Conversational repair in individuals with Alzheimer disease. / Reformulación conversacional en personas con la enfermedad de Alzheimer.

PURPOSE: many of the difficulties that usually arise in colloquial conversation may be repaired as the interaction develops. Conversational repair is a linguistic strategy that indicates evidence of the partners' abilities to promote necessary mutual understanding for effective communication. This study aims to analyze the oral text repairs of 10 older adults with Alzheimer's dementia (AD) and 10 older adults without dementia, as well as to verify whether they are a useful element for language disorders identification in AD. METHODS: autobiographical interview and application of items of the MetAphAs protocol were proposed. Data were analyzed based on the methodology of conversational analysis. RESULTS: the results indicated that self-initiated repairs are frequent in both groups, although subjects with AD made more use of inadequate repairs, which did not favor mutual understanding. Hetero-repairs occurred most frequently in conversations with individuals with AD, suggesting the need for interlocutor's intervention to adjust a specific utterance. CONCLUSION: this research has shown that using repair strategies is sensitive to individuals with AD cognitive performance.

OBJETIVO: en la conversación coloquial surgen diversas dificultades que se van reparando en vivo mientras esta se va desarrollando. La reformulación conversacional es una estrategia lingüística que va dando cuenta de las capacidades de los interlocutores para favorecer la comprensión mutua necesaria para la comunicación efectiva. El presente trabajo tiene como objetivo analizar las reformulaciones de 10 adultos mayores con Demencia tipo Alzheimer (DTA) y 10 adultos mayores sin demencia, y determinar si constituyen un elemento útil para el diagnóstico de la persona con DTA. MÉTODO: se eligió el análisis conversacional como procedimiento metodológico y se propuso una entrevista de tipo conversación de corte autobiográfico y la aplicación de algunos ítems del protocolo MetAphAs. RESULTADOS: los resultados muestran que la reformulación auto-iniciada es más frecuente que las demás en ambos grupos, aunque las personas con DTA realizan mayor número de reformulaciones inadecuadas que muchas veces no favorecen la comprensión mutua. La hetero-reformulación aparece con mayor frecuencia en las conversaciones en personas con DTA, indicando la necesidad de la intervención del interlocutor para reparar la conversación. CONCLUSIÓN: en la presente investigación se ha podido evidenciar que la capacidad de utilizar la estrategia de reformulación es sensible al desempeño cognitivo de personas con DTA.

Reformulación conversacional en personas con la enfermedad de Alzheimer / Conversational repair in individuals with Alzheimer disease

RESUMEN Objetivo en la conversación coloquial surgen diversas dificultades que se van reparando en vivo mientras esta se va desarrollando. La reformulación conversacional es una estrategia lingüística que va dando cuenta de las capacidades de los interlocutores para favorecer la comprensión mutua necesaria para la comunicación efectiva. El presente trabajo tiene como objetivo analizar las reformulaciones de 10 adultos mayores con Demencia tipo Alzheimer (DTA) y 10 adultos mayores sin demencia, y determinar si constituyen un elemento útil para el diagnóstico de la persona con DTA. Método se eligió el análisis conversacional como procedimiento metodológico y se propuso una entrevista de tipo conversación de corte autobiográfico y la aplicación de algunos ítems del protocolo MetAphAs. Resultados los resultados muestran que la reformulación auto-iniciada es más frecuente que las demás en ambos grupos, aunque las personas con DTA realizan mayor número de reformulaciones inadecuadas que muchas veces no favorecen la comprensión mutua. La hetero-reformulación aparece con mayor frecuencia en las conversaciones en personas con DTA, indicando la necesidad de la intervención del interlocutor para reparar la conversación. Conclusión en la presente investigación se ha podido evidenciar que la capacidad de utilizar la estrategia de reformulación es sensible al desempeño cognitivo de personas con DTA.

ABSTRACT Purpose many of the difficulties that usually arise in colloquial conversation may be repaired as the interaction develops. Conversational repair is a linguistic strategy that indicates evidence of the partners' abilities to promote necessary mutual understanding for effective communication. This study aims to analyze the oral text repairs of 10 older adults with Alzheimer's dementia (AD) and 10 older adults without dementia, as well as to verify whether they are a useful element for language disorders identification in AD. Methods autobiographical interview and application of items of the MetAphAs protocol were proposed. Data were analyzed based on the methodology of conversational analysis. Results the results indicated that self-initiated repairs are frequent in both groups, although subjects with AD made more use of inadequate repairs, which did not favor mutual understanding. Hetero-repairs occurred most frequently in conversations with individuals with AD, suggesting the need for interlocutor's intervention to adjust a specific utterance. Conclusion this research has shown that using repair strategies is sensitive to individuals with AD cognitive performance.

Adaptation and psychometric data of the Exploration of Natural Metalinguistic Skills in Aphasia Protocol (MetAphAs) - Chilean version. / Adaptación y datos psicométricos de la versión chilena del Protocolo de Exploración de Habilidades Metalingüísticas Naturales en Afasia (MetAphAs).

PURPOSE: This study aimed to cross culturally adapt the Protocol for the Exploration of Natural Metalinguistic Skills in Aphasia (MetAphAs), contributing to the future application in the aphasic Chilean population. METHOD: The sample corresponds to 72 healthy subjects in the region of Valparaíso, between the ages of 50 to 85. The MetAphAs measures natural metalinguistic skills and presents the basic elements on which to base the exploration of the metacognitive dimensions involved in verbal behavior. The validity was ascertained by means of Cronbach's Alpha Coefficient, including the values of each of the 6 sections; the correlations between variables were analyzed by the Pearson coefficient. RESULTS: We observed that 64% of the sample corresponded to the female and 36% to the male gender, with predominant age ranging from 61 to 70 years. We verified adequate correlation between the variables according to the Pearson coefficient, and highly positive values according to Cronbach's Alpha. CONCLUSION: The use of the protocol is viable, with data demonstrating high reliability. The results evidenced high liability, which encourages the continuation process of its validation with Chilean aphasic population.

OBJETIVO: El objetivo de este estudio fue adaptar transculturalmente el Protocolo de Exploración de Habilidades Metalingüísticas Naturales en Afasia (MetAphAs), contribuyendo a la aplicación futura del instrumento en la población afásica chilena. MÉTODO: la muestra corresponde a 72 individuos sanos de la región de Valparaíso, de 50 a 85 años. El Protocolo MetAphAs mide las habilidades metalingüísticas naturales y presenta los elementos básicos en los que debe basarse una exploración de la dimensión metacognitiva involucrada en el comportamiento verbal. La validez se verificó mediante el coeficiente alfa de Cronbach, incluidos los valores de cada una de las 6 secciones; las correlaciones entre las variables fueron analizadas por el coeficiente de Pearson. RESULTADOS: el 64% de la muestra correspondió a mujeres y el 36% a hombres, con el mayor grupo de edad de participación de 61 a 70 años; se verifica una correlación adecuada entre las variables según el coeficiente de Pearson y los valores altamente positivos según el alfa de Cronbach. CONCLUSIÓN: el uso del protocolo fue factible y relevante, con datos que demostraron una alta confiabilidad. Los resultados obtenidos y las ventajas indicadas alientan el uso de este tipo de instrumento como una opción viable para la validación en afásicos chilenos.

Autobiographical narratives in the elderly with neurocognitive disorder: an integrative literature review / Narrativas autobiográficas en la persona adulta mayor con trastorno neurocognitivo: revisión integrativa da literatura

ABSTRACT Objective: to carry out an integrative review of the literature on autobiographical narratives as a discursive activity in the older adult with neurocognitive disorder. Methods: a descriptive study that covered the Scopus, SciELO, PubMed, and Science Direct databases, from 2009 to 2019, using the keywords autobiographical, narrative, dementia, reminiscence, the elderly, and the Boolean operator. A narrative synthesis was adopted considering the characteristics of the clinical, and methodological heterogeneity of the studies. Results: the results included 3 articles published between 2012 and 2018, in the English language, from the United Kingdom, Brazil, and Argentina, which highlighted the autobiographical narratives. Although in a strict sense they did not present the narrative as a specific objective of the autobiographical study, they did provide interesting and related data which justified their inclusion. Conclusion: it is observed that the literature researched presents a limited number of articles, adressing the autobiographical narrative as a discursive activity in the elderly with neurocognitive disorder.

RESUMEN Objetivo: realizar una revisión integrativa de la literatura sobre la narrativa autobiográfica como actividad discursiva del adulto mayor con trastorno neurocognitivo. Métodos: estudio descriptivo que cubrió las bases de datos Scopus, SciELO, PubMed y Science Direct, en el periodo de 2009 a 2019, con las palabras clave: narrativa autobiográfica, demencia, reminiscencia, adulto mayor y el operador booleano and. Se adoptó una síntesis narrativa considerando las características de la heterogeneidad clínica y metodológica de los estudios. Resultados: los resultados comprenden 3 artículos, publicados entre 2012 a 2018, en Reino Unido, Brasil y Argentina. Aunque en stricto sensu no presentan como objetivo específico el estudio de aspectos discursivos de la narrativa autobiográfica, entregan datos interesantes y relacionados a ella, lo que justifica su inclusión Conclusión: se observa que todavía hay un número limitado de artículos en la literatura con el enfoque de la narrativa autobiográfica como actividad discursiva de la persona mayor con trastorno neurocognitivo.

Adaptación y datos psicométricos de la versión chilena del Protocolo de Exploración de Habilidades Metalingüísticas Naturales en Afasia (MetAphAs) / Adaptation and psychometric data of the Exploration of Natural Metalinguistic Skills in Aphasia Protocol (MetAphAs) - Chilean version

RESUMEN Objetivo: El objetivo de este estudio fue adaptar transculturalmente el Protocolo de Exploración de Habilidades Metalingüísticas Naturales en Afasia (MetAphAs), contribuyendo a la aplicación futura del instrumento en la población afásica chilena. Método: la muestra corresponde a 72 individuos sanos de la región de Valparaíso, de 50 a 85 años. El Protocolo MetAphAs mide las habilidades metalingüísticas naturales y presenta los elementos básicos en los que debe basarse una exploración de la dimensión metacognitiva involucrada en el comportamiento verbal. La validez se verificó mediante el coeficiente alfa de Cronbach, incluidos los valores de cada una de las 6 secciones; las correlaciones entre las variables fueron analizadas por el coeficiente de Pearson. Resultados: el 64% de la muestra correspondió a mujeres y el 36% a hombres, con el mayor grupo de edad de participación de 61 a 70 años; se verifica una correlación adecuada entre las variables según el coeficiente de Pearson y los valores altamente positivos según el alfa de Cronbach. Conclusión: el uso del protocolo fue factible y relevante, con datos que demostraron una alta confiabilidad. Los resultados obtenidos y las ventajas indicadas alientan el uso de este tipo de instrumento como una opción viable para la validación en afásicos chilenos.

ABSTRACT Purpose: This study aimed to cross culturally adapt the Protocol for the Exploration of Natural Metalinguistic Skills in Aphasia (MetAphAs), contributing to the future application in the aphasic Chilean population. Method: The sample corresponds to 72 healthy subjects in the region of Valparaíso, between the ages of 50 to 85. The MetAphAs measures natural metalinguistic skills and presents the basic elements on which to base the exploration of the metacognitive dimensions involved in verbal behavior. The validity was ascertained by means of Cronbach's Alpha Coefficient, including the values of each of the 6 sections; the correlations between variables were analyzed by the Pearson coefficient. Results: We observed that 64% of the sample corresponded to the female and 36% to the male gender, with predominant age ranging from 61 to 70 years. We verified adequate correlation between the variables according to the Pearson coefficient, and highly positive values according to Cronbach's Alpha. Conclusion: The use of the protocol is viable, with data demonstrating high reliability. The results evidenced high liability, which encourages the continuation process of its validation with Chilean aphasic population.

Transcranial direct current stimulation: a study on naming performance in aphasic individuals. / Estimulação transcraniana por corrente contínua: estudo sobre respostas em tarefas de nomeação em afásicos.

PURPOSE: Compare the results in naming tasks of after-stroke aphasic individuals divided into active and placebo groups pre- and post-transcranial direct current stimulation. METHODS: A double-blind, randomized, controlled study conducted with 14 individuals. Patients underwent five 20-min sessions with stimulation of 2mA's on consecutive days. The cathode was placed over the Broca's homologous area and the anode was placed over the supraorbital region of the left hemisphere. Boston and Snodgrass naming tasks were assessed before and after the stimulation sessions and the results were compared between the groups. RESULTS: No significant results were observed for sequences 1 and 2 in the Snodgrass test. The Boston test results indicated significant difference related to mean time for correct responses with strategy. CONCLUSION: The results suggest that simultaneous transcranial direct current stimulation (anodic and cathodic) is a method that can improve the rehabilitation of patients with anomic and Broca's aphasia after stroke, and that language strategies should be considered in the analysis of naming task responses.

OBJETIVO: Comparar os resultados nas tarefas de nomeação de pacientes afásicos após AVC dos grupos ativo e controle. MÉTODO: Estudo duplo-cego, randomizado controlado com 14 pacientes. Os indivíduos foram submetidos a cinco sessões de 20 minutos de 2 mA em dias consecutivos. O catodo foi posicionado na área homóloga à Broca e o anodo sobre a região supraorbital do hemisfério esquerdo. Os testes de Boston e Snodgrass foram aplicados e os resultados comparados entre os grupos. RESULTADOS: Não houve resultados significativos para as sequências 1 e 2 no teste do Snodgrass. No teste de Boston, os dados indicaram uma diferença significativa para o tempo médio de acertos com estratégia. CONCLUSÃO: Os resultados sugerem que a ETCC simultânea (anódica e catódica) é um método que pode auxiliar a reabilitação de pacientes com afasia do tipo anômica e de Broca, após AVC, e que as estratégias linguísticas deveriam ser consideradas nas análises das respostas dos testes de nomeação.

Narrative evaluation strategies as metacognitive task in subjects with schizophrenia. / Estrategias de evaluación en la narración como tarea metacognitiva en personas con esquizofrenia.

PURPOSE: This study aims to explore the differences in the evaluative component of the narrative structure in subjects diagnosed with schizophrenia compared to subjects diagnosed with affective psychosis. METHODS: The present investigation was descriptive, not experimental and it included the analysis of the narration evaluative components of interviews of 25 individuals with psychiatric diagnosis of chronic schizophrenia and 25 of chronic affective psychosis, matched by age, gender and sociodemographic characteristics. RESULTS: The relationship between diagnosis and type of evaluation showed statistically significant results with a chi square value of 39.880a (p <0.00). It was possible to observe that in the schizophrenia there is a greater inhibition in the elaboration of expressions that imply opinions and that narratives tended to identify facts regardless of how they affected subjects, suggesting a limitation of intersubjective function. CONCLUSION: The diagnostic variable confirms that in schizophrenia there is a functional deterioration in the process of elaborating narrative structures especially in the articulation of the evaluative component. In the case of the affective psychosis group, superficial dysfunctions were manifested, without compromising their performance in the evaluation of narratives.

OBJETIVO: Este estudio procura explorar las diferencias en el componente evaluativo de la estructura narrativa en personas con diagnóstico de esquizofrenia, en comparación con personas con diagnóstico de psicosis afectiva. MÉTODO: El presente estudio es descriptivo, no experimental, y comprende el análisis de los componentes evaluativos de la narrativa, en entrevistas realizadas a 25 individuos con diagnostico psiquiátrico de esquizofrenia crónica y a 25 individuos diagnosticados de psicosis afectiva crónica, pareados por edad, género y características sociodemográficas. RESULTADOS: La relación entre diagnóstico y tipo de evaluación arrojó resultados estadísticamente significativos con un valor de chi cuadrado de 39,880a (p< 0.00). Fue posible observar que en la esquizofrenia existe una mayor inhibición en la elaboración de expresiones que impliquen opiniones, que los relatos tendieron a identificar los hechos independientemente de cómo les afectaron, sugiriendo una limitación de la función intersubjetiva. CONCLUSIÓN: La variable diagnóstico confirma que en la esquizofrenia existe un deterioro funcional en la elaboración de estructuras narrativas y en la articulación del componente evaluativo. En el caso de la psicosis afectiva se manifiestan disfunciones superficiales, sin comprometer su desempeño en la evaluación de las narraciones.

Speech-language intervention in schizophrenia: an integrative review / Intervención fonoaudiológica en la esquizofrenia: revisión integrativa

ABSTRACT Objective: to perform an integrative review to identify speech and language pathology intervention for schizophrenia. Methods: the review covered SCIELO, PUBMED, OXFORD JOURNALS and SCIENCEDIRECT databases for speech and language pathology intervention studies for schizophrenia. A narrative synthesis was adopted considering the level of clinical and methodological heterogeneity amid studies. Results: the results demonstrated an increase in publications since 2012 with 11 articles meeting the criteria. Language and discourse assessment were the speech and language pathology privileged procedures. Conclusion: the review indicates that the most eligible intervention was assessment, that studies' methodology were heterogeneous and that the communication disorders identified were related to discursive, pragmatic and syntactic disorders, which evidences the importance of more systematized intervention procedures and research on schizophrenic patients.

RESUMEN Objetivo: el objetivo de este estudio fue identificar la evidencia científica sobre la intervención fonoaudiológica en esquizofrenia. Métodos: se realizó una revisión integrativa de la literatura científica sobre intervenciones fonoaudiológicas en pacientes con esquizofrenia, en SCIELO, PUBMED, OXFORD JOURNALS y SCIENCEDIRECT, desde el año 2000 hasta marzo de 2017 y en los idiomas inglés, español y portugués. Se adoptó una síntesis narrativa en vista del nivel de heterogeneidad clínica y metodológica entre los estudios. Resultados: los resultados demostraron un aumento de publicaciones a partir del año 2012 y que en los 11 artículos que cumplirán con los criterios del estudio el procedimiento privilegiado fue la evaluación del lenguaje y del discurso. Conclusión: la revisión indica que la intervención privilegiada fue la evaluación, que los estudios presentaron heterogeneidad en la metodología y resultados relacionados con los problemas discursivos, pragmáticos y trastornos sintácticos, que evidencian la importancia de buscar más sistematicidad en la intervención fonoaudiológica del paciente con esquizofrenia.

Estrategias de evaluación en la narración como tarea metacognitiva en personas con esquizofrenia / Narrative evaluation strategies as metacognitive task in subjects with schizophrenia

RESUMEN Objetivo Este estudio procura explorar las diferencias en el componente evaluativo de la estructura narrativa en personas con diagnóstico de esquizofrenia, en comparación con personas con diagnóstico de psicosis afectiva. Método El presente estudio es descriptivo, no experimental, y comprende el análisis de los componentes evaluativos de la narrativa, en entrevistas realizadas a 25 individuos con diagnostico psiquiátrico de esquizofrenia crónica y a 25 individuos diagnosticados de psicosis afectiva crónica, pareados por edad, género y características sociodemográficas. Resultados La relación entre diagnóstico y tipo de evaluación arrojó resultados estadísticamente significativos con un valor de chi cuadrado de 39,880a (p< 0.00). Fue posible observar que en la esquizofrenia existe una mayor inhibición en la elaboración de expresiones que impliquen opiniones, que los relatos tendieron a identificar los hechos independientemente de cómo les afectaron, sugiriendo una limitación de la función intersubjetiva. Conclusión La variable diagnóstico confirma que en la esquizofrenia existe un deterioro funcional en la elaboración de estructuras narrativas y en la articulación del componente evaluativo. En el caso de la psicosis afectiva se manifiestan disfunciones superficiales, sin comprometer su desempeño en la evaluación de las narraciones.

ABSTRACT Purpose This study aims to explore the differences in the evaluative component of the narrative structure in subjects diagnosed with schizophrenia compared to subjects diagnosed with affective psychosis. Methods The present investigation was descriptive, not experimental and it included the analysis of the narration evaluative components of interviews of 25 individuals with psychiatric diagnosis of chronic schizophrenia and 25 of chronic affective psychosis, matched by age, gender and sociodemographic characteristics. Results The relationship between diagnosis and type of evaluation showed statistically significant results with a chi square value of 39.880a (p <0.00). It was possible to observe that in the schizophrenia there is a greater inhibition in the elaboration of expressions that imply opinions and that narratives tended to identify facts regardless of how they affected subjects, suggesting a limitation of intersubjective function. Conclusion The diagnostic variable confirms that in schizophrenia there is a functional deterioration in the process of elaborating narrative structures especially in the articulation of the evaluative component. In the case of the affective psychosis group, superficial dysfunctions were manifested, without compromising their performance in the evaluation of narratives.

Estimulação transcraniana por corrente contínua: estudo sobre respostas em tarefas de nomeação em afásicos / Transcranial direct current stimulation: a study on naming performance in aphasic individuals

RESUMO Objetivo Comparar os resultados nas tarefas de nomeação de pacientes afásicos após AVC dos grupos ativo e controle. Método Estudo duplo-cego, randomizado controlado com 14 pacientes. Os indivíduos foram submetidos a cinco sessões de 20 minutos de 2 mA em dias consecutivos. O catodo foi posicionado na área homóloga à Broca e o anodo sobre a região supraorbital do hemisfério esquerdo. Os testes de Boston e Snodgrass foram aplicados e os resultados comparados entre os grupos. Resultados Não houve resultados significativos para as sequências 1 e 2 no teste do Snodgrass. No teste de Boston, os dados indicaram uma diferença significativa para o tempo médio de acertos com estratégia. Conclusão Os resultados sugerem que a ETCC simultânea (anódica e catódica) é um método que pode auxiliar a reabilitação de pacientes com afasia do tipo anômica e de Broca, após AVC, e que as estratégias linguísticas deveriam ser consideradas nas análises das respostas dos testes de nomeação.

ABSTRACT Purpose Compare the results in naming tasks of after-stroke aphasic individuals divided into active and placebo groups pre- and post-transcranial direct current stimulation. Methods A double-blind, randomized, controlled study conducted with 14 individuals. Patients underwent five 20-min sessions with stimulation of 2mA's on consecutive days. The cathode was placed over the Broca's homologous area and the anode was placed over the supraorbital region of the left hemisphere. Boston and Snodgrass naming tasks were assessed before and after the stimulation sessions and the results were compared between the groups. Results No significant results were observed for sequences 1 and 2 in the Snodgrass test. The Boston test results indicated significant difference related to mean time for correct responses with strategy. Conclusion The results suggest that simultaneous transcranial direct current stimulation (anodic and cathodic) is a method that can improve the rehabilitation of patients with anomic and Broca's aphasia after stroke, and that language strategies should be considered in the analysis of naming task responses.

Non-invasive brain stimulation and computational models in post-stroke aphasic patients: single session of transcranial magnetic stimulation and transcranial direct current stimulation. A randomized clinical trial.

CONTEXT AND OBJECTIVE: Patients undergoing the same neuromodulation protocol may present different responses. Computational models may help in understanding such differences. The aims of this study were, firstly, to compare the performance of aphasic patients in naming tasks before and after one session of transcranial direct current stimulation (tDCS), transcranial magnetic stimulation (TMS) and sham, and analyze the results between these neuromodulation techniques; and secondly, through computational model on the cortex and surrounding tissues, to assess current flow distribution and responses among patients who received tDCS and presented different levels of results from naming tasks. DESIGN AND SETTING: Prospective, descriptive, qualitative and quantitative, double blind, randomized and placebo-controlled study conducted at Faculdade de Ciências Médicas da Santa Casa de São Paulo. METHODS: Patients with aphasia received one session of tDCS, TMS or sham stimulation. The time taken to name pictures and the response time were evaluated before and after neuromodulation. Selected patients from the first intervention underwent a computational model stimulation procedure that simulated tDCS. RESULTS: The results did not indicate any statistically significant differences from before to after the stimulation.The computational models showed different current flow distributions. CONCLUSIONS: The present study did not show any statistically significant difference between tDCS, TMS and sham stimulation regarding naming tasks. The patients'responses to the computational model showed different patterns of current distribution.

Non-invasive brain stimulation and computational models in post-stroke aphasic patients: single session of transcranial magnetic stimulation and transcranial direct current stimulation. A randomized clinical trial

ABSTRACT CONTEXT AND OBJECTIVE: Patients undergoing the same neuromodulation protocol may present different responses. Computational models may help in understanding such differences. The aims of this study were, firstly, to compare the performance of aphasic patients in naming tasks before and after one session of transcranial direct current stimulation (tDCS), transcranial magnetic stimulation (TMS) and sham, and analyze the results between these neuromodulation techniques; and secondly, through computational model on the cortex and surrounding tissues, to assess current flow distribution and responses among patients who received tDCS and presented different levels of results from naming tasks. DESIGN AND SETTING: Prospective, descriptive, qualitative and quantitative, double blind, randomized and placebo-controlled study conducted at Faculdade de Ciências Médicas da Santa Casa de São Paulo. METHODS: Patients with aphasia received one session of tDCS, TMS or sham stimulation. The time taken to name pictures and the response time were evaluated before and after neuromodulation. Selected patients from the first intervention underwent a computational model stimulation procedure that simulated tDCS. RESULTS: The results did not indicate any statistically significant differences from before to after the stimulation.The computational models showed different current flow distributions. CONCLUSIONS: The present study did not show any statistically significant difference between tDCS, TMS and sham stimulation regarding naming tasks. The patients'responses to the computational model showed different patterns of current distribution.

Distúrbio Específico de Linguagem em Idade Escolar: revisão de literatura / Trastorno Específico del Lenguaje en Edad Escolar: revisión de la literatura / Specific Language Impairment in School Age children: literature review

Introdução: Verifica-se importante prejuízo nas aprendizagens escolares decorrente de um transtorno específico de linguagem não detectado e tratado em tempo hábil. As dificuldades decorrentes podem persistir na adolescência e idade adulta, com maior probabilidade de não serem superadas segundo o grau de gravidade. Objetivo: Realizar uma revisão sistemática de estudos sobre o distúrbio específico de linguagem em crianças de 6 a 14 anos. Método: A revisão de literatura efetuou-se nas seguintes bases de dados: Scielo Chile, Scielo Brasil, ProQuest e EBSCO. A busca de informações abrangeu o período entre março e agosto de 2014 e os arquivos de dados de 2004 a 2014. Os descritores utilizados foram: Linguagem Infantil, Transtornos da Linguagem e Desenvolvimento da Linguagem. Foram incluídos na pesquisa artigos em Espanhol, Inglês e Português. Resultados: Após a aplicação dos critérios de inclusão e exclusão, 22 artigos foram selecionados e neles se constata maior núumero de publicações a partir de 2011, em Inglês,com foco em infância como fase privilegiada e estudos com enfoque tanto cognitivo como linguístico. Conclusão: Observa-se um número reduzido de estudos com sujeitos em idade escolar entre 10 e 14 anos. Destaca-se a limitada literatura disponível em espanhol da América Latina.

Introduction: There is significant damage in school learning process resulting from specific language impairment not detected and treated in due time. Difficulties caused by this disorder may lead to persistence into adolescence and adulthood and depending on its severity there is a probability of not being overcome. Objective: To conduct a systematic review of studies on the specific language impairment in children 6-14 years. Method: A literature review was carried on the following databases: SciELO Chile, SciELO Brazil, ProQuest and EBSCO. Information search was undertaken from March and August 2014, taking into account the period from 2004 to 2014. Databases were searched for the following key terms: Child Language, Language Disorders and Language Development, including publications in Spanish, English and Portuguese. Results: After applying inclusion and exclusion criteria, the 22 articles selected showed a higher number of publications from 2011, in English, with focus on childhood and covering both cognitive and linguistic aspects. Conclusion: Studies with school-age subjects between 10 and 14 years old are less numerous. The review highlights the limited literature in Latin American Spanish.

Introducción: Se verifican daños significativos en el proceso de aprendizaje escolar si un trastorno específico del lenguaje no se detecta y se trata a tiempo. Las dificultades generadas por este trastorno pueden derivar en persistencia hasta la adolescencia y la adultez y presentar mayor riesgo de no superación según el grado de severidad. Objetivo: Realizar una revisión sistemática de estudios sobre el trastorno específico del lenguaje en niños de 6-14 años. Método: Una revisión de la literatura se llevó a cabo en las siguientes bases de datos: SciELO Chile, SciELO Brasil, ProQuest y EBSCO. Se efectuó la búsqueda de información entre marzo y agosto de 2014, teniendo en cuenta archivos de 2004 a 2014. Los descriptores adoptados fueron: Lenguaje Infantil, Trastorno del Lenguaje y Desarrollo del Lenguaje. Se incluyeron publicaciones en español, inglés y portugués. Resultados: Tras un análisis, posterior a la aplicación de los criterios de inclusión y exclusión, se escogieron 22 artículos en los cuales se verificó mayor número de publicaciones a partir del año 2011, en inglés, la niñez como rango etario privilegiado y estudios sobre aspectos tanto cognitivos como lingüísticos. Conclusión: Se observa un número reducido de estudios con sujetos en edad escolar entre los 10 y 14 años. Se destaca la limitada literatura que hay en español de Latinoamérica.

Alteraciones de la masticación en usuarios de prótesis dental removible. Revisión sistemática / Chewing alterations in removable dental prosthesis users: systematic review

Resumen:Tras el paso de los años, la pérdida de dientes genera la necesidad de recurrir al uso de prótesis dental. Específicamente, las alteraciones en el proceso de masticación en usuarios de prótesis dental removible se consideran un problema no sólo en relación a las modificaciones a nivel morfofuncional, sino que también en la propia satisfacción en cuanto a la masticación y funcionalidad de este proceso. El propósito de esta revisión es compilar y analizar los artículos científicos sobre la relación de la masticación y prótesis dental removible en adultos y adultos mayores. Se realizó una búsqueda integrativa de artículos en las bases de datos SCIELO, LILACS y PUBMED, seleccionando artículos publicados entre el año 2005 a 2014. Los artículos de revisión incluyeron estudios que identificaran la relación entre el uso de prótesis dental removible y la masticación en adultos usuarios de dicha prótesis dental. En la búsqueda se encontraron 21 documentos para potencial revisión. Finalmente, aplicando criterios de inclusión y exclusión se seleccionaron11artículos, los cuales tomaban diferentes variables de estudio, entre ellas, nivel de satisfacción, rendimiento, eficiencia y parámetros masticatorios. La satisfacción, el rendimiento, la eficiencia y los parámetros masticatorios fueron las variables que se encontraban afectadas en usuarios de prótesis dental removible.

Abstract:In aging process, the tooth loss generates the need to use a dental prosthesis. Specific alterations in mastication process of denture-users can be considered a problem not only in relation to the morphofunctional structures modification, but also in personal satisfaction associated to chewing and its functionality. The proposal of this review is to compile and analyze scientific articles about the relation between chewing and removable dental prostheses in adults and older adult's users. An integrative search of all articles on data from SCIELO, PUBMED and LILACS databases selected articles published 2006 to 2014, whose topic focused mastication and removable dental prosthesis in adults. The search presented 21 potential articles and, after applying criteria of inclusion and exclusion, 11 were selected. The satisfaction, performance, efficiency and masticatory parameters were the variables, which found to be effected in users of removable dental prosthesis.

Transcranial direct-current stimulation induced in stroke patients with aphasia: a prospective experimental cohort study.

CONTEXT AND OBJECTIVE: Previous animal and human studies have shown that transcranial direct current stimulation can induce significant and lasting neuroplasticity and may improve language recovery in patients with aphasia. The objective of the study was to describe a cohort of patients with aphasia after stroke who were treated with transcranial direct current stimulation. DESIGN AND SETTING: Prospective cohort study developed in a public university hospital. METHODS: Nineteen patients with chronic aphasia received 10 transcranial direct current stimulation sessions lasting 20 minutes each on consecutive days, using a current of 2 mA. The anode was positioned over the supraorbital area and the cathode over the contralateral motor cortex. The following variables were analyzed before and after the 10 neuromodulation sessions: oral language comprehension, copying, dictation, reading, writing, naming and verbal fluency. RESULTS: There were no adverse effects in the study. We found statistically significant differences from before to after stimulation in relation to simple sentence comprehension (P = 0.034), naming (P = 0.041) and verbal fluency for names of animals (P = 0.038). Improved scores for performing these three tasks were seen after stimulation. CONCLUSIONS: We observed that excitability of the primary motor cortex through transcranial direct current stimulation was associated with effects on different aspects of language. This can contribute towards future testing in randomized controlled trials.

Language disorders and brain lesion topography in aphasics after stroke.

UNLABELLED: Aphasia is a language disorder associated with focal brain lesions. Although the topographic definition of the language area has been widely accepted, there is not necessarily any direct correlation between the lesion site and the manifested symptoms. OBJECTIVE: To analyze aspects of language in aphasics in relation to lesion topography. METHODS: A prospective, descriptive study of qualitative nature was conducted on 31 individuals, aged older than 15 years, with at least three years of schooling, and a confirmed diagnosis of stroke. Language assessment was carried out using the Montreal Toulouse battery (alpha version), Boston naming test, and FAS test. Language test results were compared against lesion topography findings from magnetic resonance imaging. RESULTS: Heterogeneous results were found when comparing topography with aphasia, non-aphasia, and performance on language scales. CONCLUSION: No direct relationship was evident between lesion topography, aphasia, and language test performance.

Language disorders and brain lesion topography in aphasics after stroke / Distúrbios de linguagem e topografia da lesão cerebral em afásicos após acidente vascular cerebral

Aphasia is a language disorder associated with focal brain lesions. Although the topographic definition of the language area has been widely accepted, there is not necessarily any direct correlation between the lesion site and the manifested symptoms. Objective: To analyze aspects of language in aphasics in relation to lesion topography. Methods: A prospective, descriptive study of qualitative nature was conducted on 31 individuals, aged older than 15 years, with at least three years of schooling, and a confirmed diagnosis of stroke. Language assessment was carried out using the Montreal Toulouse battery (alpha version), Boston naming test, and FAS test. Language test results were compared against lesion topography findings from magnetic resonance imaging. Results: Heterogeneous results were found when comparing topography with aphasia, non-aphasia, and performance on language scales. Conclusion: No direct relationship was evident between lesion topography, aphasia, and language test performance.

Afasia é um distúrbio de linguagem associado à lesão cerebral focal. Embora a área de linguagem tenha uma definição topográfica largamente aceita, não se encontra necessariamente uma correlação direta entre o local da lesão e os sintomas manifestados. Objetivo: Analisar aspectos da linguagem em afásicos e a relação com a topografia da lesão. Métodos: Estudo prospectivo, descritivo e de caráter qualitativo e quantitativo, envolvendo 31 indivíduos com idade acima de 15 anos, escolaridade de três anos ou mais e diagnóstico confirmado de acidente vascular cerebral. Foram empregados para avaliação de linguagem o Protocolo Montreal Toulouse (versão alfa), o Teste de Nomeação do Boston e o Teste FAS. Os dados foram comparados com a topografia da lesão, obtidos por ressonância magnética. Resultados: Foi observada heterogeneidade, quando a topografia foi comparada com afasia, não-afasia e o desempenho nas provas de linguagem. Conclusão: Não observou-se relação direta entre a topografia da lesão, a afasia e o desempenho nas provas de linguagem.

Resultados preliminares do estudo da compreensão em sujeitos disatricos / A preliminary investigation on language assessment outcome in dysarthria

OBJETIVO: apresentar estudo sobre a compreensão de linguagem em sujeitos disártricos. MÉTODO: estudo retrospectivo, descritivo, de caráter qualitativo e quantitativo com 60 sujeitos com idade entre 40 a 70 anos. Foi realizado o cruzamento das tarefas de compreensão do protocolo Montreal Toulouse (versão alfa): compreensão de palavras orais (CPO) e escritas (CPE); frases simples orais (CFSO) e escritas(CFSE); frases complexas orais (CFCO) e escritas (CFCE). RESULTADOS: com respeito à comparação entre a compreensão oral e a escrita, quanto maior a CPO maior a CPE; quanto maior a CFSO, maior CFSE e vice-versa; relativamente à compreensão oral e escrita, quanto maior a CP, maior CF; quanto maior a CFS, maior CFC e vice-versa; em relação à comparação de idade, gênero, e CFCO e CFCE, não se observa relações significativas. CONCLUSÃO: nos pacientes deste estudo, verificou-se que a compreensão das estruturas mais simples favorece a compreensão das mais complexas; a dificuldade de compreensão de estruturas simples apresenta relação direta com a dificuldade de compreensão de estruturas complexas.

PURPOSE: to study language comprehension in dysarthric subjects. METHOD: a retrospective, descriptive and qualitative-quantitative study involving 60 subjects, age ranging from 40-70 years. Data crossing was carried out including sub-tests of comprehension related to: spoken words (SWC), written words (WWC), spoken simple phrases (SSPC), written simple phrases (WSPC), spoken complex phrases (SCPC) and written complex phrases (WCPC). RESULTS: the higher the SWC, the higher the WWC; the higher the SSPC, the higher the WSPC, and vice-versa; the higher the WC, the higher the PC; the higher the SPC, the higher the CPC, and vice-versa. No associations with age, gender, SCPC and WCPC were observed. CONCLUSION: both comprehension and difficulty in comprehension are associated with the degree of complexity of linguistic structure.