availability of the Neuronorma Work Unit, which allows the creation of graphical profiles of patient performance, a fundamental tool for diagnosis and research. We present the findings of subsequent research based on the proposed normative data, which demonstrate the value of the battery. The contribution of this study is discussed in the context of its immediate background.

Neurolinguistics evidence of oral discourse in schizophrenic patients. Comparative analysis with Wernicke's aphasia

Introduction: In schizophrenia, the presence of a digressive oral discourse is very frequent, plenty of paraphasias and neologisms, provoked by the alterations of thought, which is common in thisillness. This form of empty oral discourse, full of paraphasias and neologisms, is one of the characteristic clinical manifestations of Wernicke's aphasia; with the difference that, in thesepatients, the symptomatology is linguistic, not secondary to alterations of thought. What cognitive mechanisms lead to similar verbal behaviors in both groups of patients? Objective: The purpose of this research was to obtain empirical evidence about cognitive mechanisms that underlie the alterations of verbal communication in both types of patients, from the comparative analysis of their execution in neurocognitive and neurolinguistic tests. Method: The study was implemented in a population of 70 patients organized into two groups: 35 aphasics and 35 schizophrenics. Both groups were subjected to the tests of Semantic Matching of Images, Identification of Homonymous Images and Oral Denomination of Images and Comics. Data processing involved descriptive statistics and Student's t-test for comparative analysis between groups. Results: Indicate that there are no significant differences between groups in semantic processing. In the formation of lexical concepts, schizophrenics show worse performance; while aphasics perform worse on neurolinguistic examination tests. Conclusions: Empirical evidence shows that the oral discourse of both groups of patients is markedly digressive and empty, with paraphasias and neologisms, but linguistically different.

Introducción: En la esquizofrenia es muy frecuente la presencia de un discurso oral digresivo, lleno de parafasias y neologismos, provocado por las alteraciones del pensamiento común en esta enfermedad.Esta forma de discurso oral vacío, lleno de parafasias y neologismos, es una de las manifestaciones clínicas características de la afasia de Wernicke,con la diferencia de que en estos pacientes la sintomatología es lingüística, no secundaria a alteraciones del pensamiento.¿Qué mecanismos cognitivos conducen a conductas verbales similares en ambos grupos de pacientes? Objetivo: Obtener evidencia empírica sobre los mecanismos cognitivos que subyacen a las alteraciones de la comunicación verbal en ambos tipos de pacientes, a partir del análisis comparativo de su ejecución en pruebas neurocognitivas y neurolingüísticas. Método: El estudio se implementó en una población de 70 pacientes organizados en dos grupos: 35 afásicos y 35 esquizofrénicos.Ambos grupos fueron sometidos a las pruebas de Coincidencia Semántica de Imágenes, Identificación de Imágenes Homónimas y Denominación Oral de Imágenes y Cómics.El procesamiento de datos involucró estadística descriptiva y prueba t de Student para análisis comparativo entre grupos. Resultados: Indican que no existen diferencias significativas entre grupos en el procesamiento semántico.En la formación de conceptos léxicos, los esquizofrénicos muestran peor desempeño;mientras que los afásicos obtienen peores resultados en las pruebas de examen neurolingüístico. Conclusiones: La evidencia empírica muestra que el discurso oral de ambos grupos de pacientes es marcadamente digresivo y vacío, con parafasias y neologismos, pero lingüísticamente diferentes.

Introdução: Na esquizofrenia é muito frequente a presença de um discurso oral digressivo, repleto de parafasias e neologismos, provocados pelas alterações de pensamento comuns nesta doença.Essa forma de discurso oral vazio, repleto de parafasias e neologismos, é uma das manifestações clínicas características da afasia de Wernicke,com a diferença de que, nesses pacientes, a sintomatologia é linguística e não secundária a alterações do pensamento.Que mecanismos cognitivos levam a comportamentos verbais semelhantes em ambos os grupos de pacientes? Objetivos: Obter evidências empíricas sobre os mecanismos cognitivos subjacentes às alterações da comunicação verbal em ambos os tipos de pacientes, a partir da análise comparativa da sua execução em testes neurocognitivos e neurolinguísticos. Métodos: O estudo foi implementado numa população de 70 pacientes organizados em dois grupos: 35 afásicos e 35 esquizofrênicos.Ambos os grupos foram submetidos aos testes de Emparelhamento Semântico de Imagens, Identificação de Imagens Homônimas e Denominação Oral de Imagens e Quadrinhos.O processamento dos dados envolveu estatística descritiva e teste t de Student para análise comparativa entre grupos. Resultados: Indicam que não há diferenças significativas entre os grupos no processamento semântico.Na formação de conceitos lexicais, os esquizofrênicos apresentam pior desempenho;enquanto os afásicos apresentam pior desempenho nos testes de exame neurolinguístico.Conclusões:a evidência empírica mostra que o discurso oral de ambos os grupos de pacientes é marcadamente digressivo e vazio, com parafasias e neologismos, mas linguisticamente diferente.

Correlatos neuroanatómicos y neuropsicológicos del comportamiento de adicción a las compras. Una revisión sistemática / Neuroanatomical and neuropsychological correlates of shopping addiction behaviour. A systematic review

Introducción: La incidencia de la compra compulsiva ha aumentado en las últimas dos décadas y supone un impacto negativo sustancial en el funcionamiento general de los consumidores. No obstante, a pesar de su relevancia clínica, todavía se desconocen los mecanismos neuropsicológicos y los correlatos neurales subyacentes a este fenómeno. Asimismo, el comportamiento de compra compulsiva continúa sin reconocerse como una categoría diagnóstica perteneciente a los trastornos adictivos. Objetivo El objetivo del estudio es analizar de forma sistemática la evidencia empírica disponible sobre la compra compulsiva con la finalidad de identificar las variables neuropsicológicas y los correlatos neurales subyacentes. Materiales y métodos Se realizó una búsqueda en PubMed, Scopus y ScienceDirect sobre los mecanismos subyacentes a este fenómeno. Resultados Los resultados muestran únicamente 11 estudios recientes que indagan sobre estos mecanismos. Además, se realizó un registro previo del protocolo de esta revisión sistemática en el registro internacional PROSPERO (número de registro CRD42023427497). Conclusiones Los estudios analizados aluden a una alteración en la función ejecutiva, en la toma de decisiones y en la sensibilidad a la recompensa, y una tendencia a la reactividad de señales relacionadas con las compras. Este patrón conductual parece implicar una pérdida del control del comportamiento vinculado a la desregulación de estructuras como el estriado y las regiones frontales. Se examinan los resultados obtenidos y se analizan las similitudes existentes con los mecanismos subyacentes a otras adicciones. (AU)

INTRODUCTION: The incidence of compulsive buying has increased over the last two decades and it has a substantial negative impact on consumers’ overall functioning. However, despite its clinical relevance, the neuropsychological mechanisms and neural correlates underlying this phenomenon are still unknown. Also, compulsive buying behaviour remains unrecognised as a diagnostic category belonging to addictive disorders. AIM The aim of the study is to systematically analyse the available empirical evidence on compulsive buying in order to identify the underlying neuropsychological variables and neural correlates. MATERIALS AND METHODS PubMed, Scopus and ScienceDirect were searched for the mechanisms behind this phenomenon. RESULTS The results show only 11 recent studies that investigate these mechanisms. In addition, the protocol of this systematic review was pre-registered in the international PROSPERO register (registration number CRD42023427497). CONCLUSIONS The studies reviewed refer to impaired executive functions, decision-making and sensitivity to rewards, and a tendency to reactivity to purchase-related cues. This pattern of behaviour appears to involve a loss of behavioural control linked to dysregulation of structures such as the striatum and frontal regions. The results obtained are examined and similarities with the mechanisms underlying other addictions are discussed. (AU)

Teleatendimento no acompanhamento terapêutico de crianças com TEA na pandemia da COVID-19 / Teleservice in the therapeutic follow-up of children with ASD in the COVID-19 pandemic

Após o início da pandemia da COVID-19, os profissionais da saúde, especialmente os psicólogos, passaram a realizar teleatendimentos. Dessa forma, o objetivo desse estudo é analisar como os profissionais brasileiros de psicologia clínica realizaram teleatendimentos a crianças com transtorno do espectro autista (TEA) no período de isolamento social durante a pandemia da COVID-19. Foi adotado uma pesquisa de levantamento de dados, transversal de análise quanti-qualitativa em que os dados foram coletados por meio de um questionário autoadministrado com aplicação on-line. O público-alvo desse estudo foram os profissionais de psicologia que realizaram teleatendimento em crianças com TEA. Os resultados evidenciaram que metade dos respondentes são do Rio Grande do Norte (50%) e fizeram atendimento modalidade on-line e presencial (69,9%). As principais atividades listadas pelos profissionais realizadas com as crianças, assim como a orientação aos pais, estão relacionadas com a organização de rotina, atividades da vida diária e estimulação cognitiva e comportamental. No Brasil, os estudos sobre o teleatendimento necessitam ampliar as evidências científicas quanto a essa problemática, principalmente a respeito de crianças com TEA. O atendimento remoto para este público pode ser possível, o que gera impacto positivo à prática clínica do profissional e acolhimento das famílias de crianças com TEA.

After the beginning of the COVID-19 pandemic, health professionals, especially psychologists, began to perform teleservices. In this way, the objective of this study is to analyze how Brazilian clinical psychology professionals performed teleservices to children with autism spectrum disorder (ASD) during the period of social isolation during the COVID-19 pandemic. A quantitative-qualitative cross-sectional analysis was adopted, in which data were collected through a self-administered questionnaire with online application. The target audience of this study were Psychology professionals who performed teleservice in children with ASD. The results show that half of the respondents were from Rio Grande do Norte (50%) and attended online and in person (69.9%). The main activities listed by professionals carried out with children, as well as the advice given to parents, were related to routine organization, activities of daily living and cognitive and behavioral stimulation. In Brazil, studies on teleservice need to expand the scientific evidence on this issue, especially regarding children with ASD. Remote care for this target group could be possible, which would have a positive impact on the clinical practice of professionals and the care of families with children with ASD.

Perfil neurocognitivo asociado al trastorno límite de personalidad: creación de índices específicos de función ejecutiva / Neurocognitive profile associated with borderline personality disorder: building specific indices of executive function

Introducción. El objetivo de este trabajo es la creación de índices específicos de las distintas funciones ejecutivas (FE), que permitan comprender de forma más completa y no mediante pruebas aisladas el rendimiento ejecutivo asociado al trastorno límite de la personalidad (TLP). Metodología. 118 pacientes con TLP y 81 controles fueron evaluados con una batería neuropsicológica. Se crearon tres índices de atención, memoria y FE. Las pruebas que forman el índice ejecutivo se agruparon en cuatro índices ejecutivos diferentes: flexibilidad cognitiva, planificación, memoria de trabajo e inhibición de respuesta. Las puntuaciones para cada dominio se obtuvieron a través de las puntuaciones estandarizadas de las pruebas que los componían. Resultados. Los resultados mostraron diferencias significativas en los índices de memoria, atención y FE, así como en los diferentes índices ejecutivos de flexibilidad cognitiva, planificación, memoria de trabajo e inhibición de respuesta, entre los pacientes con TLP y los controles. Conclusiones. Este estudio ha permitido la creación de cuatro índices ejecutivos, siendo el primero hasta la fecha en hacerlo. Estos resultados establecen un perfil neurocognitivo del TLP caracterizado por un deterioro ejecutivo específico de la flexibilidad cognitiva, la planificación, la memoria de trabajo y la inhibición de la respuesta. Estos hallazgos avalan que los pacientes con TLP podrían beneficiarse de la aplicación de programas neuropsicológicos, especialmente enfocados en mejorar determinadas FE, y sientan las bases para la investigación de la relación entre estos déficits ejecutivos específicos y ciertas características clínicas del TLP, como diferentes tipos de comportamiento impulsivo y diferentes errores de mentalización. (AU)

Introduction. The objective of this work is the creation of specific indices of the different executive functions (EF), which allow a more complete understanding of the executive performance associated with borderline personality disorder (BPD) and not through isolated tests. Methodology. 118 patients with BPD and 81 controls were evaluated with a neuropsychological battery. Three indices of attention, memory and FE were created. The tests that make up the executive domain were grouped into four different executive indices: cognitive flexibility, planning, working memory, and response inhibition. The batteries for each domain were compared through the standardized batteries of the tests that comprised them. Results. The results showed differences in the memory, attention, and EF indices, as well as in the different executive indices of cognitive flexibility, planning, working memory, and response inhibition, between BPD patients and controls. Conclusions. This study has allowed the creation of four executive indexes, being the first to do so. These results established a neurocognitive profile of BPD characterized by executive-specific impairment of cognitive flexibility, planning, working memory, and response inhibition. These findings support that patients with BPD will benefit from the application of neuropsychological programs, especially focused on improving a certain EF, and lay the foundations for the investigation of the relationship between these specific executive deficits and certain clinical characteristics of BPD, such as different types of Impulsive behavior and different mentalization errors. (AU)

Subtipos de Dislexia do Desenvolvimento Descritos no Português Brasileiro: Uma Revisão Integrativa / Developmental Dyslexia Subtypes Described in Brazilian Portuguese: An Integrative Review / Subtipos de Dislexia del Desarrollo Descritos en Portugués Brasileño: Una Revisión Integradora

A heterogeneidade na dislexia do desenvolvimento pode ser compreendida por meio dos subtipos de dislexia do desenvolvimento (SDD), porém não foram encontrados estudos que avaliassem a literatura brasileira sobre SDD. A presente revisão buscou responder quais SDD foram identificados no português brasileiro. Foram incluídos estudos empíricos, em inglês ou português, que descrevessem ao menos um SDD, bem como critérios diagnósticos, com participantes brasileiros. As buscas foram realizadas nas bases Scielo, Pubmed e Google Scholar. Como resultado, foram encontrados 11 estudos referentes a seis SDD, sendo as dislexias fonológicas e de superfície as mais presentes, e foram descritas as definições, critérios de identificação e instrumentos de avaliação utilizados em cada estudo. Foi discutida a heterogeneidade de definições, critérios de identificação e instrumentos de avaliação encontrados. Destacam-se o pequeno número de relatos em comparação com a literatura internacional e a necessidade de tarefas padronizadas, validadas e sensíveis aos SDD no português brasileiro.(AU)

The present review aimed to explore the subtypes of developmental dyslexia (SDD), identified in the Brazilian literature, considering the heterogeneity in developmental dyslexia. This review included empirical studies in English or Portuguese, involving Brazilian students, and describing at least one SDD, along with diagnostic criteria. Searches were conducted in the Scielo, Pubmed and Google Scholar databases. The review identified 11 studies, which covered six different SDD. Phonological and surface dyslexia were the most commonly reported subtypes. The review discussed the variations in definitions, identification criteria, and evaluation instruments used in these studies. It also highlighted the limited number of reports in the Brazilian literature compared to international sources and emphasized the need for standardized, validated tasks in Brazilian Portuguese that are SDD-sensitive.(AU)

La heterogeneidad en la dislexia del desarrollo puede comprenderse a través de los subtipos de dislexia del desarrollo (SDD), pero no se encontraron estudios que evalúen la literatura brasileña sobre SDD. Esta revisión buscó responder cuáles los SDD se han identificado en el portugués brasileño. Se incluyeron estudios empíricos con participantes brasileños en inglés o portugués que describieran al menos un SDD y sus criterios de diagnósticos. Las búsquedas se realizaron en las bases de datos Scielo, Pubmed y Google Scholar. Como resultado, se encontraron 11 estudios relacionados con seis SDD, siendo las dislexias fonológicas y de superficie las más comunes, y se describieron las definiciones, criterios de identificación e instrumentos de evaluación utilizados en cada estudio. Se discutió la heterogeneidad de definiciones, criterios de identificación y herramientas de evaluación encontradas. Se destaca el escaso número de informes en comparación con la literatura internacional y la necesidad de tareas estandarizadas, validadas y sensibles a SDD en el portugués brasileño.(AU)

Diagnóstico de la variante conductual de demencia frontotemporal basado en estadios clínicos adaptado para países con baja educación: el caso de Perú

Demencia frontotemporal (DFT) es una condición neurodegenerativa escasamente reconocida en personas menores a 65 años de edad. El diagnóstico de DFT variante conductual (DFTvc) se basa en una entrevista clínica comprehensiva, complementada por una evaluación multidimensional (neurológica, cognitiva, neuropsiquiátrica, de biomarcadores e imágenes cerebrales) adaptada y validada a la población a estudiar; sin embargo, a pesar del incremento de su prevalencia en Latinoamérica y el Caribe, existe necesidad de herramientas estandarizadas y un consenso para el diagnóstico de DFTvc. El artículo intenta realizar una aproximación del enfoque de diagnóstico de DFTvc en escenario de paises con bajos y medianos ingresos, como el Perú.

Frontotemporal dementia (FTD) is a widely recognized neurodegenerative condition in people under 65 years old. The diagnosis of behavioral variant FTD (bvFTD) is based on a comprehensive clinical assessment, complemented by a multidimensional assessment (neurological, cognitive, neuropsychiatric, biomarker and brain imaging) adapted and validated to the population to be studied; however, despite its increasing prevalence in Latin America and the Caribbean, there is a need for standardized tools and consensus for the bvFTD diagnosis. The manuscript attempts to approximate the approach for the diagnosis of bvFTD in the setting of low and middle-income countries, including Peru.

Neuropsychology of epilepsy surgery and theory-based practice: an opinion review / Neuropsicologia da cirurgia de epilepsia e prática teórica: uma revisão de opinião

Abstract The present review attempts to discuss how some of the central concepts from the Lurian corpus of theories are relevant to the modern neuropsychology of epilepsy and epilepsy surgery. Through the lenses of the main Lurian concepts (such as the qualitative syndrome analysis), we discuss the barriers to clinical reasoning imposed by quadrant-based views of the brain, or even atheoretical, statistically-based and data-driven approaches. We further advice towards a systemic view inspired by Luria's clinical work and theorizing, given their importance towards our clinical practice, by contrasting it to the modular views when appropriate. Luria provided theory-guided methods of assessment and rehabilitation of higher cortical functions. Although his work did not specifically address epilepsy, his theory and clinical approaches actually apply to the whole neuropathology spectrum and accounting for the whole panorama of neurocognition. This holistic and systemic approach to the brain is consistent with the network approach of the neuroimaging era. As to epilepsy, the logic of cognitive functions organized into complex functional systems, contrary to modular views of the brain, heralds current knowledge of epilepsy as a network disease, as well as the concept of the functional deficit zone.

Resumo A presente revisão tenta discutir como alguns dos conceitos centrais do corpus de teorias lurianas são relevantes para a moderna neuropsicologia da epilepsia e cirurgia da epilepsia. Através das lentes dos principais conceitos lurianos (como a análise qualitativa de síndromes), discutimos as barreiras ao raciocínio clínico impostas por visões do cérebro baseadas em quadrantes, ou mesmo abordagens ateóricas, baseadas em estatísticas e orientadas por dados. Aconselhamos ainda uma visão sistêmica inspirada na clínica e na teorização de Luria, dada sua importância para nossa prática clínica, contrastando-a com as visões modulares quando apropriado. Luria forneceu métodos teóricos de avaliação e reabilitação de funções corticais superiores. Embora seu trabalho não abordasse especificamente a epilepsia, sua teoria e abordagens clínicas na verdade se aplicam a todo o espectro da neuropatologia e respondem por todo o panorama da neurocognição. Essa abordagem holística e sistêmica do cérebro é consistente com a abordagem de rede da era da neuroimagem. Quanto à epilepsia, a lógica das funções cognitivas organizadas em sistemas funcionais complexos, ao contrário das visões modulares do cérebro, anuncia o conhecimento atual da epilepsia como uma doença em rede, bem como o conceito de zona de déficit funcional.

Assessment of sustained attention in high-performance and attention deficit/hyperactivity disorder (ADHD) children with a vigilance task / Evaluación de la atención sostenida en niños de alto rendimiento y con trastorno por déficit de atención e hiperactividad (TDAH) en una tarea de vigilancia

El objetivo principal de este estudio fue comparar a niños se-leccionados en un contexto comunitario con TDAH, alto rendimiento, y desarrollo normotípico, en una tarea de atención sostenida. Se selecciona-ron tres grupos de niños: TDAH (n= 42), alto rendimiento (n= 20) y desarrollo normotípico (n= 28). Se aplicó una tarea breve de vigilancia computarizada (CSAT-R) para comparar la capacidad deatención y el tiempo de reacción. Para analizar la validez clínica, los participantes se divi-dieron en aquellos con "disfunción atencional" y aquellos con "atención normal”. Los niños con alto rendimiento se diferenciaron claramente de los otros dos grupos, con tamaños del efecto grandes. Las diferencias entre los grupos normotípico y TDAH solo fueron significativas en los errores y en un índice no paramétrico de capacidad de atención, pero con tamaños del efecto pequeños. La CSAT-R mostró una buena especificidad y un valor predictivo positivo aceptable, pero niveles bajos de sensibilidad y un pobre valor predictivo negativo. Por tanto, la atención sostenida podría ser un mecanismo destacado en niños con altas capacidades. La CSAT-R (y pro-bablemente la mayoría de las tareas de atención) sería moderadamente útil en entornos comunitarios para el diagnóstico del TDAH, pero no para des-cartarlo.(AU)

The main objective of this study was to compare children select-ed in a community setting with ADHD, high-performance, and normo-typical development on a sustained attention task. Three groups of chil-dren were selected: ADHD (n= 42), high-performance (n= 20), and nor-mo-typical development (n= 28). A brief computerized vigilance task (CSAT-R) was applied to compare attentional capacity and reaction time. The participants were divided into those with “attentional dysfunction” and those with “normal attention” to analyze clinical validity. Children with high-performance were clearly differentiated from the other two groups, with large effect sizes. The differences between normo-typical and ADHD groups were only significant in the errors and in a nonparametric index of attentional capacity, but with small effect sizes. The CSAT-R showed good specificity and an acceptable positive predictive value, but low levels of sensitivity, and a poor negative predictive value. Therefore, sustained attention could be a prominent mechanism in children with high capacities. The CSAT-R (and probably most of attentional tasks) would be moderately useful in community settings for ADHD diagnosis, but not to rule it out.(AU)